ATI Fundamentals - Practice A Questions
with complete solutions
A nurse is evaluating a client's use of a cane. Which of the following actions should the nurse identify as an indication of correct use? - answer The client holds the cane on the stronger side of her body.
A nurse receives report about a client who has 0.9% sodium chloride infusing IV at 125 mL/hr. When the nurse performs the initial assessment, he notes that the client has received only 80 mL over the last 2 hr. Which of the following actions should the nurse take first? - answer Check the IV tubing for obstruction.
A nurse is caring for a client who requires an NG tube for stomach decompression. Which of the following actions should the nurse take when inserting the NG tube? - answer Have the client take sips of water to promote insertion of the NG tube into the esophagus.
A nurse is reviewing a client's fluid and electrolyte status. Which of the following findings
should the nurse report to the provider? - answer Potassium 5.4 mEq/L
A nurse is providing discharge instructions to a client who will be using a walker. Which of the following statements indicates an understanding of the teaching? - answer "I will hire someone to trim the tree that hangs low over the stairs of my front porch."
A nurse is planning care for a client who has had a stroke, resulting in aphasia and dysphagia. Which of the following tasks should the nurse assign to an assistive personnel (AP)? (Select all that apply.) - answer assist the client with a partial bed bath, measure the client's BP after the nurse administers an antihypertensive medication, use a communication board to ask what the client wants for lunch
A nurse is caring for a client who is expressing anger about the diagnosis of colorectal cancer. Which of the following actions should the nurse take? - answer Reassure the
client that this is an expected response to grief.
A nurse is preparing to apply a dressing for a client who has a stage 2 pressure injury. Which of the following types of dressing should the nurse use? - answer Hydrocolloid
A nurse is administering an otic medication to an older adult client. Which of the following actions should the nurse take to ensure that the medication reaches the inner ear. - answer Press gently on the tragus of the client's ear.
A nurse is using an open irrigation technique to irrigate a client's indwelling urinary catheter. Which of the following actions should the nurse take? - answer Subtract the
amount of irrigant used from the client's urine output. A nurse is initiating a protective environment for a client who has had an allogeneic stem cell transplant. Which of the following precautions should the nurse plan for this client? - answer Make sure the client wears a mask when outside her room if there is
construction in the area.
A nurse is auscultating the anterior chest of a client who was newly admitted to a medical-surgical unit. Listen to the audio clip of what the nurse auscultates through the stethoscope and identify the type of breath sounds. (Click on the audio button to listen to the clip.) - answer Normal breath sounds
A nurse is planning strategies to manage time effectively for client care. Which of the following strategies should the nurse implement? - answer Use the planning step of the nursing process to prioritize client care delivery.
A nurse is caring for a client who is postoperative following a knee arthroplasty and requires the use of thigh-length sequential compression sleeves. Which of the following actions should the nurse take? - answer Make sure two fingers can fit under the sleeves.
A nurse is caring for a client who has a respiratory infection. Which of the following techniques should the nurse use when performing nasotracheal suctioning for the client? - answer Apply intermittent suction when withdrawing the catheter.
A nurse is assessing a client who reports increased pain following physical therapy. Which of the following questions should the nurse ask when assessing the quality of the
client's pain? - answer "Is your pain sharp or dull?"
A nurse is providing discharge teaching to a client about self-administering heparin. Which of the following instruction should the nurse include in the teaching? - answer Administer the medication into the abdomen.
A nurse is a long-term care facility is caring for a client who dies during the nurse's shift.
Identify the sequence in which the nurse should perform the following steps. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.) - answer Obtain the pronouncement of death from the provider. Remove tubes and indwelling lines. Wash the client's body. Ask the client's family members if they would like to view the body. Place a name tag on the body.
A nurse is teaching a client and his family how to care for the client's tracheostomy at home. Which of the following instructions should the nurse include in teaching? - answer Use tracheostomy covers when outdoors.
A nurse is caring for a client who has a terminal illness and is approaching death. The client is short of breath and has noisy respirations from secretions in their airway. Which
of the following should the nurse take? - answer Turn the client every 2 hr.
with complete solutions
A nurse is evaluating a client's use of a cane. Which of the following actions should the nurse identify as an indication of correct use? - answer The client holds the cane on the stronger side of her body.
A nurse receives report about a client who has 0.9% sodium chloride infusing IV at 125 mL/hr. When the nurse performs the initial assessment, he notes that the client has received only 80 mL over the last 2 hr. Which of the following actions should the nurse take first? - answer Check the IV tubing for obstruction.
A nurse is caring for a client who requires an NG tube for stomach decompression. Which of the following actions should the nurse take when inserting the NG tube? - answer Have the client take sips of water to promote insertion of the NG tube into the esophagus.
A nurse is reviewing a client's fluid and electrolyte status. Which of the following findings
should the nurse report to the provider? - answer Potassium 5.4 mEq/L
A nurse is providing discharge instructions to a client who will be using a walker. Which of the following statements indicates an understanding of the teaching? - answer "I will hire someone to trim the tree that hangs low over the stairs of my front porch."
A nurse is planning care for a client who has had a stroke, resulting in aphasia and dysphagia. Which of the following tasks should the nurse assign to an assistive personnel (AP)? (Select all that apply.) - answer assist the client with a partial bed bath, measure the client's BP after the nurse administers an antihypertensive medication, use a communication board to ask what the client wants for lunch
A nurse is caring for a client who is expressing anger about the diagnosis of colorectal cancer. Which of the following actions should the nurse take? - answer Reassure the
client that this is an expected response to grief.
A nurse is preparing to apply a dressing for a client who has a stage 2 pressure injury. Which of the following types of dressing should the nurse use? - answer Hydrocolloid
A nurse is administering an otic medication to an older adult client. Which of the following actions should the nurse take to ensure that the medication reaches the inner ear. - answer Press gently on the tragus of the client's ear.
A nurse is using an open irrigation technique to irrigate a client's indwelling urinary catheter. Which of the following actions should the nurse take? - answer Subtract the
amount of irrigant used from the client's urine output. A nurse is initiating a protective environment for a client who has had an allogeneic stem cell transplant. Which of the following precautions should the nurse plan for this client? - answer Make sure the client wears a mask when outside her room if there is
construction in the area.
A nurse is auscultating the anterior chest of a client who was newly admitted to a medical-surgical unit. Listen to the audio clip of what the nurse auscultates through the stethoscope and identify the type of breath sounds. (Click on the audio button to listen to the clip.) - answer Normal breath sounds
A nurse is planning strategies to manage time effectively for client care. Which of the following strategies should the nurse implement? - answer Use the planning step of the nursing process to prioritize client care delivery.
A nurse is caring for a client who is postoperative following a knee arthroplasty and requires the use of thigh-length sequential compression sleeves. Which of the following actions should the nurse take? - answer Make sure two fingers can fit under the sleeves.
A nurse is caring for a client who has a respiratory infection. Which of the following techniques should the nurse use when performing nasotracheal suctioning for the client? - answer Apply intermittent suction when withdrawing the catheter.
A nurse is assessing a client who reports increased pain following physical therapy. Which of the following questions should the nurse ask when assessing the quality of the
client's pain? - answer "Is your pain sharp or dull?"
A nurse is providing discharge teaching to a client about self-administering heparin. Which of the following instruction should the nurse include in the teaching? - answer Administer the medication into the abdomen.
A nurse is a long-term care facility is caring for a client who dies during the nurse's shift.
Identify the sequence in which the nurse should perform the following steps. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.) - answer Obtain the pronouncement of death from the provider. Remove tubes and indwelling lines. Wash the client's body. Ask the client's family members if they would like to view the body. Place a name tag on the body.
A nurse is teaching a client and his family how to care for the client's tracheostomy at home. Which of the following instructions should the nurse include in teaching? - answer Use tracheostomy covers when outdoors.
A nurse is caring for a client who has a terminal illness and is approaching death. The client is short of breath and has noisy respirations from secretions in their airway. Which
of the following should the nurse take? - answer Turn the client every 2 hr.
