ATI RN
ATI Nurse 142 Final Questions
Extract:
Question 1 of 5
The nurse is assessing the 6 stages of cardinal gaze. This test assesses:
Correct Answer: B
Rationale: The 6 stages of cardinal gaze assess the function of cranial nerves III (oculomotor), IV (trochlear), and VI (abducens), which control ocular motor movements. These nerves are responsible for moving the eyes in different directions, and the test evaluates the patient's ability to move their eyes smoothly in each of the six cardinal positions.
Question 2 of 5
The patient complains of chest pains that move down her left arm. The nurse will document this as:
Correct Answer: B
Rationale: Radiating pain starts at a specific point and spreads to other areas, such as chest pain moving down the left arm, a common symptom of cardiac issues. Phantom pain occurs in absent limbs, referred pain is felt in a different area from the source, and somatic pain arises from skin, muscles, or bones.
Question 3 of 5
The nurse is performing a nutritional assessment. Which of the following would be considered objective data?
Correct Answer: C
Rationale: Objective data are measurable and observable findings that can be obtained through physical examination, laboratory tests, or other diagnostic procedures. Body Mass Index (BMI) is a calculated value based on height and weight, making it objective. Dietary history, patient complaints, and history of alcohol intake are subjective as they rely on the patient's self-report and may not be entirely accurate.
Question 4 of 5
The nurse assesses the patient's visual acuity to be 20/25 using an eye chart. The patient asks what that means. Which of the following is the nurse's best response?
Correct Answer: C
Rationale: A visual acuity of 20/25 means the patient can read at 20 feet what a person with normal vision can read at 25 feet, indicating slightly below-average but normal-range vision.
Question 5 of 5
The nurse is caring for two clients who both are in pain due to sickle cell anemia. One of the clients rates the pain as a 7 out of 10 (0 is no pain and 10 is the worst pain possible). This client is moving around easily and is eating well, but has asked for pain medication. Which action by the nurse is most appropriate?
Correct Answer: B
Rationale: Pain is a subjective experience, and the client's report of pain should be respected and addressed promptly. If the pain medication is ordered and it has been longer than the ordered interval, the nurse should administer the medication as prescribed. In general, withholding pain medication for a client in pain is not an appropriate action. Administering half the ordered dose of pain medication without a healthcare provider's order is also not appropriate. The nurse should follow the healthcare provider's orders for pain medication administration and titration. It's also not appropriate to assume that the client is faking pain without adequate assessment and evidence to support such a claim.