ATI FUNDAMENTALS REMEDIATION ACTUAL EXAM COMPLETE
REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED SOLUTIONS) LATEST UPDATES |GUARANTEED PASS.
(BRAND NEW!!)
What should the nurse do to demonstrate proper body mechanics when assisting a
client to a standing position from a sitting position? (Select all that apply.)
Rock their own body weight as they pull the client up towards them.
Keep their own knees locked as they lift the client in a smooth motion.
Stand in front of the client, move their own feet apart and bend at the knees.
While standing behind the client, secure their own arms around the client's chest
and lift upward.
Assess the client and determine whether or not another care provider is needed to
assist. - ANSWER: Rock their own body weight as they pull the client up towards
them.
Stand in front of the client, move their own feet apart and bend at the knees.
Assess the client and determine whether or not another care provider is needed to
assist.
Rationale
Pulling is easier than lifting and the momentum by rocking the nurse's body uses that
body weight to enhance the force of arm muscles. Moving feet apart widens the
base of support and bending knees lowers the center of gravity. These actions are
elements of safe body mechanics. When possible, use teams to lift clients ast is
decreases the incidences of lower back injuries in healthcare workers and is safer for
the client.
The nurse is assessing a client for risk of falls. Which client behavior would be the
most informative to the nurse?
The client transfers unassisted from the bed to a chair next to the bed.
The client changes positions in bed from a prone position to sitting upright at 45
degrees.
The client is able to rise from a chair without using arms for support and walk 10 feet
and turn around.
,The client with gait belt attached ambulates up and down the hallway with the
physical therapist next to them. - ANSWER: The client is able to rise from a chair
without using arms for support and walk 10 feet and turn around.
Rationale
A client's ability to get up from a sitting position without using their arms for support
and walk 10 feet and turn around would give the nurse an assessment of the client's
balance, coordination and gait as they walked.
What nursing interventions should be implemented for a client whose absolute
neutrophil count (ANC) is below 500?
Admit to a reverse isolation room.
Begin bleeding precaution protocol.
Caution against any cut flowers in client's room.
Screen and limit individuals wishing to visit.
Provide only fresh organic fruits and vegetables. - ANSWER: Admit to a reverse
isolation room.
Screen and limit individuals wishing to visit.
Caution against any cut flowers in client's room.
Rationale
The client has neutropenia and is at risk for infection. A reverse isolation, positive
pressure room is the best choice for these clients. Cut flowers and live plants, along
with fruits and vegetables have been shown to carry organisms that could cause
harm to the immuno-compromised client. Visitors of these clients need to be limited
and screen for possible signs of infection which could be lethal to an immuno-
compromised client.
A client has a swollen, bruised, sprained ankle and states that the current pain level
has risen from a 3 to a 5 on a 10 point scale. Which analgesic medication would most
likely be prescribed to relieve this pain?
Morphine.
Ibuprofen.
Oxycodone.
Acetaminophen. - ANSWER: Ibuprofen.
,Rationale
Ibuprofen is indicated for mild to moderate pain relief. It is also a non-steroidal anti-
inflammatory drug (NSAID) which inhibits the synthesis of prostaglandins which then
inhibits the cellular response to inflammation.
What is the most important action for the nurse who is implementing a standing
order?
Compare the order with the client's current status.
Confirm the order with the healthcare provider.
Transcribe the order into the record.
Verify the order with another nurse. - ANSWER: Compare the order with the client's
current status.
Rationale
The implementation of standing orders requires the nurse to use clinical judgment.
Comparing the client's current status with the order is one way to apply clinical
judgment.
Which has been shown to be the most effective intervention a nurse can perform to
prevent most hospital-acquired infections?
Maintaining sterile technique during procedures.
Washing hands before and after each client contact.
Abiding by the hospital's established isolation room protocols.
Assuring nures assigned to surgical clients do not care for infectious clients. -
ANSWER: Washing hands before and after each client contact.
Rationale
Hand hygiene is the most effective method to prevent hospital-acquired infections.
Which pain relief intervention is based on the gate control theory of pain?
Progressive deep relaxation exercises.
Therapeutic music and sound therapy.
The performance of massage therapy.
Transcutaneous electrical nerve stimulation. - ANSWER: Transcutaneous electrical
nerve stimulation.
, Rationale
Transcutaneous electrical nerve stimulation (TENS) reduces pain impulses to the
brain, a component of the gate control theory of pain.
The nurse is reviewing the change of shift report. Which client should the nurse
assess first?
A 46-year old client admitted yesterday undergoing bowel prep for abdominal
surgery.
A 76-year old client transferred from the emergency department who requires
femur pinning due to a recent fall.
A 55-year old client who had knee replacement and is scheduled to be discharged
that day.
A 22-year old client transferred from the emergency department scheduled for
shoulder surgery due to a rotator cuff tear. - ANSWER: A 76-year old client
transferred from the emergency department who requires femur pinning due to a
recent fall.
Rationale
Because of the client's advanced age and history of falling, the 76-year old client
should be assessed first.
An adult client has vomiting, diarrhea, dry mucous membranes, skin tenting, and
delayed capillary refill. The client's vital signs are: HR 110, sitting BP 104/72 that
drops to 84/62 when the client stands up. The client's laboratory results include:
BUN 24 mg/dl and urine specific gravity 1.032. Which conditions should the nurse
consider in planning care for this client?
Extracellular fluid volume deficit..
Urinary retention.
Postural hypotension.
Cardiac output impairment.
Impaired tissue perfusion. - ANSWER: Extracellular fluid volume deficit..
Postural hypotension.
Impaired tissue perfusion.
Rationale
REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED SOLUTIONS) LATEST UPDATES |GUARANTEED PASS.
(BRAND NEW!!)
What should the nurse do to demonstrate proper body mechanics when assisting a
client to a standing position from a sitting position? (Select all that apply.)
Rock their own body weight as they pull the client up towards them.
Keep their own knees locked as they lift the client in a smooth motion.
Stand in front of the client, move their own feet apart and bend at the knees.
While standing behind the client, secure their own arms around the client's chest
and lift upward.
Assess the client and determine whether or not another care provider is needed to
assist. - ANSWER: Rock their own body weight as they pull the client up towards
them.
Stand in front of the client, move their own feet apart and bend at the knees.
Assess the client and determine whether or not another care provider is needed to
assist.
Rationale
Pulling is easier than lifting and the momentum by rocking the nurse's body uses that
body weight to enhance the force of arm muscles. Moving feet apart widens the
base of support and bending knees lowers the center of gravity. These actions are
elements of safe body mechanics. When possible, use teams to lift clients ast is
decreases the incidences of lower back injuries in healthcare workers and is safer for
the client.
The nurse is assessing a client for risk of falls. Which client behavior would be the
most informative to the nurse?
The client transfers unassisted from the bed to a chair next to the bed.
The client changes positions in bed from a prone position to sitting upright at 45
degrees.
The client is able to rise from a chair without using arms for support and walk 10 feet
and turn around.
,The client with gait belt attached ambulates up and down the hallway with the
physical therapist next to them. - ANSWER: The client is able to rise from a chair
without using arms for support and walk 10 feet and turn around.
Rationale
A client's ability to get up from a sitting position without using their arms for support
and walk 10 feet and turn around would give the nurse an assessment of the client's
balance, coordination and gait as they walked.
What nursing interventions should be implemented for a client whose absolute
neutrophil count (ANC) is below 500?
Admit to a reverse isolation room.
Begin bleeding precaution protocol.
Caution against any cut flowers in client's room.
Screen and limit individuals wishing to visit.
Provide only fresh organic fruits and vegetables. - ANSWER: Admit to a reverse
isolation room.
Screen and limit individuals wishing to visit.
Caution against any cut flowers in client's room.
Rationale
The client has neutropenia and is at risk for infection. A reverse isolation, positive
pressure room is the best choice for these clients. Cut flowers and live plants, along
with fruits and vegetables have been shown to carry organisms that could cause
harm to the immuno-compromised client. Visitors of these clients need to be limited
and screen for possible signs of infection which could be lethal to an immuno-
compromised client.
A client has a swollen, bruised, sprained ankle and states that the current pain level
has risen from a 3 to a 5 on a 10 point scale. Which analgesic medication would most
likely be prescribed to relieve this pain?
Morphine.
Ibuprofen.
Oxycodone.
Acetaminophen. - ANSWER: Ibuprofen.
,Rationale
Ibuprofen is indicated for mild to moderate pain relief. It is also a non-steroidal anti-
inflammatory drug (NSAID) which inhibits the synthesis of prostaglandins which then
inhibits the cellular response to inflammation.
What is the most important action for the nurse who is implementing a standing
order?
Compare the order with the client's current status.
Confirm the order with the healthcare provider.
Transcribe the order into the record.
Verify the order with another nurse. - ANSWER: Compare the order with the client's
current status.
Rationale
The implementation of standing orders requires the nurse to use clinical judgment.
Comparing the client's current status with the order is one way to apply clinical
judgment.
Which has been shown to be the most effective intervention a nurse can perform to
prevent most hospital-acquired infections?
Maintaining sterile technique during procedures.
Washing hands before and after each client contact.
Abiding by the hospital's established isolation room protocols.
Assuring nures assigned to surgical clients do not care for infectious clients. -
ANSWER: Washing hands before and after each client contact.
Rationale
Hand hygiene is the most effective method to prevent hospital-acquired infections.
Which pain relief intervention is based on the gate control theory of pain?
Progressive deep relaxation exercises.
Therapeutic music and sound therapy.
The performance of massage therapy.
Transcutaneous electrical nerve stimulation. - ANSWER: Transcutaneous electrical
nerve stimulation.
, Rationale
Transcutaneous electrical nerve stimulation (TENS) reduces pain impulses to the
brain, a component of the gate control theory of pain.
The nurse is reviewing the change of shift report. Which client should the nurse
assess first?
A 46-year old client admitted yesterday undergoing bowel prep for abdominal
surgery.
A 76-year old client transferred from the emergency department who requires
femur pinning due to a recent fall.
A 55-year old client who had knee replacement and is scheduled to be discharged
that day.
A 22-year old client transferred from the emergency department scheduled for
shoulder surgery due to a rotator cuff tear. - ANSWER: A 76-year old client
transferred from the emergency department who requires femur pinning due to a
recent fall.
Rationale
Because of the client's advanced age and history of falling, the 76-year old client
should be assessed first.
An adult client has vomiting, diarrhea, dry mucous membranes, skin tenting, and
delayed capillary refill. The client's vital signs are: HR 110, sitting BP 104/72 that
drops to 84/62 when the client stands up. The client's laboratory results include:
BUN 24 mg/dl and urine specific gravity 1.032. Which conditions should the nurse
consider in planning care for this client?
Extracellular fluid volume deficit..
Urinary retention.
Postural hypotension.
Cardiac output impairment.
Impaired tissue perfusion. - ANSWER: Extracellular fluid volume deficit..
Postural hypotension.
Impaired tissue perfusion.
Rationale
