ATI Fundamentals Retake\\\ATI
Fundamentals Retake 2025 – Complete
Questions & Verified A+ Answers
A charge nurse is discussing THE responsibility of nurses caring for clients who have Clostridium
difficile infection. Which of THE following information should THE nurse include in THE teaching?
a. assign THE client to a room with a negative airflow system
b. use alcohol-based hand sanitizer when leaving THE client's room
c. clean contaminated surfaces in THE client's room with a phenol solution
d. have family members wear a gown and gloves when visiting
d. have family members wear a gown and gloves when visiting
A client who has a Clostridium difficile infection requires a private room, but a negative airflow system is
not necessary.
Use alcohol-based hand sanitizer when leaving THE client's room. THE nurse should use soap and water
for hand hygiene because alcohol-based hand sanitizer does not kill Clostridium difficile spores.
Clean contaminated surfaces in THE client's room with a phenol solution.THE nurse should use a phenol
solution to clean surfaces contaminated with bacteria and fungi. However, phenol does not
kill Clostridium difficile spores. Chlorine bleach is an example of a disinfectant that kills spores.
Have family members wear a gown and gloves when visiting.Nurses are responsible for ensuring that
family members wear a gown and gloves to prevent THE transmission of Clostridium difficile spores.
Staff must also wear gowns and gloves.
A nurse is giving change of shift report about a client THEy admitted earlier that day who has
pneumonia. Which of THE following pieces of info is THE priority for THE nurse to provide?
a. admitting diagnosis
b. breath sounds
c. body temperature
d. diagnostic test results
b. breath sounds
When using THE airway, breathing, circulation approach to client care, THE nurse should determine that
THE priority information to provide is THE current status of THE client's breath sounds. Knowing THE
client's admitting diagnosis is essential for planning care and following critical pathways; however,
oTHEr information is THE nurse's priority to provide. Body temperature
Knowing THE client's current body temperature is essential for planning care and following critical
pathways; however, oTHEr information is THE nurse's priority to provide. Knowing diagnostic test results
,is essential for planning care and following critical pathways; however, oTHEr information is THE nurse's
priority to provide.
A nurse is preparing to delegate client care tasks to an assistive personnel(AP). Which of THE following
tasks should THE nurse delegate?
a. ambulating a client who is postop
b. inserting an indwelling urinary caTHEter for a client
c. demonstrating THE use of an incentive spirometer to a client
d. confirming that a client's pain has decreased after receiving an analgesic
a. ambulating a client who is postop
Ambulating a client is within THE range of function of an AP. THE nurse can delegate tasks to THE AP
that do not require special skills, assessment, or teaching.
Inserting an indwelling urinary caTHEter for a clientIndwelling urinary caTHEter insertion requires
advanced nursing judgment and sterile technique. This task is outside THE range of function of an AP.
Demonstrating THE use of an incentive spirometer to a clientClient education requires advanced nursing
knowledge and is outside THE range of function of an AP.
Confirming that a client's pain has decreased after receiving an analgesicEvaluating a client's pain level
requires advanced nursing judgment and is outside THE range of function of an AP.
A nurse enters a client's room and finds her on THE floor. THE client's roommate reports that THE
client was trying to get out of bed and fell over THE side rail onto THE floor. Which of THE following
statements should THE nurse document about this incident?
a. "incident report completed"
b. "client climbed over THE side rails"
c. "client found lying on THE floor"
d. "client was trying to get out of bed"
c. "client found lying on THE floor"
An incident report is an internal document that is part of a facility's risk management system. THE nurse
should not document completion of an incident report in THE client's medical record for THE facility's
protection in THE event of litigation.
"Client climbed over THE side rails."Unless THE nurse witnessed THE client climbing over THE bed's side
rails, this statement is not an objective account of THE nurse's findings.
"Client found lying on floor." THE nurse should include documentation of information that is descriptive
and objective concerning what THE nurse actually observed, without including any opinions or
judgments about motives or cause.
"Client was trying to get out of bed."Unless THE nurse witnessed THE client trying to get out of bed, this
statement is not an objective account of THE nurse's findings.
A nurse is caring for a client who has a prescription for wound irrigation. Which of THE following
actions should THE nurse take?
a. wear sterile gloves when removing THE old dressing
b. warm THE irrigation solution to 40.5(105 degrees farenheit)
,c. cleanse THE wound from THE center outward
d. use a 20 mL syringe to irrigate THE wound.
c. cleanse THE wound from THE center outward
THE nurse should wear clean gloves to remove THE old dressing.
Warm THE irrigation solution to 40.5° C (105° F).THE nurse should warm THE irrigation solution to body
temperature.
Cleanse THE wound from THE center outward. THE nurse should clean THE wound from THE center
outward to prevent introduction of micro-organisms from THE outer skin surface.
Use a 20-mL syringe to irrigate THE wound.THE nurse should use a 35-mL syringe to irrigate THE wound.
Syringes that hold 30 to 60 mL of fluid create a safe but effective amount of pressure for wound
irrigation.
A nurse is admitting a client who has rubella. Which of THE following types of transmission based
precautions should THE nurse initiate?
a. droplet
b. airborne
c. contact
d. protective environment
a. droplet
Droplet precautions are a requirement for clients who have infections that spread via droplet nuclei that
are larger than 5 microns in diameter, including influenza, rubella, meningococcal pneumonia, and
streptococcal pharyngitis.
Airborne precautions are a requirement for clients who have infections that spread via droplet nuclei
that are smaller than 5 microns in diameter, including varicella, tuberculosis, and measles.
Contact precautions are a requirement for clients who have infections that spread via direct contact
with anoTHEr person or contact with THE environment, including vancomycin-resistant enterococci,
methicillin-resistant Staphylococcus aureus, and scabies.
Protective environment Clients who have a compromised immune system, such as those who have had
an allogeneic hematopoietic stem cell transplant, require a protective environment.
THE nurse is providing discharge teaching for a client who has a new prescription for a home oxygen
concentrator. Which of THE following instructions should THE nurse provide to THE client and his
family? select all that apply.
a. check THE cord routinely for frays and tearing
b. keep THE unit at least 1.2 m (4 feet) away from a gas stove
c. consider purchasing a generator for power backup
d. observe for signs of hypoxia
d. select synTHEtic clothing and bedding
a,c,d
, Check THE cord routinely for frays or tearing is correct. Oxygen concentrators require electrical power.
Safe use of this delivery system includes assessing THE electrical function of THE device; THErefore, THE
nurse should instruct THE client to routinely check THE condition of THE cord.Keep THE unit at least 1.2
m (4 feet) away from a gas stove is incorrect. Safe use of home oxygen equipment includes keeping THE
unit at least 3.05 m (10 feet) away from open flames, such as from a fireplace or a gas stove, and at least
2.4 m (8 feet) away from oTHEr heat sources.Consider purchasing a generator for power backup is
correct. Loss of electricity prevents THE oxygen concentrator from functioning and could deprive THE
client of necessary oxygen. THE nurse should also instruct THE family to have THE client placed on THEir
municipality's priority list for restoring power after an outage occurs.Observe for signs of hypoxia is
correct. THE nurse should instruct THE family to observe for
A nurse is calculating a client's fluid intake over THE past 8 hr. Which of THE following should THE
nurse plan to document on THE client's intake and output record as 120 mL of fluid?
a. 2 cups of soup
b. 1 quart of water
c. 8 oz of ice chips
d. 6 oz of tea
c. 8 oz of ice chips
2 cups of soup. THE nurse should understand that 2 cups of soup are equivalent to 480 mL of fluid.
1 quart of water. THE nurse should understand that 1 quart of water is equivalent to 960 to 1,000 mL of
fluid.
8 oz of ice chips. THE nurse should document half of THE volume of ice chips when calculating fluid
intake to account for THE air in between THE chips. THE nurse should understand that 4 oz of liquid
water is equal to 120 mL of fluid.
6 oz of tea. THE nurse should understand that 6 oz of tea is equal to 180 mL of fluid.
A nurse is caring for a client who has tuberculosis. Which of THE following actions should THE nurse
take? (select all that apply)
a. place THE client in a room with negative airflow pressure
b. wear gloves when assisting THE client with oral care
c. limit each visitor to 2 hr increments
d. wear a surgical mask when providing client care
e. use antimicrobial sanitizer for hand hygiene
a,b,e
A nurse is caring for a client who is refusing a blood transfusion for religious reasons. THE client's
partner wants THE client to have THE blood transfusion. Which of THE following actions should THE
nurse take?
a. ask THE client to consider a direct donation
b. withhold THE blood transfusion
c. request a consultation with THE ethics committee
d. ask THE client's family to intervene
Fundamentals Retake 2025 – Complete
Questions & Verified A+ Answers
A charge nurse is discussing THE responsibility of nurses caring for clients who have Clostridium
difficile infection. Which of THE following information should THE nurse include in THE teaching?
a. assign THE client to a room with a negative airflow system
b. use alcohol-based hand sanitizer when leaving THE client's room
c. clean contaminated surfaces in THE client's room with a phenol solution
d. have family members wear a gown and gloves when visiting
d. have family members wear a gown and gloves when visiting
A client who has a Clostridium difficile infection requires a private room, but a negative airflow system is
not necessary.
Use alcohol-based hand sanitizer when leaving THE client's room. THE nurse should use soap and water
for hand hygiene because alcohol-based hand sanitizer does not kill Clostridium difficile spores.
Clean contaminated surfaces in THE client's room with a phenol solution.THE nurse should use a phenol
solution to clean surfaces contaminated with bacteria and fungi. However, phenol does not
kill Clostridium difficile spores. Chlorine bleach is an example of a disinfectant that kills spores.
Have family members wear a gown and gloves when visiting.Nurses are responsible for ensuring that
family members wear a gown and gloves to prevent THE transmission of Clostridium difficile spores.
Staff must also wear gowns and gloves.
A nurse is giving change of shift report about a client THEy admitted earlier that day who has
pneumonia. Which of THE following pieces of info is THE priority for THE nurse to provide?
a. admitting diagnosis
b. breath sounds
c. body temperature
d. diagnostic test results
b. breath sounds
When using THE airway, breathing, circulation approach to client care, THE nurse should determine that
THE priority information to provide is THE current status of THE client's breath sounds. Knowing THE
client's admitting diagnosis is essential for planning care and following critical pathways; however,
oTHEr information is THE nurse's priority to provide. Body temperature
Knowing THE client's current body temperature is essential for planning care and following critical
pathways; however, oTHEr information is THE nurse's priority to provide. Knowing diagnostic test results
,is essential for planning care and following critical pathways; however, oTHEr information is THE nurse's
priority to provide.
A nurse is preparing to delegate client care tasks to an assistive personnel(AP). Which of THE following
tasks should THE nurse delegate?
a. ambulating a client who is postop
b. inserting an indwelling urinary caTHEter for a client
c. demonstrating THE use of an incentive spirometer to a client
d. confirming that a client's pain has decreased after receiving an analgesic
a. ambulating a client who is postop
Ambulating a client is within THE range of function of an AP. THE nurse can delegate tasks to THE AP
that do not require special skills, assessment, or teaching.
Inserting an indwelling urinary caTHEter for a clientIndwelling urinary caTHEter insertion requires
advanced nursing judgment and sterile technique. This task is outside THE range of function of an AP.
Demonstrating THE use of an incentive spirometer to a clientClient education requires advanced nursing
knowledge and is outside THE range of function of an AP.
Confirming that a client's pain has decreased after receiving an analgesicEvaluating a client's pain level
requires advanced nursing judgment and is outside THE range of function of an AP.
A nurse enters a client's room and finds her on THE floor. THE client's roommate reports that THE
client was trying to get out of bed and fell over THE side rail onto THE floor. Which of THE following
statements should THE nurse document about this incident?
a. "incident report completed"
b. "client climbed over THE side rails"
c. "client found lying on THE floor"
d. "client was trying to get out of bed"
c. "client found lying on THE floor"
An incident report is an internal document that is part of a facility's risk management system. THE nurse
should not document completion of an incident report in THE client's medical record for THE facility's
protection in THE event of litigation.
"Client climbed over THE side rails."Unless THE nurse witnessed THE client climbing over THE bed's side
rails, this statement is not an objective account of THE nurse's findings.
"Client found lying on floor." THE nurse should include documentation of information that is descriptive
and objective concerning what THE nurse actually observed, without including any opinions or
judgments about motives or cause.
"Client was trying to get out of bed."Unless THE nurse witnessed THE client trying to get out of bed, this
statement is not an objective account of THE nurse's findings.
A nurse is caring for a client who has a prescription for wound irrigation. Which of THE following
actions should THE nurse take?
a. wear sterile gloves when removing THE old dressing
b. warm THE irrigation solution to 40.5(105 degrees farenheit)
,c. cleanse THE wound from THE center outward
d. use a 20 mL syringe to irrigate THE wound.
c. cleanse THE wound from THE center outward
THE nurse should wear clean gloves to remove THE old dressing.
Warm THE irrigation solution to 40.5° C (105° F).THE nurse should warm THE irrigation solution to body
temperature.
Cleanse THE wound from THE center outward. THE nurse should clean THE wound from THE center
outward to prevent introduction of micro-organisms from THE outer skin surface.
Use a 20-mL syringe to irrigate THE wound.THE nurse should use a 35-mL syringe to irrigate THE wound.
Syringes that hold 30 to 60 mL of fluid create a safe but effective amount of pressure for wound
irrigation.
A nurse is admitting a client who has rubella. Which of THE following types of transmission based
precautions should THE nurse initiate?
a. droplet
b. airborne
c. contact
d. protective environment
a. droplet
Droplet precautions are a requirement for clients who have infections that spread via droplet nuclei that
are larger than 5 microns in diameter, including influenza, rubella, meningococcal pneumonia, and
streptococcal pharyngitis.
Airborne precautions are a requirement for clients who have infections that spread via droplet nuclei
that are smaller than 5 microns in diameter, including varicella, tuberculosis, and measles.
Contact precautions are a requirement for clients who have infections that spread via direct contact
with anoTHEr person or contact with THE environment, including vancomycin-resistant enterococci,
methicillin-resistant Staphylococcus aureus, and scabies.
Protective environment Clients who have a compromised immune system, such as those who have had
an allogeneic hematopoietic stem cell transplant, require a protective environment.
THE nurse is providing discharge teaching for a client who has a new prescription for a home oxygen
concentrator. Which of THE following instructions should THE nurse provide to THE client and his
family? select all that apply.
a. check THE cord routinely for frays and tearing
b. keep THE unit at least 1.2 m (4 feet) away from a gas stove
c. consider purchasing a generator for power backup
d. observe for signs of hypoxia
d. select synTHEtic clothing and bedding
a,c,d
, Check THE cord routinely for frays or tearing is correct. Oxygen concentrators require electrical power.
Safe use of this delivery system includes assessing THE electrical function of THE device; THErefore, THE
nurse should instruct THE client to routinely check THE condition of THE cord.Keep THE unit at least 1.2
m (4 feet) away from a gas stove is incorrect. Safe use of home oxygen equipment includes keeping THE
unit at least 3.05 m (10 feet) away from open flames, such as from a fireplace or a gas stove, and at least
2.4 m (8 feet) away from oTHEr heat sources.Consider purchasing a generator for power backup is
correct. Loss of electricity prevents THE oxygen concentrator from functioning and could deprive THE
client of necessary oxygen. THE nurse should also instruct THE family to have THE client placed on THEir
municipality's priority list for restoring power after an outage occurs.Observe for signs of hypoxia is
correct. THE nurse should instruct THE family to observe for
A nurse is calculating a client's fluid intake over THE past 8 hr. Which of THE following should THE
nurse plan to document on THE client's intake and output record as 120 mL of fluid?
a. 2 cups of soup
b. 1 quart of water
c. 8 oz of ice chips
d. 6 oz of tea
c. 8 oz of ice chips
2 cups of soup. THE nurse should understand that 2 cups of soup are equivalent to 480 mL of fluid.
1 quart of water. THE nurse should understand that 1 quart of water is equivalent to 960 to 1,000 mL of
fluid.
8 oz of ice chips. THE nurse should document half of THE volume of ice chips when calculating fluid
intake to account for THE air in between THE chips. THE nurse should understand that 4 oz of liquid
water is equal to 120 mL of fluid.
6 oz of tea. THE nurse should understand that 6 oz of tea is equal to 180 mL of fluid.
A nurse is caring for a client who has tuberculosis. Which of THE following actions should THE nurse
take? (select all that apply)
a. place THE client in a room with negative airflow pressure
b. wear gloves when assisting THE client with oral care
c. limit each visitor to 2 hr increments
d. wear a surgical mask when providing client care
e. use antimicrobial sanitizer for hand hygiene
a,b,e
A nurse is caring for a client who is refusing a blood transfusion for religious reasons. THE client's
partner wants THE client to have THE blood transfusion. Which of THE following actions should THE
nurse take?
a. ask THE client to consider a direct donation
b. withhold THE blood transfusion
c. request a consultation with THE ethics committee
d. ask THE client's family to intervene
