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ATI FUNDAMENTALS FINAL EXAM
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ATI FUNDAMENTALS FINAL EXAM
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ATI FUNDAMENTALS FINAL EXAMA nurse is admitting a client who will undergo a craniotomy. During the planning phase
of the nursing process, which of the following actions should the nurse take?
A) establish client outcomes
B) collect information about past health problems
C) determine whether the client has met specific goals
D) identify the client's specific health problem - answers-a) establish client outcomes
The planning phase includes developing goals and outcomes that help the nurse create
the client's plan of care.
The nursing process:
Step 1. Assessment phase- collect information about past health problems (vitals, age,
height)
Step 2. Analysis phase- identify the client's specific health problem
Step 3. Planning phase- establish client goals and outcomes and selects interventions
that will help to achieve them. Also involves setting care priorities.
Step 4. Implementation- provides client care and uses interpersonal/technical skills
when implementing nursing interventions
Step 5. Evaluation phase- use critical thinking skills to determine whether the client has
met a specific goal. Examines results, compares the data, identifies errors, and
considers pt's situation
A nurse in a provider's office is measuring a client & notes a loss in height from the
previous year. The nurse should identify this finding as a manifestation of which of the
following musculoskeletal system disorders?
A) osteoporosis
B) scoliosis
C) kyphosis
D) lordosis - answers-a) osteoporosis
A loss of height is often an early indication of osteoporosis with occurs due to a loss of
calcium in the vertebrae which can cause them to fracture and collapse.
- scoliosis does not precipitate a decrease in the height of the client. It is an abnormal
lateral curve of the sign
- kyphosis does not precipitate a decrease in the height of a client. It is an exaggerated
posterior curvature of the thoracic spine hunchback
- lordosis does not precipitate a decrease in the height of a client. It is an exaggerated
lumbar curvature way back
Not on ati:
,The nurse is planning care for a pt with severe burns. Which of the following is this pt at
risk for developing?
1. Intracellular fluid deficit
2. Intracellular fluid overload
3. Extracellular fluid deficit
4. Interstitial fluid deficit - answers-1. Intracellular fluid deficit
Because this pt was severely burned, the fluid within the cells is diminished, leading to
an intracellular fluid deficit.
Not on ati:
The nurse is to obtain a stool specimen from a client who reported that he is taking iron
supplements. The nurse would expect the stool to be which color?
a) black
b) red
c) dark brown
d) green - answers-black
A nurse is obtaining a health history from the newly admitted client who has chronic
pain in the knee. What should the nurse include in the pain assessment? Select all that
apply.
1) pain history, including location, intensity, and quality of pain
2) client's purposeful body movement in arranging the papers on the bedside table
3) pain pattern, including precipitating and alleviating factors
4) vital signs such as increased blood pressure and heart rate
5) the client's family statement about increases in pain with ambulation - answers-1)
pain history, including location, intensity, and quality of pain
3) pain pattern, including precipitating and alleviating factors
A nurse is obtaining a clients blood pressure in a client's lower extremity. Which of the
following actions should the nurse take?
A) auscultate the bp at the dorsalis pedis artery
B) measure the clients bp with the client sitting at the side of the bed
C) place the cuff 7.6cm (3in) above the popliteal artery
D) place the bladder of the cuff over the posterior aspect of the thigh - answers-d) place
the bladder of the cuff over the posterior aspect of the thigh
This is the correct position for the bladder of the class when the nurse is measuring a
lower extremity blood pressure
- a nurse should auscultate the blood pressure at the popliteal artery
- the nurse should measure the blood pressure with the client prone is possible
otherwise the client should lie supine with knee flexed
- the nurse should position the cuff 2.5cm (1 in) above the popliteal artery
, Not ati
The nurse is performing nasotracheal suctioning. After suctioning the client's trachea for
fifteen seconds, large amounts of thick yellow secretions return. What action should the
nurse implement next?
A. Encourage the client to cough to help loosen secretions.
B. Advise the client to increase the intake of oral fluids.
C. Rotate the suction catheter to obtain any remaining secretions.
D. Re-oxygenate the client before attempting to suction again. - answers-d) re-
oxygenate the client before attempting to suction again.
A client who reports shortness of breath requests the nurse's help in changing positions.
After repositioning the client, which of the following actions should the nurse take next?
A) encourage the client to take deep breaths
B) observe the client's rate, depth, and character of respirations
C) prepare to administer oxygen
D) give the client a backrub to promote relaxation - answers-b) observe the client's rate,
depth, and character of respirations
A nurse is collecting health history data from a client who is deaf and uses american
sign language(asl) to communicate. The nurse will be working with an asl interpreter.
Which of the following actions should the nurse take when working with the interpreter?
A) face away from the client to avoid distractions
B) pace speech to allow time for the interpreter to convey the words
C) make eye contact with the interpreter when explaining the procedure
D) stand in the background while the interpreter translates the message - answers-b)
pace speech to allow time for the interpreter to convey the words
A nurse manager is providing teaching to a group of newly licensed nurses about the
ways that clients acquire healthcare-associated-infections (hai's). Which of the following
routes of infection should the manager identify as an iatrogenic hai?
A) infection required from improper hand hygiene
B) infection acquired by drug resistance
C) infection acquired by inappropriate waste disposal
D) infection acquired from diagnostic procedure - answers-d) infection acquired from
diagnostic procedure
Iatrogenic hais directly result from diagnostic or therapeutic procedures
A nurse is caring for a client who has clostridium difficile infection and is in contact
isolation. Which of the following actions should the nurse take?
A) wear gloves when changing the clients gown
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