ATI Fundamentals Test Exam 2 2024 VERIFIED A+ GRADED

ATI Fundamentals Test Exam 2 2024
VERIFIED A+ GRADED
ATnurseTinTaTmedical-surgicalTunitTisTcaringTforTsixTclients.

CompleteTtheTfollowingTsentenceTbyTusingTtheTlistTofToptions.

TheTfirstTclientTtheTnurseTshouldTassessTis followedTby .

ClientT1:TClientTisTadmittedTwithTaTnewTdiagnosisTofTrheumatoidTarthritis.ClientT2:TClientThas
TaThistoryTofThyperlipidemia.TAtorvastatinT20TmgTPOTadministeredTasTprescribed.ClientT3:TCl

ientTisT1TdayTpostoperative.TReportsTpainTasT8TonTaTscaleTofT0TtoT10.TMorphineT5TmgTsubcuta
neousTadministeredTasTprescribed.ClientT4:TClientTisTadmittedTwithTaTnewTdiagnosisTofTheartT
failure.ClientT5:TClientThasTaTstageT2TpressureTinjuryTonTtheTleftTheel.ClientT6:TClientTisTadmi
ttedTwithTaTnewTdiagnosisTofTdiabetesTmellitus.T-TCorrectTAnswerT(1):
ClientT3
WhenTusingTtheTairway,Tbreathing,TcirculationTapproachTtoTclientTcare,TtheTnurseTshouldTdete
rmineTthatTthisTclientTisTtheTpriorityTclientTtoTassess.TTheTclientThasTanToxygenTsaturationTthat
TisTlessTthanTtheTexpectedTreferenceTrange,TwhichTisTanTindicationTofThypoxia.



CorrectTAnswerT(2):
ClientT4
WhenTusingTtheTairway,Tbreathing,TcirculationTapproachTtoTclientTcare,TtheTnurseTshouldTdeter
mineTthatTthisTclientTisTtheTnextTpriorityTclientTtoTassess.TTheTclientThasTaTpotassiumTlevelTthatTi
sTlessTthanTtheTexpectedTreferenceTrange,TwhichTplacesTtheTclientTatTriskTforTdysrhythmias.

IncorrectTAnswersT(1):
ClientT1TisTincorrect.TTheTnurseTshouldTassessTthisTclientTbecauseTtheTclient'sTC-
reactiveTproteinTisTgreaterTthanTtheTexpectedTreferenceTrange,TwhichTisTanTindicationTofTinfla
mmation.
However,TthereTisTanotherTclientTtheTnurseTshouldTassessTfirst.

ClientT2TisTincorrect.TTheTnurseTshouldTassessTthisTclientTbecauseTtheTclient'sTcholesterolTleve
lTisTgreaterTthanTtheTexpectedTreferenceTrange,TwhichTplacesTthemTatTriskTforTcoronaryTheartT
disease.THowever,TthereTisTanotherTclientTtheTnurseTshouldTassessTfirst.

IncorrectTAnswersT(2):
ClientT5TisTincorrect.TTheTnurseTshouldTassessTthisTclientTbecauseTtheirTprealbuminTlevelTisTles
sTthanTtheTexpectedTreferenceTrange,TwhichTplacesTthemTatTriskTforTdelayedTwoundThealing.
However,TthisTclientTisTnotTtheTnextTpriorityTclientTtoTassess.

ClientT6TisTincorrect.TTheTnurseTshouldTassessTthisTclientTbecauseTtheirTglycosylatedThemoglo
binTlevelTisTgreaterTthanTtheTexpectedTreferenceTrange,TwhichTindicatesTpoorTdiabeticTcontrol.
THowever,TthisTclientTisTnotTtheTnextTpriorityTclientTtoTassess.



ATnurseTisTcaringTforTaTclientTwhoThasTCOPD.

SelectTtheT3TfindingsTthatTrequireTfollow-up.

BreathTsoundsTBl
oodTpressure

,OxygenTsaturation
TTemperature

HeartTrateT-TCorrectTAnswer:
BreathTSounds
CracklesTareTcausedTbyTmucousTinTtheTairwaysTandTareTaTmanifestationTofTpneumonia.TDecre
asedTbreathTsoundsTindicateTdecreasedTventilationTandTrequireTfollow-upTbyTtheTnurse.

OxygenTSaturation
TheTclient'sToxygenTsaturationTisTbelowTtheTexpectedTreferenceTrangeTofT95%TtoT100%,Tindic
atingThypoxia,TandTrequiresTfollow-upTbyTtheTnurse.

Temperature
TheTclient'sTtemperatureTisTgreaterTthanTtheTexpectedTreferenceTrange,TindicatingTanTinfection,
TandTrequiresTfollow-upTbyTtheTnurse.



IncorrectTAnswer:
BloodTpressureTisTincorrect.TTheTclient'sTbloodTpressureTisTwithinTtheTexpectedTreferenceTrangeT
andTdoesTnotTrequireTfollow-upTbyTtheTnurse.

HeartTrateTisTincorrect.TTheTclient'sTheartTrateTisTwithinTtheTexpectedTreferenceTrangeTofT60TtoT1
00/minTandTdoesTnotTrequireTfollow-upTbyTtheTnurse.

ATnurseTinTtheTemergencyTdepartmentT(ED)TisTcaringTforTaTclientTwhoTreportsTabdominalTpain.

BasedTonTtheTclient'sTclinicalTfindings,TwhichTofTtheTfollowingTactionsTshouldTtheTnurseTtake?TS
electTallTthatTapply.

AssistTtheTclientTtoTaTleftTside-
lyingTpositionTwithTtheTrightTkneeTflexed.TPrepareTtheTclientTforTaTches
tTx-ray.
AdministerTaTcleansingTenema.TAuscult
ateTtheTclient'sTbowelTsounds.
PerformTaTmanualTdigitalTexaminationTofTtheTclient'sTrectum.TAdminis
terToxycodoneTextended-releaseTtablets.
PrepareTtheTclientTforTNGTtubeTplacement.T-TCorrectTAnswer:
AssistTtheTclientTtoTaTleftTside-lyingTpositionTwithTtheTrightTkneeTflexed
TheTnurseTshouldTplaceTtheTclientTinTaTleftTside-
lyingTpositionTwithTtheTrightTkneeTflexedTpriorTtoTadministeringTanTenema.TBecauseTtheTpro
viderTprescribedTaTcleansingTenemaTforTtheTclient,TtheTnurseTshouldTprepareTtheTclientTforTth
eTprocedure.

AdministerTaTcleansingTenema
TheTnurseTshouldTadministerTaTcleansingTenemaTforTtheTclientTasTaTresultTofTtheTprovider'sTpres
cription.TATcleansingTenemaTisTintendedTtoTassistTwithTbowelTeliminationTandTremoveTanyTimpa
ctedTfecalTmatterTindicatedTbyTtheTabdominalTx-ray.

AuscultateTtheTclient'sTbowelTsounds
TheTnurseTshouldTauscultateTtheTclient'sTbowelTsoundsTtoTdetermineTtheTstatusTofTtheTclient
'sTperistalsis.TThisTisTaTnecessaryTpartTofTdeterminingTtheTpresenceTofTbowelTsounds,Twhich
TareTanTindicationTofTtheTstatusTofTtheTclient'sTgastrointestinalTtract.



PerformTaTmanualTdigitalTexaminationTofTtheTclient'sTrectum

,TheTnurseTshouldTperformTaTmanualTdigitalTexaminationTofTtheTclient'sTrectumTtoTdetermineTi
fTimpactedTstoolTisTpresent.TThisTisTaTpartTofTtheTnecessaryTevaluationTofTtheTstatusTofTtheTclie
nt'sTgastrointestinalTtract.

IncorrectTAnswer:
PrepareTtheTclientTforTaTchestTx-rayTisTincorrect.TATchestTx-
rayTisTtypicallyTperformedTforTaTclientTwhoThasTanTimpairmentTofTtheTupperTthoraxTorTlungs,T
notTtheTabdomen.TTheTclientThasTalreadyTreceivedTanTabdominalTx-ray;Ttherefore,TaTchestTx-
rayTisTnotTnecessary.

PrepareTtheTclientTforTNGTtubeTplacementTisTincorrect.TTheTnurseTshouldTnotTprepareTtheTclie
ntTforTplacementTofTanTNGTtubeTbecauseTthereTisTnoTindicationTorTprescriptionTtoTdoTso.
PlacementTofTanTNGTtubeTisTrequiredTwhenTthereTisTanTobstructionTofTtheTgastrointestinalTtrac
tTandTperistalsisTisTabsent.

ATnurseTisTcaringTforTaTclientTwhoTasksTaboutTtheTpurposeTofTadvanceTdirectives.TWhichTofTtheT
followingTstatementsTshouldTtheTnurseTmake?

"TheyTallowTtheTcourtTtoToverruleTanTadultTclient'sTrefusalTofTmedicalTtreatment."
"TheyTindicateTtheTformTofTtreatmentTaTclientTisTwillingTtoTacceptTinTtheTeventTofTaTseriousTill
ness."
"TheyTpermitTaTclientTtoTwithholdTmedicalTinformationTfromThealthTcareTpersonnel."T
"TheyTallowThealthTcareTpersonnelTinTtheTemergencyTdepartmentTtoTstabilizeTaTclient'
sTcondition."T-TCorrectTAnswer:
"TheyTindicateTtheTformTofTtreatmentTaTclientTisTwillingTtoTacceptTinTtheTeventTofTaTseriousTill
ness."
AdvanceTdirectivesTincludeTaTlivingTwill,TwhichTpermitsTclientsTtoTdirectTtheTtreatmentTtheyT
willTreceiveTinTtheTeventTofTaTmedicalTemergencyTorTseriousTillness.

IncorrectTAnswer:
"TheyTallowTtheTcourtTtoToverruleTanTadultTclient'sTrefusalTofTmedicalTtreatment."
ATcourtTcanTonlyToverruleTanTadultTclient'sTrefusalTofTmedicalTtreatmentTifTtheTclientTisTlegallyTi
ncompetent.

"TheyTpermitTaTclientTtoTwithholdTmedicalTinformationTfromThealthTcareTpersonnel."
TheTAmericansTwithTDisabilitiesTAct,TnotTadvanceTdirectives,TprotectsTtheTprivacyTofTaTclient
TwhoTchoosesTnotTtoTdiscloseTaTmedicalTdisability.



"TheyTallowThealthTcareTpersonnelTinTtheTemergencyTdepartmentTtoTstabilizeTaTclient'sTconditi
on."
TheTEmergencyTMedicalTTreatmentTandTActiveTLaborTAct,TnotTadvanceTdirectives,TdirectsTeme
rgencyTpersonnelTtoTprovideTscreeningTandTstabilizingTcareTbeforeTdischargingTorTtransferringT
clientsTtoTanotherTfacility.

ATnurseTisTcaringTforTaTclientTwhoThasTaTprescriptionTforT5TunitsTofTregularTinsulinTandT10Tun
itsTofTNPHTinsulinTtoTmixTtogetherTandTadministerTsubcutaneously.TDetermineTtheTcorrectTor
derTofTstepsTforTthisTprocedure.

InjectT5TunitsTofTairTintoTtheTbottleTofTregularTinsulinTWithdr
awTtheTcorrectTdoseTofTNPHTinsulinTfromTtheTbottleTInjectT1
0TunitsTofTairTintoTtheTbottleTofTNPHTinsulin

, WithdrawTtheTcorrectTdoseTofTregularTinsulinTfromTtheTbottleT-
TCorrectTAnswer:TInjectT10TunitsTofTairTintoTtheTbottleTofTNPHTinsulin

InjectT5TunitsTofTairTintoTtheTbottleTofTregularTinsulinTWithdr
awTtheTcorrectTdoseTofTregularTinsulinTfromTtheTbottleTWithd
rawTtheTcorrectTdoseTofTNPHTinsulinTfromTtheTbottle

TheTnurseTshouldTfirstTinjectTairTintoTtheTvialTofTNPHTinsulinTwithoutTtouchingTtheTneedleTto
TtheTsolution.TNext,TtheTnurseTshouldTinjectTairTintoTtheTvialTofTregularTinsulinTandTwithdrawT

theTcorrectTamountTofTtheTregularTinsulin.TFinally,TtheTnurseTshouldTinsertTtheTneedleTintoTthe
TNPHTinsulinTvialTandTwithdrawTtheTcorrectTamountTofTNPHTinsulin.TTheTnurseTshouldTfollo

wTtheseTstepsTtoTpreventTcontaminatingTtheTregularTinsulinTwithTNPHTinsulin.

ATnurseTisTperformingTaTRombergTtestTduringTtheTphysicalTassessmentTofTaTclient.TWhichTo
fTtheTfollowingTtechniquesTshouldTtheTnurseTuse?

TouchTtheTfaceTwithTaTcottonTball.
ApplyTaTvibratingTtuningTforkTtoTtheTclient'sTforehead.
HaveTtheTclientTstandTwithTtheirTarmsTatTtheirTsidesTandTtheirTfeetTtogethe
r.TPerformTdirectTpercussionToverTtheTareaTofTtheTkidneys.T-
TCorrectTAnswer:THaveTtheTclientTstandTwithTtheirTarmsTatTtheirTsidesTan

dTtheirTfeetTtogether.
ATRombergTtestThelpsTidentifyTalterationsTinTbalance.TTheTnurseTshouldThaveTtheTclientTstand
TwithTtheirTarmsTatTtheirTsidesTandTtheirTfeetTtogetherTtoTobserveTforTswayingTandTaTlossTofTb

alance.

IncorrectTAnswer:
TouchTtheTfaceTwithTaTcottonTball.
TheTnurseTshouldTtouchTtheTclient'sTcorneasTwithTaTwispTofTcottonTandTmeasureTlightTtouchTand
TpainTacrossTtheTclient'sTfaceTtoTtestTcranialTnerveTV,TtheTtrigeminalTnerve.



ApplyTaTvibratingTtuningTforkTtoTtheTclient'sTforehead.
TheTnurseTshouldTapplyTaTvibratingTtuningTforkTtoTtheTclient'sTheadTtoTperformTtheTWeberTtes
tTtoTidentifyTsoundTlateralizationTwhenTassessingThearing.

PerformTdirectTpercussionToverTtheTareaTofTtheTkidneys.
TheTnurseTshouldTperformTdirectTpercussionToverTtheTareaTofTtheTkidneysTtoTevaluateTthemTfo
rTinflammation.

ATnurseTisTprovidingTdischargeTteachingTforTaTclientTwhoThasTaTnewTprescriptionTforTaThomeT
oxygenTconcentrator.TWhichTofTtheTfollowingTinstructionsTshouldTtheTnurseTprovideTtoTtheTcl
ientTandTtheirTfamily.

CheckTtheTcordTroutinelyTforTfraysTorTtearing.
KeepTtheTunitTatTleastT1.2TmT(4Tft)TawayTfromTaTgasTstove.TC
onsiderTpurchasingTaTgeneratorTforTpowerTbackup.
ObserveTforTsignsTofThypoxia.
SelectTsyntheticTclothingTandTbedding.T-TCorrectTAnswer:
CheckTtheTcordTroutinelyTforTfraysTorTtearing.
OxygenTconcentratorsTrequireTelectricalTpower.TSafeTuseTofTthisTdeliveryTsystemTincludesTasses
singTtheTelectricalTfunctionTofTtheTdevice;Ttherefore,TtheTnurseTshouldTinstructTtheTclientTtoTrouti
nelyTcheckTtheTconditionTofTtheTcord.