RN ATI Fundamentals of Nursing | Nurselytic

Questions 67

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RN ATI Fundamentals of Nursing Questions

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Question 1 of 5

The family of an older adult client brings him to the emergency department after finding him wandering outside. During the initial assessment.the nurse notes that the client flinches when she palpates his abdomen yet responds to questions only by nodding and smiling. Which of the following factors should the nurse identify as a likely explanation for the client's behavior?

Correct Answer: B

Rationale: The correct answer is B: Confusion. The client's behavior of nodding and smiling but flinching when his abdomen is palpated suggests a cognitive impairment, such as confusion. Confusion can manifest as disorientation, difficulty understanding questions, and altered pain perception. This could explain the client's inconsistent responses and physical reactions.

Incorrect choices:
A: Hard of hearing - Unlikely to cause nodding, smiling, and flinching in response to palpation.
C: Pain - Pain alone wouldn't explain the client's cognitive and communication difficulties.
D: Language barrier - Doesn't explain the client's physical reactions and limited communication.
E: None - Incorrect as the client is exhibiting signs of confusion.
F: None - Incorrect as the client's behavior requires further assessment and consideration of potential confusion.

Question 2 of 5

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Question 3 of 5

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Question 4 of 5

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Question 5 of 5

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