ATI RN
ATI Nur 231 Fundamentals Exam Questions
Extract:
Question 1 of 5
The nurse is assigned to the care of the following patients. In planning nursing care, the nurse knows to use touch cautiously when communicating with which patient?
Correct Answer: A
Rationale: Middle-aged man experiencing the acute phase of myocardial infarction (MI): During the acute phase of an MI, the patient may be experiencing significant physical and emotional stress.
Touch may be perceived as intrusive or overwhelming.
Question 2 of 5
A nurse is assessing a client at a follow-up clinic visit for acute low back pain. A goal for this client is to use proper body mechanics at all times. Which of the following findings indicates that the client is meeting this goal?
Correct Answer: A
Rationale: The client faces the direction of movement when sliding an object across the floor: This finding indicates that the client is using proper body mechanics. Facing the direction of movement helps maintain balance and reduces the risk of injury.
Question 3 of 5
A nurse is teaching an assistive personnel (AP) about using personal protective equipment while caring for clients. Which of the following statements should the nurse identify as an indication that the AP understands the instructions?
Correct Answer: A
Rationale: I will wear gloves and a gown when bathing a client who has open skin lesions: This statement indicates an understanding of the appropriate use of personal protective equipment (PPE) in a situation where there is a risk of exposure to blood or bodily fluids.
Question 4 of 5
A nurse is reviewing the laboratory results of a client who has a pressure ulcer. The nurse should identify an elevation in which of the following laboratory values as an indication that the client has developed an infection?
Correct Answer: B
Rationale: WBC count: An elevated white blood cell (WB
C) count is a classic indicator of infection. The body responds to infection by increasing the production of white blood cells to fight off pathogens. A significantly elevated WBC count, especially if accompanied by a shift to the left (an increase in immature neutrophils), suggests an acute inflammatory response and the presence of an infection, making this the correct answer.
Question 5 of 5
What color and consistency would you expect serous drainage from a Jackson-Pratt (JP) drain to have?
Correct Answer: C
Rationale: Clear, watery fluid with a pale yellow tint: This describes serous drainage, which is typically light in color and has a watery consistency. Serous fluid is a normal finding in the early stages of wound healing, as it contains plasma and does not indicate infection or excessive bleeding.