ATI FUNDAMENTALS 2 QUESTIONS AND ANSWERS
A nurse is caring for a toddler at a well-child visit when the mother calls to the nurse, "Help! My baby is
choking on his food." Which of the following findings indicates the toddler has an airway obstruction? -
Answer Inability of the toddle to cry or speak.
bc no sounds passing through vocal cords
use heimliech maneuver
A nurse is planning care for a client who has a prescription for collection of a sputum specimen for
culture and sensitivity. Which of the following actions should the nurse take when obtaining the
specimen? - Answer Collect the specimen upon arising in the morning.
in the morning it's easier to cough up secretions
deepest specimens are usually collected in morning
try to collect before breakfast
prior to coughing into container: rinse mouth and deep breathe
A nurse is caring for a client who has a history of dysrhythmias. Upon entering the room, the nurse
discovers the client is unresponsive to verbal or painful stimuli, has no respirations, and is pulseless.
Which of the following actions should the nurse take first? - Answer Start chest compressions.
give priority to the factor or situation posing the greatest safety risk.
A nurse is teaching a client who is recovering from gallbladder surgery how to use an incentive
spirometer. Which of the following information should the nurse include in the teaching? - Answer
Hold breath for 5 seconds after goal volume is reached.
Rationale: decreases collapse of alveoli, which helps prevent risk of atelectasis and pneumonia
, nurse is preparing to remove an NG tube for a client who had a partial colectomy. Which of the
following actions should the nurse take? - Answer Pinch the NG tube while removing the tube.
decreases risk of aspiration of any GI contents
A nurse is providing teaching to a client who has a new colostomy about proper care. Which of the
following information should the nurse include in the teaching. - Answer Cleanse the skin around the
stoma with warm water.
using soap can leave a residue and cause poor adherence of pouch
A nurse is performing a straight urinary catheterization for a female client who has urinary retention.
Which of the following actions indicates the nurse is maintaining sterile technique? - Answer Wipes
the labia minor in an anteroposterior direction.
The nurse should wipe anteroposterior both the right & left labia minora w/ sperate cotton swabs to
destroy any microorganisms in the area that would contaminate.
A nurse is caring for a client who has an NG tube for intermittent enteral feedings. Which of the
following actions should the nurse take?
. - Answer Elevate the client's head of bed 45 degrees before the feeding.
Rationale: the nurse should do this to prevent aspiration
nurse is collecting a urine specimen for a culture and sensitivity for a client who has a urinary tract
infection. The client has an indwelling urinary catheter in place. Which of the following actions should
the nurse take? - Answer Clamp the tubing below the collection port.
A nurse is caring for a toddler at a well-child visit when the mother calls to the nurse, "Help! My baby is
choking on his food." Which of the following findings indicates the toddler has an airway obstruction? -
Answer Inability of the toddle to cry or speak.
bc no sounds passing through vocal cords
use heimliech maneuver
A nurse is planning care for a client who has a prescription for collection of a sputum specimen for
culture and sensitivity. Which of the following actions should the nurse take when obtaining the
specimen? - Answer Collect the specimen upon arising in the morning.
in the morning it's easier to cough up secretions
deepest specimens are usually collected in morning
try to collect before breakfast
prior to coughing into container: rinse mouth and deep breathe
A nurse is caring for a client who has a history of dysrhythmias. Upon entering the room, the nurse
discovers the client is unresponsive to verbal or painful stimuli, has no respirations, and is pulseless.
Which of the following actions should the nurse take first? - Answer Start chest compressions.
give priority to the factor or situation posing the greatest safety risk.
A nurse is teaching a client who is recovering from gallbladder surgery how to use an incentive
spirometer. Which of the following information should the nurse include in the teaching? - Answer
Hold breath for 5 seconds after goal volume is reached.
Rationale: decreases collapse of alveoli, which helps prevent risk of atelectasis and pneumonia
, nurse is preparing to remove an NG tube for a client who had a partial colectomy. Which of the
following actions should the nurse take? - Answer Pinch the NG tube while removing the tube.
decreases risk of aspiration of any GI contents
A nurse is providing teaching to a client who has a new colostomy about proper care. Which of the
following information should the nurse include in the teaching. - Answer Cleanse the skin around the
stoma with warm water.
using soap can leave a residue and cause poor adherence of pouch
A nurse is performing a straight urinary catheterization for a female client who has urinary retention.
Which of the following actions indicates the nurse is maintaining sterile technique? - Answer Wipes
the labia minor in an anteroposterior direction.
The nurse should wipe anteroposterior both the right & left labia minora w/ sperate cotton swabs to
destroy any microorganisms in the area that would contaminate.
A nurse is caring for a client who has an NG tube for intermittent enteral feedings. Which of the
following actions should the nurse take?
. - Answer Elevate the client's head of bed 45 degrees before the feeding.
Rationale: the nurse should do this to prevent aspiration
nurse is collecting a urine specimen for a culture and sensitivity for a client who has a urinary tract
infection. The client has an indwelling urinary catheter in place. Which of the following actions should
the nurse take? - Answer Clamp the tubing below the collection port.
