FUNDAMENTAL PN ATI TEST BANK /ATI PN
FUNDAMENTAL TEST BANK REAL 300+QUESTION
AND ANSWERS WITH RATIONALES LATEST 2024-
2023.
A nurse is collecting data from a client who is 2 days postoperative following a
colostomy. Which of the following findings should the nurse report to the
provider?
a. a purple-colored stoma
b. protrusion of the stoma
c. a small amount of bleeding from the stoma
d. intestinal gas in the pouch - ANSWER- a. a purple-colored stoma
RATIONALE:--The stoma should be reddish-pink and moist. A purple colored
stoma is an indication of poor circulation, and the nurse should report this finding
to the provider immediately.
A nurse is reinforcing teaching about carbohydrate counting with a client who has a
new diagnosis of diabetes mellitus. Which of the following actions should the
nurse take first?
a. use pictures of different food groups to help the client plan a daily menu
b. ask the client what he already knows about meal planning
c. give the client a brochure with sample menus for all meals
d. involve the family in the discussion of the client's meal plan - ANSWER- b. ask
the client what he already knows about meal planning
RATIONALE:--The first action the nurse should take using the nursing process is
to collect data to determine the client's current level of knowledge. Then, the nurse
can plan education to meet the client's needs.
A nurse is assisting with the admission of an adult client to a medical-surgical unit.
Which of the following findings should the nurse identify as an indication that the
client is malnourished? a. heart rate 89/min
b. pink mucous membranes
c. pale, scaly skin
,d. body mass index 23 - ANSWER- c. pale, scaly skin
RATIONALE:--The nurse should identify that pale, scaly skin can indicate
malnutrition. The skin should be smooth and pink in light-skinned individuals who
are well-nourished.
A nurse is reinforcing teaching about advance directives with a client who has
endstage renal disease. Which of the following client statements indicates an
understanding of the teaching?
a. "I know that i can change my advance directives if I need to in the future."
b. "My health care proxy will make my health care decisions as soon as I have
signed the power of attorney."
c. "My family can overrule the decisions made by my health care proxy."
d. "Advance directives from one state are valid in any other state." - ANSWER- a.
"I know that i can change my advance directives if I need to in the future."
RATIONALE:--The client can change her advance directives at her discretion.
A nurse is preparing a client for a Romberg test. Which of the following statements
should the nurse make?
a. "Stand with your feet together and your arms at your sides."
b. "After I place the tuning fork, tell me when you no longer hear the sound"
c. "I'm going to stroke the lateral side of the bottom of your foot."
d. "Touch each fingertip as quickly as possible with your thumb." - ANSWER- a.
"Stand with your feet together and your arms at your sides."
RATIONALE:--The Romberg test measures stability with and without the eyes
closed. The nurse should instruct the client to stand with his feet together and his
arms at his sides.
A nurse is preparing to administer a medication to a preschooler and must convert
the child's weight from pounds to kilograms. The child weighs 30 lb. How many
kilograms does the child weigh?
(Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use
a trailing zero.) - ANSWER- 13.6 Kg
30/2.2
A nurse is contributing to the plan of care for a client who is dying. Which of the
following interventions should the nurse recommend to include the client's family
in the plan of care? (Select all that apply.)
a. keep the family updated about the client's status
,b. Suggest the family members return home at night to allow the client to rest
c. encourage the family to comb the clients hair
d. tell the client's family what to expect as the client's death nears
e. ask the family to encourage the client to eat - ANSWER- a. keep the family
updated about the client's status
RATIONALE:--the nurse should keep the family updated about the client's status
to assist the family in planning for the near future
b. Suggest the family members return home at night to allow the client to rest the
nurse should encourage a family member to stay throughout the night to lessen
the client's feelings of isolation
c. encourage the family to comb the clients hair
-the nurse should find simple care activities for the family to perform, such as
combing the client's hair
d. tell the client's family what to expect as the client's death nears
-Many family members do not know what to expect. The nurse should explain the
manifestations of impending death to reduce the family members' anxiety and
stress.
e. ask the family to encourage the client to eat
-The nurse should inform the family that forcing the client to eat can increase
discomfort.
A nurse is checking a client for a pulse deficit after detecting an irregular heart rate.
Which of the following actions should the nurse take?
a. count the client's radial and apical pulses simultaneously with another nurse.
b. calculate the client's pulse for 30 seconds and multiply by 2
c. assist the client to a side-lying position
d. auscultate the area of the client's chest over the Erb's point - ANSWER- a. count
the client's radial and apical pulses simultaneously with another nurse.
RATIONALE:--The nurse should have another nurse count the radial pulse as he
counts the apical pulse. A pulse deficit occurs when there are differences between
the radial and apical pulse rates.
A nurse is reinforcing teaching with a client who is scheduled for a bladder scan.
Which of the following instructions should the nurse include in the teaching? a.
"You will need to sign a consent form before we begin the procedure."
b. "I will place a gel pad directly above your pubic area before I place the probe."
c. "You will need to hold your urine for 1 hour prior to the procedure."
, d. "You will receive a contrast dye through an IV catheter prior to the scan." -
ANSWER- b. "I will place a gel pad directly above your pubic area before I
place the probe."
RATIONALE:--The nurse should use a gel pad, which promotes ultrasound
transmission and accurate measurement. The correct placement of the ultrasound
device is just above the symphysis pubis.
A charge nurse is reinforcing teaching with a newly licensed nurse who is setting
up a sterile field. Which of the following actions by the newly licensed nurse
indicates an understanding of the teaching?
a. opening the first flap of a sterile package toward herself
b. dropping sterile gauze onto the field from a height of 7.5 cm (3 in)
c. removing and inverting a lid before placing it onto a nonsterile surface
d. maintaining the sterile field below waist level. - ANSWER- c. removing and
inverting a lid before placing it onto a nonsterile surface
RATIONALE:--The nurse should invert the lid to prevent contamination of the
inside surface prior to placing ti on a nonsterile surface
A nurse is caring for a client who has been vomiting excessively and has diarrhea.
Which of the following findings should the nurse identify as an indication of fluid
volume deficit?
a. BUN 18 mg/dL
b. a bounding pulse
c. urine specific gravity 1.045
d. prominent neck veins - ANSWER- c. urine specific gravity 1.045
RATIONALE:--The nurse should identify that a specific gravity higher than
1.025 indicates that the client's urine is more concentrated, which can be a
manifestation of fluid volume deficit resulting from dehydration
A nurse is providing care to four clients in an acute care setting. The nurse should
identify that which of the following client statements presents and ethical
dilemma?
a. "I might file a lawsuit because of how my surgery went."
b. "Please don't tell my doctor, but I am taking my partner's oxycodone."
c. "Please don't get me out of bed this morning. It hurts too much."
d. "I don't want to take my medicine. It makes me sick to my stomach." -
ANSWER- b. "Please don't tell my doctor, but I am taking my partner's
oxycodone."
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