ATI RN
ATI Fundamentals Exam Nursing 100 Exam 3 Questions
Extract:
Question 1 of 5
Upon assessment of a client's wound,the nurse notes the formation of granulation tissue. The tissue bleeds easily when the nurse performs wound care. What is the phase of wound healing characterized by the nurse's assessment?
Correct Answer: D
Rationale: Granulation tissue formation and easy bleeding are characteristic of the proliferation phase involving tissue repair. Hemostasis controls bleeding inflammation removes debris and maturation remodels collagen.
Question 2 of 5
A nurse is completing her physical assessment on her newly admitted patient. She is assessing the patient's skin and documenting her findings. How should she document the following wound?
Correct Answer: B
Rationale: Stage II pressure ulcers involve partial-thickness skin loss as depicted in the wound. Stage I is non-blanching erythema Stage III involves full-thickness loss with visible fat and Stage IV exposes muscle or bone. Yes
Question 3 of 5
During the inspection of a client's abdomen,the nurse notes that it is visibly distended. The nurse should proceed with the client's abdominal assessment by next performing:
Correct Answer: C
Rationale: Auscultation is the next step after inspection to assess bowel sounds before palpation or percussion which could alter findings. This sequence ensures accurate assessment of abdominal distension.
Question 4 of 5
The patient is receiving 30 mg of citalopram daily for depression. Citalopram is available in 20 mg scored tablets. How many tablets should be administered? (Round to the nearest tenth.)
Correct Answer: 1.5
Rationale: Number of tablets = total dose/tablet strength: 30 mg ÷ 20 mg = 1.5 tablets.
Question 5 of 5
When measuring the size,depth,and wound tunneling of a client's stage 4 pressure injury what action should the nurse perform first?
Correct Answer: A
Rationale: Performing hand hygiene before wound care prevents infection and maintains aseptic technique preceding assessment or measurement steps.