EXIT Comprehensive HESI PN Test Bank
NURSING NGN ATI Fundamental Exam Questions And
Answers with Rationales Rated A+
A nurse is planning to use non formal logical pain methods for a client who reports still
having mild back pain after receiving analgesia 1 hour ago. Which of the following actions
should the nurse include in the plan?
a. Apply an ice pack to the client's back for 1 hr.
◗ Cold therapy = reduced inflammation & slows down nerve impulses
◗ Heat therapy = stimulates blood flow & inhibits pain messages
◗ Avoid long applications of either cold or heat b/c results in tissue damage
b. Remove distractions from the client’s room.
c. Instruct the client to take deep rhythmic breaths.
d. Encourage the client to apply a heating pad for 2 hr at a time.- 2 hours seems too long
A nurse is caring for a client who is on bed rest following an abdominal surgery. Which
of the followingfindings indicates the need to increase the frequency of position changes?
Sacrum , buttock and heals areprone for ulcers. NON blancking erthyema in merks
manual . blanching is considered good since that means tissue perfusion
a. Flat rash on the client's ankle
b. Non blanching red area over my clients trochanter
c. Ecchymosis on the clients left shoulder
d. Petechiae on the client's right anterior thigh
A nurse is assessing a client whose therapy has included bed rest for several weeks. Which
of the followingfindings should the nurse identify as the priority? Chapter 40 mobiltiy page
220
a. Musculoskeletal weakness
, b. Loss of appetite
c. Increased heart rate during physical activity
d. Left lower extremity tenderness- warmth and tenderness = DVT= PE if it dislodges!!!
Effects on the heart and blood
Like the muscular system, the cardiovascular system functions best when the body is in an
upright position, working against gravity. After just a few days of bed rest, blood starts to pool in
the legs. On standing, this canlead to dizziness and falls.
Immobility also causes the heart to beat more quickly, and the volume of blood pumped is lower.
The volume ofblood generally in the body is lower, and there is less oxygen uptake by the body.
This results in poorer aerobic fitness and fatigue sets in more easily.
The blood also becomes thicker and stickier, which increases the risk of a blood clot forming,
especially in thelegs (deep vein thrombosis) and the lungs (pulmonary embolism).
A nurse is assessing a client's ability to balance. Which of the following actions is
appropriate when thenurse conducts a Romberg test? Page 168 chapter 31
musculosketal and neuro systems
a. Ask the client to extend her arms in front of her body.
b. Ask the client to walk in a straight line heel To toe.
c. Have the client stand with her feet together.- also with eyes closed. There should not
be swaying
d. How the client place her hands on her hips.
, A nurse is providing care for a client who is to undergo total laryngectomy. which of
the followinginterventions is the nurse’s priority?
a. Schedule a support session for the client.
b. Explain the techniques of esophageal speech.
c. Review the use of artificial larynx with the client.
d. Determine the client's reading ability.
ESOPHAGEAL SPEECH is based on the technique in which the patient transports a small
amount of air intothe esophagus.
A nurse at an assisted living facility is preparing an in-service for residents about electrical
safety. Which ofthe following instructions should the nurse include?
a. Avoid taping electrical cords to the floor.
b. Clean electrical equipment prior to disconnection.
c. Cover exposed wires with tape before used.
d. Disconnect electrical equipment by grasping the plug.
A nurse is caring for a client who has a tracheostomy collar. As the nurse is performing
tracheal suctioning,the client’s heart rate and oxygen saturation decrease. which of the
following actions should the nurse take?
a. Elevate the head of the bed.
b. Remove the inner cannula.
c. Irrigate the stoma.
d. Discontinued suctioning.
A nurse is caring for a client who has a new diagnosis of terminal cancer. Which of
the followinginterventions is a priority?
a. Teach the client to use progressive relaxation techniques.
b. Help the client to find a local support group.
, c. Discuss the client's prior coping mechanism.
d. Develop a list of goals with the client.
A staff nurse is teaching a newly hired nurse how to complete an informed consent
document for a client.the stop should include that the nurse signature on the form confirms
which of the following requirements? (Select all that apply.)
a. The client was not coerced.
b. The client does not have a mental health condition.
c. The client Signed in the nurse’s presence.
d. The client speaks the same language as the nurse.
e. The client has legal authority to
do so.ATI: FUNDA PG. 17
A nurse is caring for a client who has a chest tube following thoracic surgery. Which of the
following tasksshould the nurse delegate to an assistive personnel?
a. Teach deep breathing and coughing to the client.- Teaching is always RNS job
NURSING NGN ATI Fundamental Exam Questions And
Answers with Rationales Rated A+
A nurse is planning to use non formal logical pain methods for a client who reports still
having mild back pain after receiving analgesia 1 hour ago. Which of the following actions
should the nurse include in the plan?
a. Apply an ice pack to the client's back for 1 hr.
◗ Cold therapy = reduced inflammation & slows down nerve impulses
◗ Heat therapy = stimulates blood flow & inhibits pain messages
◗ Avoid long applications of either cold or heat b/c results in tissue damage
b. Remove distractions from the client’s room.
c. Instruct the client to take deep rhythmic breaths.
d. Encourage the client to apply a heating pad for 2 hr at a time.- 2 hours seems too long
A nurse is caring for a client who is on bed rest following an abdominal surgery. Which
of the followingfindings indicates the need to increase the frequency of position changes?
Sacrum , buttock and heals areprone for ulcers. NON blancking erthyema in merks
manual . blanching is considered good since that means tissue perfusion
a. Flat rash on the client's ankle
b. Non blanching red area over my clients trochanter
c. Ecchymosis on the clients left shoulder
d. Petechiae on the client's right anterior thigh
A nurse is assessing a client whose therapy has included bed rest for several weeks. Which
of the followingfindings should the nurse identify as the priority? Chapter 40 mobiltiy page
220
a. Musculoskeletal weakness
, b. Loss of appetite
c. Increased heart rate during physical activity
d. Left lower extremity tenderness- warmth and tenderness = DVT= PE if it dislodges!!!
Effects on the heart and blood
Like the muscular system, the cardiovascular system functions best when the body is in an
upright position, working against gravity. After just a few days of bed rest, blood starts to pool in
the legs. On standing, this canlead to dizziness and falls.
Immobility also causes the heart to beat more quickly, and the volume of blood pumped is lower.
The volume ofblood generally in the body is lower, and there is less oxygen uptake by the body.
This results in poorer aerobic fitness and fatigue sets in more easily.
The blood also becomes thicker and stickier, which increases the risk of a blood clot forming,
especially in thelegs (deep vein thrombosis) and the lungs (pulmonary embolism).
A nurse is assessing a client's ability to balance. Which of the following actions is
appropriate when thenurse conducts a Romberg test? Page 168 chapter 31
musculosketal and neuro systems
a. Ask the client to extend her arms in front of her body.
b. Ask the client to walk in a straight line heel To toe.
c. Have the client stand with her feet together.- also with eyes closed. There should not
be swaying
d. How the client place her hands on her hips.
, A nurse is providing care for a client who is to undergo total laryngectomy. which of
the followinginterventions is the nurse’s priority?
a. Schedule a support session for the client.
b. Explain the techniques of esophageal speech.
c. Review the use of artificial larynx with the client.
d. Determine the client's reading ability.
ESOPHAGEAL SPEECH is based on the technique in which the patient transports a small
amount of air intothe esophagus.
A nurse at an assisted living facility is preparing an in-service for residents about electrical
safety. Which ofthe following instructions should the nurse include?
a. Avoid taping electrical cords to the floor.
b. Clean electrical equipment prior to disconnection.
c. Cover exposed wires with tape before used.
d. Disconnect electrical equipment by grasping the plug.
A nurse is caring for a client who has a tracheostomy collar. As the nurse is performing
tracheal suctioning,the client’s heart rate and oxygen saturation decrease. which of the
following actions should the nurse take?
a. Elevate the head of the bed.
b. Remove the inner cannula.
c. Irrigate the stoma.
d. Discontinued suctioning.
A nurse is caring for a client who has a new diagnosis of terminal cancer. Which of
the followinginterventions is a priority?
a. Teach the client to use progressive relaxation techniques.
b. Help the client to find a local support group.
, c. Discuss the client's prior coping mechanism.
d. Develop a list of goals with the client.
A staff nurse is teaching a newly hired nurse how to complete an informed consent
document for a client.the stop should include that the nurse signature on the form confirms
which of the following requirements? (Select all that apply.)
a. The client was not coerced.
b. The client does not have a mental health condition.
c. The client Signed in the nurse’s presence.
d. The client speaks the same language as the nurse.
e. The client has legal authority to
do so.ATI: FUNDA PG. 17
A nurse is caring for a client who has a chest tube following thoracic surgery. Which of the
following tasksshould the nurse delegate to an assistive personnel?
a. Teach deep breathing and coughing to the client.- Teaching is always RNS job
