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_627921a950102_stuvia_909199_ati_fundamentals_proctored_examATI Fundamentals Proctored Exam | Questions and Answers with Rationales | LATEST 2021/ 2022  A nurse is planning to collect a stool specimen for ova and parasites from a client who has diarrhea. Which of the following actions should the nurse take when collecting the specimen? A.Instruct the client to defecate into the toilet bowl -incorrect: The nurse should have the client defecate into a bedpan or a container for stool collection. The toilet water can dilute and contaminate the liquid specimen. B.Transfer the specimen to a sterile container -incorrect: The nurse should place the stool specimen in a clean container using a tongue depressor. C.Refrigerate the collected specimen -incorrect: The nurse should send the collected stool specimen immediately to the laboratory after labeling the specimen properly to prevent contamination with microorganisms and keep the specimen from getting cold. D.Place the stool specimen collection container in a biohazard bag -The nurse should place the specimen collection container in a biohazard bag with the client label on the container and the bag for easy identification. This will also prevent contamination with microorganisms.  A nurse is caring for a client who has a tracheostomy and requires suctioning. Which of the following actions should the nurse take? A.Hyper oxygenate the client before suctioning -The nurse should use a manual resuscitation bag to hyper oxygenate the client for several minutes prior to suctioning. B.Insert the catheter during exhalation -incorrect: The nurse should insert the catheter during inhalation C.Apply suction during insertion of the catheter harry -incorrect: Applying suction while inserting the catheter increases the risk of damage to the tracheal mucosa and removes oxygen from the airways. D.Apply suction for no more than 15 secs -incorrect: The nurse should apply suction for no more than 10 seconds  A nurse is assisting a client who has dysphagia at mealtimes. Which of the following actions should the nurse take? A.Assist the client into a semi-sitting position -incorrect: The nurse should assist the client to sit in an upright position when eating. B.Have the client lean slightly backward -incorrect: The nurse should have the client lean slightly forward when eating C.Advise the client to tuck his chin downward -To help the client swallow safely, the nurse should have the client sit upright, lean slightly forward, tilt his head forward, and tuck his chin. This position helps moves the food downward without lodging in the throat, where the client could aspirate it. D.Instruct the client to tilt his head slightly backward -incorrect: The nurse should instruct the client to tilt his head slightly forward when eating.  A nurse is assessing a client who is experiencing an obstruction of the flow of the vitreous humor in the eye. This manifestation is consistent with which of the following eye disorders? A.Retinopathy -incorrect: Manifestations of retinopathy include changes in the blood vessels of the retina that can lead to blindness. B.Glaucoma -The nurse should identify that an obstruction of the flow of the vitreous humor of the eye is a manifestation of glaucoma. This obstruction leads to an increase in intraocular pressure, resulting in damage to the eye. C.Cataracts harry -incorrect: Manifestations of cataracts include an increase in the opacity of the lens, blocking rays of light from entering the eye. D.Macular degeneration -incorrect: Manifestations of macular degeneration include changes in sharp and central vision and are often associated with aging. harry  A charge nurse is providing teaching to a newly licensed nurse about removing sutures from a client’s laceration. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? A.“I will use a staple remover and remove each suture individually.” -incorrect: A staple remover is used to remove staples, not sutures. B.“Bandage scissors are used to cut the sutures.” -incorrect: Bandage scissors are ineffective in removing sutures, as the tips of the scissors are too large and blunt to capture the suture material. Special suture scissors with a short, curved tip are used to remove sutures. C.“Tweezers are necessary only for removing retention sutures.” -incorrect: Retention sutures are placed more deeply within the body than regular sutures. Agency policy will determine if nurses are allowed to remove them. Tweezers, however, can be used to remove all types of sutures, not just retention ones. D.“I will clip each suture close to the skin and pull it through from the other side.” -Clipping close to the skin and pulling the suture from the other side does not disrupt the wound- healing process.  A nurse is preparing to insert an indwelling urinary catheter for a female client. Which of the following actions should the nurse have the client perform just before inserting the catheter? A.Swallow water -incorrect: Swallowing eases the passage of a nasogastric tube past the client’s oropharynx. B.Prepare for painful sensation -incorrect: The insertion of a catheter can feel uncomfortable but should not cause pain, and it can ease the discomfort of bladder distention. C.Hold her breath harry -incorrect: The nurse should ask the client to take a slow, deep breath just before insertion. D.Bear down gently -Bearing down helps the nurse visualize the urinary meatus and relaxes the external sphincter, which facilitates the insertion of the catheter.  A nurse is reviewing the use of side rails with an assistive personnel (AP). Which of the following statements by the AP indicates that further teaching is required? A.“I should not leave all 4 side rails up unless there is a prescription for restraints.” -incorrect: Side rails are a form of restraint when all 4 rails are raised. This requires a prescription form the provider after less restrictive methods have been unsuccessful. B.“An alert client will be safest if I raise the 2 upper side rails at the head of the bed.” -incorrect: Leaving the 2 upper side rails up improves the client’s ability to turn and move around in bed. The client will also be able to use the rails when getting out of bed, which will help prevent falls. C.“If the client seems confused, I’ll raise all 4 side rails so that he doesn’t hurt himself.” -Raising all 4 side rails can put the client at greater risk for injury. For example, the client might try to climb over the side rails, which could result in a fall. D.“If a client is sedated, I should raise all 4 side rails to prevent a fall out of bed.” -incorrect: Raising all 4 side rails is not considered a restraint if the client is sedated. This action reduces the client’s risk for injury due to falling out of bed.

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