ATI Fundamentals CMS 2023 Questions And
Correct Answers Graded A+
A nurse is assessing the heart sounds of a client who has developed chest pain that
becomes worse with inspiration. the nurse auscultates a high-pitched scratching
sound during both systole and diastole with the diaphragm of the stethoscope
positioned at the left sternal border. which heart sounds should the nurse
document?
pericardial friction rub
a nurse is obtaining the blood pressure in a clients lower extremity. which action
should the nurse take?
place the bladder of the cuff over the posterior aspect of the thigh
a charge nurse is teaching adult CPR to a group of new nurses. which actions
should the charge nurse teach as the first response in CPR?
confirm unresponsiveness
a nurse is caring for a client who requires a chest xray. prior to the client being
transported for the procedure, which actions should the nurse take first?
identify the client using two identifiers
,a nurse is caring for a child who is postop following a tonsillectomy. which actions
should the nurse take?
administer analgesics to the child on a routine schedule throughout the day and
night
a nurse is providing teaching to a client who has heart failure about how to reduce
his daily intake of sodium. which factors is the most important in determining the
clients ability to learn new dietary habits?
the involvement of the client in planning the change
a charge nurse is observing a new nurse perform tracheostomy care for a client.
which actions by the new nurse requires intervention?
obtaining cotton balls for the trach care
a nurse is preparing to perform mouth care for an unresponsive client. which
actions should the nurse plan to take?
raise the level of the bed
a nurse is witnessing a client sign an informed consent form for surgery. which
describes what the nurse is affirming by this action?
the signature on the preop consent form is the clients
, a nurse is preparing to provide tracheostomy care for a client. which actions should
the nurse take first?
perform hand hygiene
a nurse is caring for an older adult client who becomes agitated when the nurse
requests that the clients dentures be removed prior to surgery. which responses
should the nurse make?
what worries you about being without your teeth?
a nurse in an oncology clinic is assessing a client who is undergoing treatment for
ovarian cancer. which assessment statements by the client indicates she is
experiencing psychological distress?
i keep having nightmares about my upcoming surgery
a nurse on a med surg unit is caring for a client. which actions should the nurse
take first when using the nursing process?
obtain client information
a nurse is caring for an older adult client who is violent and attempting to
disconnect her IV lines. the provider prescribes soft wrist restraints. which actions
should the nurse take while the client is in restraints?
remove the restraints one at a time
Correct Answers Graded A+
A nurse is assessing the heart sounds of a client who has developed chest pain that
becomes worse with inspiration. the nurse auscultates a high-pitched scratching
sound during both systole and diastole with the diaphragm of the stethoscope
positioned at the left sternal border. which heart sounds should the nurse
document?
pericardial friction rub
a nurse is obtaining the blood pressure in a clients lower extremity. which action
should the nurse take?
place the bladder of the cuff over the posterior aspect of the thigh
a charge nurse is teaching adult CPR to a group of new nurses. which actions
should the charge nurse teach as the first response in CPR?
confirm unresponsiveness
a nurse is caring for a client who requires a chest xray. prior to the client being
transported for the procedure, which actions should the nurse take first?
identify the client using two identifiers
,a nurse is caring for a child who is postop following a tonsillectomy. which actions
should the nurse take?
administer analgesics to the child on a routine schedule throughout the day and
night
a nurse is providing teaching to a client who has heart failure about how to reduce
his daily intake of sodium. which factors is the most important in determining the
clients ability to learn new dietary habits?
the involvement of the client in planning the change
a charge nurse is observing a new nurse perform tracheostomy care for a client.
which actions by the new nurse requires intervention?
obtaining cotton balls for the trach care
a nurse is preparing to perform mouth care for an unresponsive client. which
actions should the nurse plan to take?
raise the level of the bed
a nurse is witnessing a client sign an informed consent form for surgery. which
describes what the nurse is affirming by this action?
the signature on the preop consent form is the clients
, a nurse is preparing to provide tracheostomy care for a client. which actions should
the nurse take first?
perform hand hygiene
a nurse is caring for an older adult client who becomes agitated when the nurse
requests that the clients dentures be removed prior to surgery. which responses
should the nurse make?
what worries you about being without your teeth?
a nurse in an oncology clinic is assessing a client who is undergoing treatment for
ovarian cancer. which assessment statements by the client indicates she is
experiencing psychological distress?
i keep having nightmares about my upcoming surgery
a nurse on a med surg unit is caring for a client. which actions should the nurse
take first when using the nursing process?
obtain client information
a nurse is caring for an older adult client who is violent and attempting to
disconnect her IV lines. the provider prescribes soft wrist restraints. which actions
should the nurse take while the client is in restraints?
remove the restraints one at a time
