ATI RN
ATI Msn De5320 Fundamentals Exam Questions
Extract:
Question 1 of 5
Which of the following is essential when restraints are applied to a client?
Correct Answer: B
Rationale: Assessing circulation and neurological integrity every 2 hours prevents restraint-related injuries. Square knots are hard to release, side rails risk entrapment, and 12-hour checks are too infrequent.
Question 2 of 5
A nurse is caring for a client who is at the end of life. Vital Signs: Temperature 38.5°C (101.3°F), Blood pressure 76/46 mm Hg, Heart rate 112/min, Respiratory rate 34/min, irregular, Pulse oximetry 84% on 40% humidified face mask. Which of the following 3 actions should the nurse plan to take?
Correct Answer: B,C,D
Rationale: Turning the client on their side prevents aspiration, a fan eases breathing discomfort, and opioids manage pain and dyspnea. Informing the client about others in the room is irrelevant, and deep suctioning causes distress without benefit.
Question 3 of 5
A nurse is teaching a class about stress. The nurse should include that which of the following is a manifestation of prolonged stress?
Correct Answer: D
Rationale: Prolonged stress suppresses the immune system via chronic cortisol elevation, increasing infection risk. Anemia is unrelated, stress causes hyperglycemia, and blood pressure typically rises.
Question 4 of 5
A nurse is reinforcing teaching about a new prescription for haloperidol with a client who has schizophrenia. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: C
Rationale: Haloperidol increases photosensitivity, risking sunburn, which the client correctly identifies. Tinnitus, incontinence, and metallic taste are not common side effects.
Question 5 of 5
The nurse working in the ER is admitting a toddler to the orthopedic unit. The parents and grandparents are at bedside. What should the nurse use as the best source of data for this client?
Correct Answer: C
Rationale: Parents are the most reliable source for a toddler’s medical history, current symptoms, and behavioral changes, as they are primary caregivers with daily involvement. Grandparents may provide supplementary data, but parents have the most current insights. The admitting provider offers clinical assessments but lacks personal history depth. Medical records may be outdated or lack recent context.