ATI RN FUNDAMENTALS ONLINE PRAC
33 33 33 33
TICE 2023 B EXAM QUESTIONS AND
33 33 33 33 33
33 ANSWERS
Arnurserinrarmedical-surgicalrunitrisrcaringrforrsixrclients.
Completertherfollowingrsentencerbyrusingrtherlistrofroptions.
Therfirstrclientrthernursershouldrassessrisr_____rfollowedrbyr_____.
Clientr1:rClientrisradmittedrwithrarnewrdiagnosisrofrrheumatoidrarthritis.Clientr2:rClientrhasrar
historyrofrhyperlipidemia.rAtorvastatinr20rmgrPOradministeredrasrprescribed.Clientr3:rClient
risr1rdayrpostoperative.rReportsrpainrasr8ronrarscalerofr0rtor10.rMorphiner5rmgrsubcutaneousr
administeredrasrprescribed.Clientr4:rClientrisradmittedrwithrarnewrdiagnosisrofrheartrfailure.
Clientr5:rClientrhasrarstager2rpressurerinjuryronrtherleftrheel.Clientr6:rClientrisradmittedrwithrar
newrdiagnosisrofrdiabetesrmellitus.r-rans✔✔CorrectrAnswerr(1):
Clientr3
Whenrusingrtherairway,rbreathing,rcirculationrapproachrtorclientrcare,rthernursershouldrdeter
minerthatrthisrclientrisrtherpriorityrclientrtorassess.rTherclientrhasranroxygenrsaturationrthatrisrl
essrthanrtherexpectedrreferencerrange,rwhichrisranrindicationrofrhypoxia.
CorrectrAnswerr(2):
Clientr4
Whenrusingrtherairway,rbreathing,rcirculationrapproachrtorclientrcare,rthernursershouldrdeter
minerthatrthisrclientrisrthernextrpriorityrclientrtorassess.rTherclientrhasrarpotassiumrlevelrthatris
rlessrthanrtherexpectedrreferencerrange,rwhichrplacesrtherclientratrriskrforrdysrhythmias.
IncorrectrAnswersr(1):
Clientr1risrincorrect.rThernursershouldrassessrthisrclientrbecausertherclient'srC-
reactiverproteinrisrgreaterrthanrtherexpectedrreferencerrange,rwhichrisranrindicationrofrinflam
mation.rHowever,rthererisranotherrclientrthernursershouldrassessrfirst.
,Clientr2risrincorrect.rThernursershouldrassessrthisrclientrbecausertherclient'srcholesterolrleve
lrisrgreaterrthanrtherexpectedrreferencerrange,rwhichrplacesrthemratrriskrforrcoronaryrheartrdi
sease.rHowever,rthererisranotherrclientrthernursershouldrassessrfirst.
IncorrectrAnswersr(2):
Clientr5risrincorrect.rThernursershouldrassessrthisrclientrbecausertheirrprealbuminrlevelrisrles
srthanrtherexpectedrreferencerrange,rwhichrplacesrthemratrriskrforrdelayedrwoundrhealing.rH
owever,rthisrclientrisrnotrthernextrpriorityrclientrtorassess.
Clientr6risrincorrect.rThernursershouldrassessrthisrclientrbecausertheirrglycosylatedrhemoglo
binrlevelrisrgreaterrthanrtherexpectedrreferencerrange,rwhichrindicatesrpoorrdiabeticrcontrol.r
However,rthisrclientrisrnotrthernextrpriorityrclientrtorassess.
ArnurserisrcaringrforrarclientrwhorhasrCOPD.
Selectrther3rfindingsrthatrrequirerfollow-up.
Breathrsounds
Bloodrpressure
Oxygenrsaturation
Temperature
Heartrrater-rans✔✔CorrectrAnswer:
BreathrSounds
Cracklesrarercausedrbyrmucousrinrtherairwaysrandrarerarmanifestationrofrpneumonia.rDecre
asedrbreathrsoundsrindicaterdecreasedrventilationrandrrequirerfollow-uprbyrthernurse.
OxygenrSaturation
Therclient'sroxygenrsaturationrisrbelowrtherexpectedrreferencerrangerofr95%rtor100%,rindica
tingrhypoxia,randrrequiresrfollow-uprbyrthernurse.
Temperature
Therclient'srtemperaturerisrgreaterrthanrtherexpectedrreferencerrange,rindicatingranrinfectio
n,randrrequiresrfollow-uprbyrthernurse.
IncorrectrAnswer:
Bloodrpressurerisrincorrect.rTherclient'srbloodrpressurerisrwithinrtherexpectedrreferencerran
gerandrdoesrnotrrequirerfollow-uprbyrthernurse.
Heartrraterisrincorrect.rTherclient'srheartrraterisrwithinrtherexpectedrreferencerrangerofr60rtor1
00/minrandrdoesrnotrrequirerfollow-uprbyrthernurse.
Arnurserinrtheremergencyrdepartmentr(ED)risrcaringrforrarclientrwhorreportsrabdominalrpain.r
Basedronrtherclient'srclinicalrfindings,rwhichrofrtherfollowingractionsrshouldrthernursertake?
rSelectrallrthatrapply.
,Assistrtherclientrtorarleftrside-lyingrpositionrwithrtherrightrkneerflexed.
Preparertherclientrforrarchestrx-ray.
Administerrarcleansingrenema.
Auscultatertherclient'srbowelrsounds.
Performrarmanualrdigitalrexaminationrofrtherclient'srrectum.
Administerroxycodonerextended-releasertablets.
PreparertherclientrforrNGrtuberplacement.r-rans✔✔CorrectrAnswer:
Assistrtherclientrtorarleftrside-lyingrpositionrwithrtherrightrkneerflexedr
Thernursershouldrplacertherclientrinrarleftrside-
lyingrpositionrwithrtherrightrkneerflexedrpriorrtoradministeringranrenema.rBecausertherprovid
errprescribedrarcleansingrenemarforrtherclient,rthernursershouldrpreparertherclientrforrtherpro
cedure.
Administerrarcleansingrenemar
Thernursershouldradministerrarcleansingrenemarforrtherclientrasrarresultrofrtherprovider'srpre
scription.rArcleansingrenemarisrintendedrtorassistrwithrbowelreliminationrandrremoveranyrim
pactedrfecalrmatterrindicatedrbyrtherabdominalrx-ray.
Auscultatertherclient'srbowelrsoundsr
Thernursershouldrauscultatertherclient'srbowelrsoundsrtordeterminertherstatusrofrtherclient'sr
peristalsis.rThisrisrarnecessaryrpartrofrdeterminingrtherpresencerofrbowelrsounds,rwhichrarer
anrindicationrofrtherstatusrofrtherclient'srgastrointestinalrtract.
Performrarmanualrdigitalrexaminationrofrtherclient'srrectum
Thernursershouldrperformrarmanualrdigitalrexaminationrofrtherclient'srrectumrtordeterminerifri
mpactedrstoolrisrpresent.rThisrisrarpartrofrthernecessaryrevaluationrofrtherstatusrofrtherclient'
srgastrointestinalrtract.
IncorrectrAnswer:
Preparertherclientrforrarchestrx-rayrisrincorrect.rArchestrx-
rayrisrtypicallyrperformedrforrarclientrwhorhasranrimpairmentrofrtherupperrthoraxrorrlungs,rnotr
therabdomen.rTherclientrhasralreadyrreceivedranrabdominalrx-ray;rtherefore,rarchestrx-
rayrisrnotrnecessary.
PreparertherclientrforrNGrtuberplacementrisrincorrect.rThernursershouldrnotrpreparertherclien
trforrplacementrofranrNGrtuberbecauserthererisrnorindicationrorrprescriptionrtordorso.rPlacem
entrofranrNGrtuberisrrequiredrwhenrthererisranrobstructionrofrthergastrointestinalrtractrandrper
istalsisrisrabsent.
Arnurserisrcaringrforrarclientrwhorasksraboutrtherpurposerofradvancerdirectives.rWhichrofrtherf
ollowingrstatementsrshouldrthernursermake?
"Theyrallowrthercourtrtoroverruleranradultrclient'srrefusalrofrmedicalrtreatment."
"Theyrindicatertherformrofrtreatmentrarclientrisrwillingrtoracceptrinrthereventrofrarseriousrillnes
s."
"Theyrpermitrarclientrtorwithholdrmedicalrinformationrfromrhealthrcarerpersonnel."
, "Theyrallowrhealthrcarerpersonnelrinrtheremergencyrdepartmentrtorstabilizerarclient'srconditi
on."r-rans✔✔CorrectrAnswer:
"Theyrindicatertherformrofrtreatmentrarclientrisrwillingrtoracceptrinrthereventrofrarseriousrillnes
s."
Advancerdirectivesrincluderarlivingrwill,rwhichrpermitsrclientsrtordirectrthertreatmentrtheyrwillr
receiverinrthereventrofrarmedicalremergencyrorrseriousrillness.
IncorrectrAnswer:
"Theyrallowrthercourtrtoroverruleranradultrclient'srrefusalrofrmedicalrtreatment."
Arcourtrcanronlyroverruleranradultrclient'srrefusalrofrmedicalrtreatmentrifrtherclientrisrlegallyrin
competent.
"Theyrpermitrarclientrtorwithholdrmedicalrinformationrfromrhealthrcarerpersonnel."
TherAmericansrwithrDisabilitiesrAct,rnotradvancerdirectives,rprotectsrtherprivacyrofrarclientrw
horchoosesrnotrtordiscloserarmedicalrdisability.
"Theyrallowrhealthrcarerpersonnelrinrtheremergencyrdepartmentrtorstabilizerarclient'srconditi
on."
TherEmergencyrMedicalrTreatmentrandrActiverLaborrAct,rnotradvancerdirectives,rdirectsre
mergencyrpersonnelrtorproviderscreeningrandrstabilizingrcarerbeforerdischargingrorrtransfer
ringrclientsrtoranotherrfacility.
Arnurserisrcaringrforrarclientrwhorhasrarprescriptionrforr5runitsrofrregularrinsulinrandr10runitsrof
rNPHrinsulinrtormixrtogetherrandradministerrsubcutaneously. rDeterminerthercorrectrorderrofr
stepsrforrthisrprocedure.r
Injectr5runitsrofrairrintortherbottlerofrregularrinsulin
WithdrawrthercorrectrdoserofrNPHrinsulinrfromrtherbottle
Injectr10runitsrofrairrintortherbottlerofrNPHrinsulin
Withdrawrthercorrectrdoserofrregularrinsulinrfromrtherbottler-rans✔✔CorrectrAnswer:
Injectr10runitsrofrairrintortherbottlerofrNPHrinsulin
Injectr5runitsrofrairrintortherbottlerofrregularrinsulin
Withdrawrthercorrectrdoserofrregularrinsulinrfromrtherbottle
WithdrawrthercorrectrdoserofrNPHrinsulinrfromrtherbottle
ThernursershouldrfirstrinjectrairrintorthervialrofrNPHrinsulinrwithoutrtouchingrtherneedlertorther
solution.rNext,rthernursershouldrinjectrairrintorthervialrofrregularrinsulinrandrwithdrawrthercorr
ectramountrofrtherregularrinsulin.rFinally,rthernursershouldrinsertrtherneedlerintortherNPHrins
ulinrvialrandrwithdrawrthercorrectramountrofrNPHrinsulin.rThernursershouldrfollowrtheserstep
srtorpreventrcontaminatingrtherregularrinsulinrwithrNPHrinsulin.
ArnurserisrperformingrarRombergrtestrduringrtherphysicalrassessmentrofrarclient.rWhichrofrth
erfollowingrtechniquesrshouldrthernurseruse?
Touchrtherfacerwithrarcottonrball.
Applyrarvibratingrtuningrforkrtortherclient'srforehead.
33 33 33 33
TICE 2023 B EXAM QUESTIONS AND
33 33 33 33 33
33 ANSWERS
Arnurserinrarmedical-surgicalrunitrisrcaringrforrsixrclients.
Completertherfollowingrsentencerbyrusingrtherlistrofroptions.
Therfirstrclientrthernursershouldrassessrisr_____rfollowedrbyr_____.
Clientr1:rClientrisradmittedrwithrarnewrdiagnosisrofrrheumatoidrarthritis.Clientr2:rClientrhasrar
historyrofrhyperlipidemia.rAtorvastatinr20rmgrPOradministeredrasrprescribed.Clientr3:rClient
risr1rdayrpostoperative.rReportsrpainrasr8ronrarscalerofr0rtor10.rMorphiner5rmgrsubcutaneousr
administeredrasrprescribed.Clientr4:rClientrisradmittedrwithrarnewrdiagnosisrofrheartrfailure.
Clientr5:rClientrhasrarstager2rpressurerinjuryronrtherleftrheel.Clientr6:rClientrisradmittedrwithrar
newrdiagnosisrofrdiabetesrmellitus.r-rans✔✔CorrectrAnswerr(1):
Clientr3
Whenrusingrtherairway,rbreathing,rcirculationrapproachrtorclientrcare,rthernursershouldrdeter
minerthatrthisrclientrisrtherpriorityrclientrtorassess.rTherclientrhasranroxygenrsaturationrthatrisrl
essrthanrtherexpectedrreferencerrange,rwhichrisranrindicationrofrhypoxia.
CorrectrAnswerr(2):
Clientr4
Whenrusingrtherairway,rbreathing,rcirculationrapproachrtorclientrcare,rthernursershouldrdeter
minerthatrthisrclientrisrthernextrpriorityrclientrtorassess.rTherclientrhasrarpotassiumrlevelrthatris
rlessrthanrtherexpectedrreferencerrange,rwhichrplacesrtherclientratrriskrforrdysrhythmias.
IncorrectrAnswersr(1):
Clientr1risrincorrect.rThernursershouldrassessrthisrclientrbecausertherclient'srC-
reactiverproteinrisrgreaterrthanrtherexpectedrreferencerrange,rwhichrisranrindicationrofrinflam
mation.rHowever,rthererisranotherrclientrthernursershouldrassessrfirst.
,Clientr2risrincorrect.rThernursershouldrassessrthisrclientrbecausertherclient'srcholesterolrleve
lrisrgreaterrthanrtherexpectedrreferencerrange,rwhichrplacesrthemratrriskrforrcoronaryrheartrdi
sease.rHowever,rthererisranotherrclientrthernursershouldrassessrfirst.
IncorrectrAnswersr(2):
Clientr5risrincorrect.rThernursershouldrassessrthisrclientrbecausertheirrprealbuminrlevelrisrles
srthanrtherexpectedrreferencerrange,rwhichrplacesrthemratrriskrforrdelayedrwoundrhealing.rH
owever,rthisrclientrisrnotrthernextrpriorityrclientrtorassess.
Clientr6risrincorrect.rThernursershouldrassessrthisrclientrbecausertheirrglycosylatedrhemoglo
binrlevelrisrgreaterrthanrtherexpectedrreferencerrange,rwhichrindicatesrpoorrdiabeticrcontrol.r
However,rthisrclientrisrnotrthernextrpriorityrclientrtorassess.
ArnurserisrcaringrforrarclientrwhorhasrCOPD.
Selectrther3rfindingsrthatrrequirerfollow-up.
Breathrsounds
Bloodrpressure
Oxygenrsaturation
Temperature
Heartrrater-rans✔✔CorrectrAnswer:
BreathrSounds
Cracklesrarercausedrbyrmucousrinrtherairwaysrandrarerarmanifestationrofrpneumonia.rDecre
asedrbreathrsoundsrindicaterdecreasedrventilationrandrrequirerfollow-uprbyrthernurse.
OxygenrSaturation
Therclient'sroxygenrsaturationrisrbelowrtherexpectedrreferencerrangerofr95%rtor100%,rindica
tingrhypoxia,randrrequiresrfollow-uprbyrthernurse.
Temperature
Therclient'srtemperaturerisrgreaterrthanrtherexpectedrreferencerrange,rindicatingranrinfectio
n,randrrequiresrfollow-uprbyrthernurse.
IncorrectrAnswer:
Bloodrpressurerisrincorrect.rTherclient'srbloodrpressurerisrwithinrtherexpectedrreferencerran
gerandrdoesrnotrrequirerfollow-uprbyrthernurse.
Heartrraterisrincorrect.rTherclient'srheartrraterisrwithinrtherexpectedrreferencerrangerofr60rtor1
00/minrandrdoesrnotrrequirerfollow-uprbyrthernurse.
Arnurserinrtheremergencyrdepartmentr(ED)risrcaringrforrarclientrwhorreportsrabdominalrpain.r
Basedronrtherclient'srclinicalrfindings,rwhichrofrtherfollowingractionsrshouldrthernursertake?
rSelectrallrthatrapply.
,Assistrtherclientrtorarleftrside-lyingrpositionrwithrtherrightrkneerflexed.
Preparertherclientrforrarchestrx-ray.
Administerrarcleansingrenema.
Auscultatertherclient'srbowelrsounds.
Performrarmanualrdigitalrexaminationrofrtherclient'srrectum.
Administerroxycodonerextended-releasertablets.
PreparertherclientrforrNGrtuberplacement.r-rans✔✔CorrectrAnswer:
Assistrtherclientrtorarleftrside-lyingrpositionrwithrtherrightrkneerflexedr
Thernursershouldrplacertherclientrinrarleftrside-
lyingrpositionrwithrtherrightrkneerflexedrpriorrtoradministeringranrenema.rBecausertherprovid
errprescribedrarcleansingrenemarforrtherclient,rthernursershouldrpreparertherclientrforrtherpro
cedure.
Administerrarcleansingrenemar
Thernursershouldradministerrarcleansingrenemarforrtherclientrasrarresultrofrtherprovider'srpre
scription.rArcleansingrenemarisrintendedrtorassistrwithrbowelreliminationrandrremoveranyrim
pactedrfecalrmatterrindicatedrbyrtherabdominalrx-ray.
Auscultatertherclient'srbowelrsoundsr
Thernursershouldrauscultatertherclient'srbowelrsoundsrtordeterminertherstatusrofrtherclient'sr
peristalsis.rThisrisrarnecessaryrpartrofrdeterminingrtherpresencerofrbowelrsounds,rwhichrarer
anrindicationrofrtherstatusrofrtherclient'srgastrointestinalrtract.
Performrarmanualrdigitalrexaminationrofrtherclient'srrectum
Thernursershouldrperformrarmanualrdigitalrexaminationrofrtherclient'srrectumrtordeterminerifri
mpactedrstoolrisrpresent.rThisrisrarpartrofrthernecessaryrevaluationrofrtherstatusrofrtherclient'
srgastrointestinalrtract.
IncorrectrAnswer:
Preparertherclientrforrarchestrx-rayrisrincorrect.rArchestrx-
rayrisrtypicallyrperformedrforrarclientrwhorhasranrimpairmentrofrtherupperrthoraxrorrlungs,rnotr
therabdomen.rTherclientrhasralreadyrreceivedranrabdominalrx-ray;rtherefore,rarchestrx-
rayrisrnotrnecessary.
PreparertherclientrforrNGrtuberplacementrisrincorrect.rThernursershouldrnotrpreparertherclien
trforrplacementrofranrNGrtuberbecauserthererisrnorindicationrorrprescriptionrtordorso.rPlacem
entrofranrNGrtuberisrrequiredrwhenrthererisranrobstructionrofrthergastrointestinalrtractrandrper
istalsisrisrabsent.
Arnurserisrcaringrforrarclientrwhorasksraboutrtherpurposerofradvancerdirectives.rWhichrofrtherf
ollowingrstatementsrshouldrthernursermake?
"Theyrallowrthercourtrtoroverruleranradultrclient'srrefusalrofrmedicalrtreatment."
"Theyrindicatertherformrofrtreatmentrarclientrisrwillingrtoracceptrinrthereventrofrarseriousrillnes
s."
"Theyrpermitrarclientrtorwithholdrmedicalrinformationrfromrhealthrcarerpersonnel."
, "Theyrallowrhealthrcarerpersonnelrinrtheremergencyrdepartmentrtorstabilizerarclient'srconditi
on."r-rans✔✔CorrectrAnswer:
"Theyrindicatertherformrofrtreatmentrarclientrisrwillingrtoracceptrinrthereventrofrarseriousrillnes
s."
Advancerdirectivesrincluderarlivingrwill,rwhichrpermitsrclientsrtordirectrthertreatmentrtheyrwillr
receiverinrthereventrofrarmedicalremergencyrorrseriousrillness.
IncorrectrAnswer:
"Theyrallowrthercourtrtoroverruleranradultrclient'srrefusalrofrmedicalrtreatment."
Arcourtrcanronlyroverruleranradultrclient'srrefusalrofrmedicalrtreatmentrifrtherclientrisrlegallyrin
competent.
"Theyrpermitrarclientrtorwithholdrmedicalrinformationrfromrhealthrcarerpersonnel."
TherAmericansrwithrDisabilitiesrAct,rnotradvancerdirectives,rprotectsrtherprivacyrofrarclientrw
horchoosesrnotrtordiscloserarmedicalrdisability.
"Theyrallowrhealthrcarerpersonnelrinrtheremergencyrdepartmentrtorstabilizerarclient'srconditi
on."
TherEmergencyrMedicalrTreatmentrandrActiverLaborrAct,rnotradvancerdirectives,rdirectsre
mergencyrpersonnelrtorproviderscreeningrandrstabilizingrcarerbeforerdischargingrorrtransfer
ringrclientsrtoranotherrfacility.
Arnurserisrcaringrforrarclientrwhorhasrarprescriptionrforr5runitsrofrregularrinsulinrandr10runitsrof
rNPHrinsulinrtormixrtogetherrandradministerrsubcutaneously. rDeterminerthercorrectrorderrofr
stepsrforrthisrprocedure.r
Injectr5runitsrofrairrintortherbottlerofrregularrinsulin
WithdrawrthercorrectrdoserofrNPHrinsulinrfromrtherbottle
Injectr10runitsrofrairrintortherbottlerofrNPHrinsulin
Withdrawrthercorrectrdoserofrregularrinsulinrfromrtherbottler-rans✔✔CorrectrAnswer:
Injectr10runitsrofrairrintortherbottlerofrNPHrinsulin
Injectr5runitsrofrairrintortherbottlerofrregularrinsulin
Withdrawrthercorrectrdoserofrregularrinsulinrfromrtherbottle
WithdrawrthercorrectrdoserofrNPHrinsulinrfromrtherbottle
ThernursershouldrfirstrinjectrairrintorthervialrofrNPHrinsulinrwithoutrtouchingrtherneedlertorther
solution.rNext,rthernursershouldrinjectrairrintorthervialrofrregularrinsulinrandrwithdrawrthercorr
ectramountrofrtherregularrinsulin.rFinally,rthernursershouldrinsertrtherneedlerintortherNPHrins
ulinrvialrandrwithdrawrthercorrectramountrofrNPHrinsulin.rThernursershouldrfollowrtheserstep
srtorpreventrcontaminatingrtherregularrinsulinrwithrNPHrinsulin.
ArnurserisrperformingrarRombergrtestrduringrtherphysicalrassessmentrofrarclient.rWhichrofrth
erfollowingrtechniquesrshouldrthernurseruse?
Touchrtherfacerwithrarcottonrball.
Applyrarvibratingrtuningrforkrtortherclient'srforehead.
