ATI RN
ATI Fundamental Proctored Exam Study Guide 2024-2025 Questions
Extract:
Question 1 of 5
The nurse is completing an admission history on a new home health patient. The patient has been experiencing seizures as the result of a recent brain injury. Which interventions should the nurse utilize for this patient and family? (Select all that apply.)
Correct Answer: D, E
Rationale:
Correct Answer: D, E
Rationale:
D: Discussing steps to take if the seizure does not discontinue is crucial in ensuring the patient's safety. This empowers the family to know when to seek further medical assistance.
E: Instructing the family to reorient and reassure the patient after consciousness is regained helps to provide emotional support and maintain a sense of safety post-seizure.
Incorrect
Choices:
A: Demonstrating how to restrain the patient during a seizure is not recommended as it can lead to injury. Restraints should never be used during a seizure.
B: Moving the patient to a bed during a seizure can be dangerous and may cause harm. It is safer to protect the patient from injury in the current location.
C: Inserting a tongue depressor during a seizure is not recommended as it poses a risk of injury to the patient and can obstruct the airway.
Question 2 of 5
When making rounds the nurse observes a purple wristband on a patient's wrist. How will the nurse interpret this finding?
Correct Answer: B
Rationale: The correct interpretation is B: The patient has do not resuscitate preferences. A purple wristband typically signifies that a patient has chosen not to be resuscitated in the event of cardiac arrest or other life-threatening situations. This is important information for healthcare providers to be aware of so they can provide appropriate care according to the patient's wishes.
Choices A, C, and D are incorrect because a purple wristband specifically indicates do not resuscitate preferences, not allergies, fall risk, or seizure risk.
Question 3 of 5
A patient may need restraints. Which task can the nurse delegate to a nursing assistive personnel?
Correct Answer: D
Rationale: The correct answer is D: Applying the restraint. The rationale is that nursing assistive personnel can be delegated tasks that involve the physical application of restraints once a decision has been made by the healthcare provider to use them. This is within the scope of their training and does not require clinical judgment. Tasks such as determining the need for restraints (
A), assessing the patient's orientation (
B), and obtaining an order for a restraint (
C) involve clinical judgment and assessment skills, which should be done by a licensed nurse or healthcare provider.
Therefore, option D is the appropriate task to delegate to nursing assistive personnel in this scenario.
Question 4 of 5
The nurse is caring for a group of medical-surgical patients. The unit has been notified of a fire on an adjacent wing of the hospital. The nurse quickly formulates a plan to keep the patients safe. Which actions will the nurse take? (Select all that apply.)
Correct Answer: A, B, C, D
Rationale: The correct actions the nurse will take are A, B, C, and D. Closing all doors helps contain smoke and fire. Noting evacuation routes ensures safe movement of patients. Noting oxygen shut-offs prevents fueling the fire. Moving bedridden patients in their beds avoids injury during evacuation. Waiting for the fire department (E) delays safety measures. Using type B fire extinguishers for electrical fires (F) is incorrect; type C extinguishers are for electrical fires.
Question 5 of 5
A homeless adult patient presents to the emergency department with vital signs: temperature 94.8° F, blood pressure 106/56, apical pulse 58, and respiratory rate 12. Which vital sign should the nurse address immediately?
Correct Answer: B
Rationale: The nurse should address the temperature immediately. A temperature of 94.8°F is significantly below the normal range (around 98.6°F) and indicates hypothermia, which can be life-threatening. Hypothermia can lead to various complications, including altered mental status, cardiac arrhythmias, and even cardiac arrest.
Therefore, prompt intervention is crucial to prevent further deterioration. The other vital signs are within acceptable ranges for an adult, although the blood pressure is slightly low but not immediately critical like hypothermia. Addressing the temperature first is essential to stabilize the patient's condition and prevent potential complications.