ATI RN
ATI Nur 231 Fundamentals Exam Questions
Extract:
Question 1 of 5
The nurse is notifying the HCP of the client's change in status using the SBAR format. In which order should the nurse place the statements? 1. 'I suggest that the client be transferred to the critical care unit, and I would like you to come evaluate the client.' 2. 'The client is deteriorating, and I'm afraid the client is going to arrest.' 3. 'I am calling about (client name and location). Vital signs are BP=100/50, P=120, RR=30, T=100.4°F (38°C).' 4. 'The client is becoming confused and agitated. The skin is pale, mottled, and diaphoretic. The client is very dyspneic with an oxygen saturation of 85% despite placing a nonrebreather mask.'
Correct Answer: A
Rationale: In SBAR format, the order is: Situation (2), Background (4), Assessment (3), and Recommendation (1). This statement provides a clear and urgent indication of the client's current status, emphasizing the severity of the situation and the immediate concern for potential cardiac arrest. The nurse’s choice of language conveys a sense of urgency that is crucial for the HCP to understand the need for prompt action.
Question 2 of 5
A nurse is preparing a poster presentation about communicating with clients. Which of the following strategies should the nurse include to enhance communication? (Select All that Apply.)
Correct Answer: A,B,C,D
Rationale: Convey empathy for a client who voices painful emotions: Demonstrating empathy is essential. Show respect for a client who is making decisions about treatment: Respecting autonomy is vital. Exhibit receptive body language when discussing difficult topics: Nonverbal communication is significant. Speak to a client using clear and simple words and phrases: Clear language facilitates understanding.
Question 3 of 5
A charge nurse is making client care assignments. Which of the following tasks should the nurse delegate to assistive personnel (AP)? (Select all that apply.)
Correct Answer: A,C,E
Rationale: Bathe a client who had an amputation 2 days ago: This task can be delegated to assistive personnel (AP). Feed a client who had a stroke 3 months ago: This task can be delegated to APs, provided that the client is stable. Assist a client to ambulate using a gait belt: This task can be delegated to APs.
Question 4 of 5
A nurse accidentally sticks her hand with a syringe after administering an IM injection to a client. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: Wash the area of the puncture thoroughly with soap and water: The first action the nurse should take after a needlestick injury is to immediately wash the area with soap and water. This is crucial for minimizing the risk of infection and exposure to potentially infectious materials.
Question 5 of 5
What does a score of 6 on the Katz Index of Independence in Activities of Daily Living (ADLs) indicate?
Correct Answer: C
Rationale: Full independence in performing daily activities: A score of 6 on the Katz Index signifies that the individual can perform all six activities of daily living independently, demonstrating a high level of functional ability.