ATI RN
ATI Nursing 100 Day Exam 4 Fundamentals Questions
Extract:
Question 1 of 5
The nurse understands that the major factor affecting oxygenation in a client who has fluid in the lungs is:
Correct Answer: B
Rationale: Fluid in the lungs (e.g. pulmonary edema) impairs oxygen diffusion across the alveolar membrane reducing oxygenation as fluid blocks gas exchange. Poor perfusion lowered hemoglobin or reduced ambient oxygen are secondary or unrelated to lung fluid’s direct effect on diffusion.
Question 2 of 5
The nurse is assessing a client who exhibits positive Trousseau's and Chvostek's signs. What laboratory value would validate these clinical findings? A serum:
Correct Answer: D
Rationale: Low calcium (6.9 mg/dL below normal 8.5-10.2 mg/dL) causes neuromuscular excitability leading to Trousseau’s (arm spasm with cuff inflation) and Chvostek’s (facial twitching) signs. Normal potassium (3.5-5.0 mEq/L) phosphate (2.5-4.5 mg/dL) and magnesium (1.8-2.5 mEq/L) do not explain these findings.
Question 3 of 5
The best way for the nurse to assess a client's level of dyspnea is to:
Correct Answer: B
Rationale: Observing dyspnea at rest and during activity provides a comprehensive assessment of respiratory distress by noting changes in breathing patterns effort and symptoms. Documentation offers historical data subjective reports may be unreliable and lung sounds assess lung function not dyspnea severity directly.
Question 4 of 5
The client has an open wound on the sacrum with an order for the following: Apply hydrogel dressing on the wound. Change dressing every day. The nurse recognizes that the primary purpose of this dressing is to:
Correct Answer: B
Rationale: Hydrogel dressings provide a moist environment to promote healing by facilitating autolytic debridement and granulation tissue formation. They do not primarily protect from pressure (handled by devices) enhance primary intention (for surgical wounds) or absorb drainage (hydrocolloids do this).
Question 5 of 5
A client has a serum potassium level of 6.3 mEq/L. The nurse recognizes that the highest priority intervention(s) for this client are to:
Correct Answer: C,E
Rationale: Hyperkalemia (6.3 mEq/L above normal 3.5-5.0 mEq/L) risks cardiac dysrhythmias and neuromuscular issues requiring immediate assessment for muscle weakness/flaccid paralysis and cardiac monitoring to detect life-threatening arrhythmias. Diluting potassium or encouraging potassium-rich foods worsens hyperkalemia and intake/output monitoring is secondary.