ATI RN
ATI RN Fundamentals Exam 3 Questions
Extract:
Question 1 of 5
The following arterial blood gas results would demonstrate to the nurse that the client is experiencing which acid-base imbalance? pH 7.31 PaCO2 40,HCO3 18 pa02 92
Correct Answer: D
Rationale: A pH of 7.31 (low) and HCO3 of 18 (low) indicate metabolic acidosis as the primary issue is a decrease in bicarbonate. Normal PaCO2 (40) rules out respiratory issues and high pH or high HCO3 would indicate alkalosis.
Question 2 of 5
It is a busy day on the medical-surgical floor,and the nurse must teach a client ready for discharge about his medications. How can the nurse most efficiently utilize time and provide this education?
Correct Answer: A
Rationale: Teaching about medications as they are given integrates education into routine care saving time while ensuring immediate relevance. Bath discussions are distracting post-discharge calls delay teaching and written instructions alone may not ensure understanding.
Question 3 of 5
The nurse is preparing to administer an enteral tube feeding to a client via a nasogastric tube. Which nursing action should be completed first?
Correct Answer: C
Rationale: Confirming nasogastric tube placement by aspirating stomach contents and checking pH (typically <5 for gastric placement) is the first step to ensure the tube is in the stomach not the lungs preventing aspiration. Allowing the formula to reach room temperature (
A) prevents discomfort but is secondary. Labeling the container (
B) ensures safety but follows placement confirmation. Assessing residual volume (
D) checks for gastric emptying but requires confirmed tube placement first.
Question 4 of 5
The physician has discussed the need for surgery with a client and has obtained informed consent. The nurse determines that the client does not understand the risks and benefits of the procedure. What is the nurse's best action?
Correct Answer: A
Rationale: Informed consent requires that the client fully understands the procedure including its risks benefits and alternatives. If the nurse determines that the client does not comprehend these aspects the best action is to notify the physician who is responsible for obtaining informed consent. The physician can then reassess the client's understanding and provide further clarification. Explaining the procedure in simple terms may be helpful but does not address the legal and ethical responsibility of ensuring informed consent which lies with the physician. Canceling the surgery is premature without first addressing the misunderstanding and witnessing the signature without resolving the comprehension issue would be unethical.
Question 5 of 5
The nurse has finished providing a tube feeding to a client. What should the nurse document about this procedure? (SELECT ALL THAT APPLY)
Correct Answer: A,C,D,E
Rationale: Documentation for tube feeding includes the solution provided client tolerance amount of solution and duration to ensure accurate records and continuity of care. The prescribing physician’s name is not typically required in this context.