ATI RN Fundamentals Online Practice 2024 B, Exam Questions & Answers
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ATI RN Fundamentals Online Practice 2024 B
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ATI RN Fundamentals Online Practice 2024 B
ATI RN Fundamentals Online Practice 2024 B, Exam Questions & Answers-A charge nurse is observing a newly licensed nurse prepare a sterile field for a dressing change. Which of the following actions by the newly licensed nurse requires intervention by the charge nurse?
The newly licensed nurse pl...
ATI RN Fundamentals Online Practice 2024 B,
Exam Questions & Answers
A charge nurse is observing a newly licensed nurse prepare a sterile field for a dressing change.
Which of the following actions by the newly licensed nurse requires intervention by the charge
nurse?
The newly licensed nurse places the cap of a bottle of sterile saline solution on the sterile field.
The newly licensed nurse places sterile objects 2.5 cm (1 in) within the border of the field.
The newly licensed nurse holds the bottle of sterile saline outside the edge of the field when
pouring.
The sterile field is positioned at the level of the newly licensed nurse's waist. - Correct Answer:
The newly licensed nurse places the cap of a bottle of sterile saline solution on the sterile field.
The newly licensed nurse should place the cap with the sterile side up on a clean surface because
the outer edges are unsterile and will contaminate the sterile field.
Incorrect Answer:
The newly licensed nurse places sterile objects 2.5 cm (1 in) within the border of the field.
The edges of the sterile field are considered contaminated. Therefore, the nurse should place all
sterile items inside the 2.5 cm (1 in) border of the field.
The newly licensed nurse holds the bottle of sterile saline outside the edge of the field when
pouring.
The newly licensed nurse should hold the bottle of sterile saline outside the edge of the field
when pouring to prevent contaminating the field.
The sterile field is positioned at the level of the newly licensed nurse's waist.
An object that is below waist level is considered nonsterile. Positioning the table at waist level
does not require intervention.
A client demonstrates anger when the nurse does not respond within 5 min of ringing for the
nurse. Which of the following is an appropriate response by the nurse?
"I'm sorry, but another client needed my attention."
"I could not arrive any sooner. What can I do for you?"
"We had an emergency on the unit and that was a priority, but now I'm here."
"That must be frustrating for you. How can I help you right now?" - Correct Answer:
"That must be frustrating for you. How can I help you right now?"
This response is therapeutic because the nurse is acknowledging the client's feelings and offering
help.
Incorrect Answer:
"I'm sorry, but another client needed my attention."
This response is nontherapeutic because the nurse is responding defensively.
,"I could not arrive any sooner. What can I do for you?"
This response is nontherapeutic because the nurse is responding defensively.
"We had an emergency on the unit and that was a priority, but now I'm here."
This response is nontherapeutic because the nurse is responding defensively.
A home health nurse is completing an admission assessment of an older adult client who has
their caregiver present. Which of the following findings should the nurse identify as potential
indications of elder abuse?
The caregiver is the client's financial power of attorney.
The client is in a wheelchair with the wheels locked.
The client reports receiving a full bath twice each week.
The caregiver insists on remaining in the room. - Correct Answer:
The caregiver insists on remaining in the room.
A caregiver who refuses to leave the room during an admission assessment can be an indication
of potential mistreatment of the client who is receiving care. The nurse should evaluate the client
for additional signs of potential mistreatment throughout the admission assessment.
Incorrect Answer:
The caregiver is the client's financial power of attorney.
Having a caregiver who is the client's financial power of attorney allows the caregiver to perform
necessary financial transactions on the client's behalf. This it is not an indication of elder abuse.
The client is in a wheelchair with the wheels locked.
If the client uses a wheelchair, it is important to lock the wheels when the client is stationary to
keep the client safe. Locking the wheels of a wheelchair is not an indication of elder abuse.
The client reports receiving a full bath twice each week.
Neglect is a form of abuse or mistreatment that is characterized by omission of necessary care.
Although hygiene is an important part of care for all clients, a full bath is not necessary every
day for older adults due to the adverse effects it can have on fragile skin. Therefore, a full bath
twice each week is sufficient for effective care and is not an indication of neglect or elder abuse.
A nurse in a clinic is caring for a middle adult client who states, "The doctor says that, since I am
at an average risk for colon cancer, I should have a routine screening. What does that involve?"
Which of the following responses should the nurse make?
"I'll get a blood sample from you and send it for a screening test."
"Beginning at age 60, you should have a colonoscopy."
"You should have a fecal occult blood test every year."
"The recommendation is to have a sigmoidoscopy every 10 years." - Correct Answer:
"You should have a fecal occult blood test every year."
Colorectal cancer screening for clients who are at average risk begins at age 45. One option for
screening is a fecal occult blood test annually.
,Incorrect Answer:
"I'll get a blood sample from you and send it for a screening test."
Blood tests do not detect colorectal cancer. One option for screening is a double-contrast barium
enema every 5 years.
"Beginning at age 60, you should have a colonoscopy."
Colorectal cancer screening for clients who are at average risk begins at age 50. One option for
screening is a colonoscopy every 10 years.
"The recommendation is to have a sigmoidoscopy every 10 years."
One option for screening is a flexible sigmoidoscopy every 5 years.
A nurse in a medical-surgical unit is caring for six clients.
Complete the following sentence by using the list of options.
The first client the nurse should assess is _____ followed by _____.
Client 1: Client is admitted with a new diagnosis of rheumatoid arthritis.Client 2: Client has a
history of hyperlipidemia. Atorvastatin 20 mg PO administered as prescribed.Client 3: Client is 1
day postoperative. Reports pain as 8 on a scale of 0 to 10. Morphine 5 mg subcutaneous
administered as prescribed.Client 4: Client is admitted with a new diagnosis of heart
failure.Client 5: Client has a stage 2 pressure injury on the left heel.Client 6: Client is admitted
with a new diagnosis of diabetes mellitus. - Correct Answer (1):
Client 3
When using the airway, breathing, circulation approach to client care, the nurse should determine
that this client is the priority client to assess. The client has an oxygen saturation that is less than
the expected reference range, which is an indication of hypoxia.
Correct Answer (2):
Client 4
When using the airway, breathing, circulation approach to client care, the nurse should determine
that this client is the next priority client to assess. The client has a potassium level that is less
than the expected reference range, which places the client at risk for dysrhythmias.
Incorrect Answers (1):
Client 1 is incorrect. The nurse should assess this client because the client's C-reactive protein is
greater than the expected reference range, which is an indication of inflammation. However,
there is another client the nurse should assess first.
Client 2 is incorrect. The nurse should assess this client because the client's cholesterol level is
greater than the expected reference range, which places them at risk for coronary heart disease.
However, there is another client the nurse should assess first.
Incorrect Answers (2):
, Client 5 is incorrect. The nurse should assess this client because their prealbumin level is less
than the expected reference range, which places them at risk for delayed wound healing.
However, this client is not the next priority client to assess.
Client 6 is incorrect. The nurse should assess this client because their glycosylated hemoglobin
level is greater than the expected reference range, which indicates poor diabetic control.
However, this client is not the next priority client to assess.
A nurse in the emergency department (ED) is caring for a client who reports abdominal pain.
Based on the client's clinical findings, which of the following actions should the nurse take?
Select all that apply.
Assist the client to a left side-lying position with the right knee flexed.
Prepare the client for a chest x-ray.
Administer a cleansing enema.
Auscultate the client's bowel sounds.
Perform a manual digital examination of the client's rectum.
Administer oxycodone extended-release tablets.
Prepare the client for NG tube placement. - Correct Answer:
Assist the client to a left side-lying position with the right knee flexed
The nurse should place the client in a left side-lying position with the right knee flexed prior to
administering an enema. Because the provider prescribed a cleansing enema for the client, the
nurse should prepare the client for the procedure.
Administer a cleansing enema
The nurse should administer a cleansing enema for the client as a result of the provider's
prescription. A cleansing enema is intended to assist with bowel elimination and remove any
impacted fecal matter indicated by the abdominal x-ray.
Auscultate the client's bowel sounds
The nurse should auscultate the client's bowel sounds to determine the status of the client's
peristalsis. This is a necessary part of determining the presence of bowel sounds, which are an
indication of the status of the client's gastrointestinal tract.
Perform a manual digital examination of the client's rectum
The nurse should perform a manual digital examination of the client's rectum to determine if
impacted stool is present. This is a part of the necessary evaluation of the status of the client's
gastrointestinal tract.
Incorrect Answer:
Prepare the client for a chest x-ray is incorrect. A chest x-ray is typically performed for a client
who has an impairment of the upper thorax or lungs, not the abdomen. The client has already
received an abdominal x-ray; therefore, a chest x-ray is not necessary.
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