ATI Fundamentals Proctored Exam, ATI
Fundamentals Retake complete latest
update
A nurse is planning care for a group of clients. Which of the following tasks should the
nurse delegate to an assistive personnel?
a. Changing the dressing for a client who has a stage 3 pressure injury
b. Determining a client's response to a diuretic
c. Comparing radial pulses for a client who is postoperative
d. Providing postmortem care to a client - answers d. Providing postmortem care to a
client
A nurse is conducting a health assessment for a client who takes herbal supplements.
Which of the following statements by the client indicates an understanding of the use of
the supplements?
A. I take ginkgo biloba for a headache
B. I take echinacea to control my cholesterol
C. I use ginger when I get car sick
D. I use garlic for my menopausal symptoms
- answers I use ginger when I get car sick
A nurse is caring for a client who has influenza and isolation precautions in place.
Which of the following actions should the nurse take to prevent the spread of infection?
A. Wear a mask when working within 3 feet of the client
B. Administer metronidazole
C. Don protective eyewear before entering the room.
D. Place the client in a negative airflow room. - answers Wear a mask when working
within 3 feet of the client
A nurse obtains a prescription for wrist restraints for a client who is trying to pull out his
NG tube. Which of the following actions should the nurse take?
A. Attach the restraints securely to the side rails of the client's bed.
B. Apply the restraints to allow as little movement as possible
C.Allow room for two fingers to fit between the clients skin and the restraints
,d. remove the restraints every 4 hours - answers Allow room for two fingers to fit
between the clients skin and the restraints
A nurse is admitting a client who has tuberculosis. Which of the following types of
transmission precautions should the nurse plan to initiate?
A. Droplet
B. Airborne
c. protective environment
d. contact - answers Airborne
A nurse in a well-child clinic receives a telephone call from a parent who states that their
child accidentally swallowed paint thinner. The child is awake and alert. Which of the
following responses should the nurse make?
A. Have your child drink one large glass of water.
B. Hang up and call a poison control center hotline.
C. Bring your child into the clinic later today.
D. Induce vomiting in your child with syrup of ipecac. - answers Have your child drink
one large glass of water
A nurse is documenting a client's medical record. Which of the following entries should
the nurse record.
A. Oral temperature slightly elevated at 0800
B. Administered pain medication
C. Incision without redness or drainage
D. Drank adequate amounts of fluid with meals. - answers Administered pain
medication
A nurse is providing oral care for a client who is unconscious. Which of the following
actions should the nurse take?
A. Place the client in a side-lying position.
B. Brush the clients teeth daily
C. Apply mineral oil to the client's lips
D. Rinse the client's mouth with an alcohol-based mouthwash - answers Place the
client in a side-lying position
A nurse is collaborating with a risk management team about potential legal issues
involving client care. The nurse should identify which of the following situations is an
example of negligence?
A. A nurse administers a medication without first identifying the client.
B. An assistive personnel discusses client care in the facility cafeteria with visitors
present.
C. A nurse begins a blood transfusion without obtaining consent.
D. An assistive personnel prevents a client from leaving the facility. - answers A nurse
begins a blood transfusion without obtaining consent
A nurse is collecting a sputum specimen for culture from a client who has a respiratory
infection. Which of the following actions should the nurse take?
,A. Wear sterile gloves when collecting the specimen.
B. Offer the client oral hygiene after the collection
C. Collect the specimen in the evening.
D Collect 1 ml of sputum. - answers Offer the client oral hygiene after the collection
A nurse is assessing an older client. Which of the following findings should the nurse
expect?
a. Decreased sense of balance
b. Increased nighttime sleeping
c. Heightened sense of pain
d. Nighttime urinary incontinence - answers Decreased sense of balance
A nurse is completing discharge teaching about ostomy care with a client who has a
new stoma. Which of the following instructions should the nurse include in the teaching?
(select all that apply)
a. "Cut the opening of the pouch 1⁄8 of an inch larger than the stoma "
b. "Place a piece a gauze over the stoma while changing the pouch"
c. "Use povidone-iodine to clean around the stoma"
d. "Empty the ostomy pouch when it becomes one-third full of contents"
e. expect the stoma to turn a purple-blue color as its heals" - answers Cut the opening
of the pouch 1⁄8 of an inch larger than the stoma
Place a piece a gauze over the stoma while changing the pouch
Use povidone-iodine to clean around the stoma
Empty the ostomy pouch when it becomes one-third full of contents
A nurse is preparing to obtain informed consent from a client who speaks a different
language than the nurse. Which of the following actions should the nurse take?
a. "Request that an assistive personnel interpret the information for the client"
b. "Use proper medical terms when giving information to the client"
c. "Offer written information in the client's language"
d. "Avoid using gestures when speaking to the client" - answers Offer written
information in the client's language
A nurse is teaching a client about home care equipment. Which of the following
information should the nurse include in the teaching? (select all that apply)
a. "Avoid using wool blankets when receiving oxygen"
b. check the O2 delivery rate at least once a day
c. align the middle of the ball in the flow meter with the line of the prescribed flow rate
d. "Keep the oxygen delivery system 0.6 m (2 feet) from any heat source"
e. "Lay the oxygen tank flat when storing" - answers Avoid using wool blankets when
receiving oxygen
check the O2 delivery rate at least once a day
, align the middle of the ball in the flow meter with the line of the prescribed flow rate
A nurse is planning care for a client who reports insomnia. Which of the following
actions should the nurse perform shortly before bedtime?
a. Provide a late supper.
b. Offer a wet washcloth for the client to wash her face
c. Perform range-of-motion exercises
d. Prepare hot cocoa or tea for the client - answers Provide a late supper
A nurse on a medical-surgical unit is receiving a change-of-shift report for four clients.
Which of the following clients should the nurse see first?
a. A client who has acute abdominal pain of 4 on a scale from 0 to 10
b. A client who has pneumonia and an oxygen saturation of 96%
c. A client who has new onset of dyspnea 24hr after a total hip arthroplasty •
d. A client who
has a urinary tract infection and low-grade fever - answers A client who has new onset
of dyspnea 24hr after a total hip arthroplasty
A nurse is reviewing a client's intake and output and notes the following: 0.9% sodium
chloride 600mL IV infusion, cefazolin 250 mg in dextrose 5% in water 100mL
intermittent IV bolus, 200mL emesis, 40mL voided urine, and 20mL urine from straight
catheterization. The nurse should record the client's net fluid intake as how many mL?
(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not
use a trailing zero.)
DOSAGE CALCULATION - answers 700 mL
A nurse is discussing incident reports with a group of newly licensed nurses. The nurse
should include that which if the following requires the completion of an incident report?
a. A client's prescribed laboratory testing was not obtained
b. A client withdrew consent for a procedure
c. An oncoming nurse arrived to work late
d. A nurse transfused a unit of packed RBCs in 2 hr. - answers A client's prescribed
laboratory testing was not obtained
A nurse is caring for a client who has a new prescription for negative-pressure therapy
for a chronic wound. The nurse is unfamiliar with the procedure. Which of the following
resources should the nurse consult to learn more about the intervention.
a. The client's plan of care
b. The nurse practice act
c. The material safety data sheet
d. The policy and procedure manual - answers The policy and procedure manual
A nurse is performing postural drainage with percussion and vibration for a client who
has cystic fibrosis. Which of the following actions should the nurse take?
a. Cover the area of percussion with a towel.
b. Instruct the client to exhale quickly during vibration
c. Schedule postural drainage after meals
Fundamentals Retake complete latest
update
A nurse is planning care for a group of clients. Which of the following tasks should the
nurse delegate to an assistive personnel?
a. Changing the dressing for a client who has a stage 3 pressure injury
b. Determining a client's response to a diuretic
c. Comparing radial pulses for a client who is postoperative
d. Providing postmortem care to a client - answers d. Providing postmortem care to a
client
A nurse is conducting a health assessment for a client who takes herbal supplements.
Which of the following statements by the client indicates an understanding of the use of
the supplements?
A. I take ginkgo biloba for a headache
B. I take echinacea to control my cholesterol
C. I use ginger when I get car sick
D. I use garlic for my menopausal symptoms
- answers I use ginger when I get car sick
A nurse is caring for a client who has influenza and isolation precautions in place.
Which of the following actions should the nurse take to prevent the spread of infection?
A. Wear a mask when working within 3 feet of the client
B. Administer metronidazole
C. Don protective eyewear before entering the room.
D. Place the client in a negative airflow room. - answers Wear a mask when working
within 3 feet of the client
A nurse obtains a prescription for wrist restraints for a client who is trying to pull out his
NG tube. Which of the following actions should the nurse take?
A. Attach the restraints securely to the side rails of the client's bed.
B. Apply the restraints to allow as little movement as possible
C.Allow room for two fingers to fit between the clients skin and the restraints
,d. remove the restraints every 4 hours - answers Allow room for two fingers to fit
between the clients skin and the restraints
A nurse is admitting a client who has tuberculosis. Which of the following types of
transmission precautions should the nurse plan to initiate?
A. Droplet
B. Airborne
c. protective environment
d. contact - answers Airborne
A nurse in a well-child clinic receives a telephone call from a parent who states that their
child accidentally swallowed paint thinner. The child is awake and alert. Which of the
following responses should the nurse make?
A. Have your child drink one large glass of water.
B. Hang up and call a poison control center hotline.
C. Bring your child into the clinic later today.
D. Induce vomiting in your child with syrup of ipecac. - answers Have your child drink
one large glass of water
A nurse is documenting a client's medical record. Which of the following entries should
the nurse record.
A. Oral temperature slightly elevated at 0800
B. Administered pain medication
C. Incision without redness or drainage
D. Drank adequate amounts of fluid with meals. - answers Administered pain
medication
A nurse is providing oral care for a client who is unconscious. Which of the following
actions should the nurse take?
A. Place the client in a side-lying position.
B. Brush the clients teeth daily
C. Apply mineral oil to the client's lips
D. Rinse the client's mouth with an alcohol-based mouthwash - answers Place the
client in a side-lying position
A nurse is collaborating with a risk management team about potential legal issues
involving client care. The nurse should identify which of the following situations is an
example of negligence?
A. A nurse administers a medication without first identifying the client.
B. An assistive personnel discusses client care in the facility cafeteria with visitors
present.
C. A nurse begins a blood transfusion without obtaining consent.
D. An assistive personnel prevents a client from leaving the facility. - answers A nurse
begins a blood transfusion without obtaining consent
A nurse is collecting a sputum specimen for culture from a client who has a respiratory
infection. Which of the following actions should the nurse take?
,A. Wear sterile gloves when collecting the specimen.
B. Offer the client oral hygiene after the collection
C. Collect the specimen in the evening.
D Collect 1 ml of sputum. - answers Offer the client oral hygiene after the collection
A nurse is assessing an older client. Which of the following findings should the nurse
expect?
a. Decreased sense of balance
b. Increased nighttime sleeping
c. Heightened sense of pain
d. Nighttime urinary incontinence - answers Decreased sense of balance
A nurse is completing discharge teaching about ostomy care with a client who has a
new stoma. Which of the following instructions should the nurse include in the teaching?
(select all that apply)
a. "Cut the opening of the pouch 1⁄8 of an inch larger than the stoma "
b. "Place a piece a gauze over the stoma while changing the pouch"
c. "Use povidone-iodine to clean around the stoma"
d. "Empty the ostomy pouch when it becomes one-third full of contents"
e. expect the stoma to turn a purple-blue color as its heals" - answers Cut the opening
of the pouch 1⁄8 of an inch larger than the stoma
Place a piece a gauze over the stoma while changing the pouch
Use povidone-iodine to clean around the stoma
Empty the ostomy pouch when it becomes one-third full of contents
A nurse is preparing to obtain informed consent from a client who speaks a different
language than the nurse. Which of the following actions should the nurse take?
a. "Request that an assistive personnel interpret the information for the client"
b. "Use proper medical terms when giving information to the client"
c. "Offer written information in the client's language"
d. "Avoid using gestures when speaking to the client" - answers Offer written
information in the client's language
A nurse is teaching a client about home care equipment. Which of the following
information should the nurse include in the teaching? (select all that apply)
a. "Avoid using wool blankets when receiving oxygen"
b. check the O2 delivery rate at least once a day
c. align the middle of the ball in the flow meter with the line of the prescribed flow rate
d. "Keep the oxygen delivery system 0.6 m (2 feet) from any heat source"
e. "Lay the oxygen tank flat when storing" - answers Avoid using wool blankets when
receiving oxygen
check the O2 delivery rate at least once a day
, align the middle of the ball in the flow meter with the line of the prescribed flow rate
A nurse is planning care for a client who reports insomnia. Which of the following
actions should the nurse perform shortly before bedtime?
a. Provide a late supper.
b. Offer a wet washcloth for the client to wash her face
c. Perform range-of-motion exercises
d. Prepare hot cocoa or tea for the client - answers Provide a late supper
A nurse on a medical-surgical unit is receiving a change-of-shift report for four clients.
Which of the following clients should the nurse see first?
a. A client who has acute abdominal pain of 4 on a scale from 0 to 10
b. A client who has pneumonia and an oxygen saturation of 96%
c. A client who has new onset of dyspnea 24hr after a total hip arthroplasty •
d. A client who
has a urinary tract infection and low-grade fever - answers A client who has new onset
of dyspnea 24hr after a total hip arthroplasty
A nurse is reviewing a client's intake and output and notes the following: 0.9% sodium
chloride 600mL IV infusion, cefazolin 250 mg in dextrose 5% in water 100mL
intermittent IV bolus, 200mL emesis, 40mL voided urine, and 20mL urine from straight
catheterization. The nurse should record the client's net fluid intake as how many mL?
(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not
use a trailing zero.)
DOSAGE CALCULATION - answers 700 mL
A nurse is discussing incident reports with a group of newly licensed nurses. The nurse
should include that which if the following requires the completion of an incident report?
a. A client's prescribed laboratory testing was not obtained
b. A client withdrew consent for a procedure
c. An oncoming nurse arrived to work late
d. A nurse transfused a unit of packed RBCs in 2 hr. - answers A client's prescribed
laboratory testing was not obtained
A nurse is caring for a client who has a new prescription for negative-pressure therapy
for a chronic wound. The nurse is unfamiliar with the procedure. Which of the following
resources should the nurse consult to learn more about the intervention.
a. The client's plan of care
b. The nurse practice act
c. The material safety data sheet
d. The policy and procedure manual - answers The policy and procedure manual
A nurse is performing postural drainage with percussion and vibration for a client who
has cystic fibrosis. Which of the following actions should the nurse take?
a. Cover the area of percussion with a towel.
b. Instruct the client to exhale quickly during vibration
c. Schedule postural drainage after meals
