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Page 1 Walden UniversityNURS 6512
ATI Fundamentals 2022 Proctored Exam |
Fundamentals Proctored Exam Questions & Answers
LATEST 2023 APRIL/ A nurse is planning care for a group
of clients.
FUNDAMENTALS PROCTORED EXAM 2023 RETAKE
- A nurse is planning care for a group of clients. Which of the following tasks should the nursedelegate 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 Postmortem care serves several purposes, including: preparing the patient for viewing by family. ensuring proper identification of the patient prior to transportation to the morgue or funeral home. providing appropriate disposition of patient's belongings. maintaining vital organs, if donation is planned.)
- A nurse is conducting a health assessment for a client who takes herbal supplements. Which ofthe 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
- A nurse is caring for a client who has influenza and isolation precautions in place. Which ofthe 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.
- A nurse obtains a prescription for wrist restraints for a client who is trying to pull out his NGtube. 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 hr.
- A nurse is admitting a client who has tuberculosis. Which of the following types oftransmission precautions should the nurse plan to initiate? A. Dropl et B. Airbornes C. Protective environment D. Contact
- A nurse in a well-child clinic receives a telephone call from a parent who states that their childaccidentally 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.
nurse record.
ATI FUNDAMENTALS PROCTORED EXAM 2019 RETAKE
Page 2 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.
- A nurse is providing oral care for a client who is unconscious. Which of the following
actionsshould 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
- A nurse is collaborating with a risk management team about potential legal issues
involvingclient 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.
- A nurse is collecting a sputum specimen for culture from a client who has a
respiratoryinfection. 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.
- A nurse is assessing an older client. Which of the following findings should the nurse expect?
Decreased sense of balanced Increased nighttime sleeping Heightened sense of pain Nighttime urinary incontinence
- 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 allthat apply) “Cut the opening of the pouch ⅛ 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” “Expect the stoma to turn a purple-blue color as its heals”
- A nurse is preparing to obtain informed consent from a client who speaks a
differentlanguage than the nurse. Which of the following actions should the nurse take? “Request that an assistive personnel interpret the information for the client” “Use proper medical terms when giving information to the client”
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- A nurse is performing postural drainage with percussion and vibration for a client who
hascystic fibrosis. Which of the following actions should the nurse take? Cover the area of percussion with a towel. Instruct the client to exhale quickly during vibration Schedule postural drainage after meals Perform percussion over the lower back
- A nurse is preparing to administer diphenhydramine 20 mg orally to a 6-year-old child
whohas difficulty swallowing pills. Available is diphenhydramine 12.5mg/5ml oral syrup. Which ofthe following images indicates the correct number of mL the nurse should administer? (round answer to the nearest whole number.) Should be the first syringe 8ml
- A nurse is admitting a client who is malnourished. The client states, “My wedding ring
isloose and I'm worried I will lose it if it falls off.”Which of the following is an appropriate response by the nurse? “ I will place it in your drawer so it won’t get lost.”
ATI FUNDAMENTALS PROCTORED EXAM 2019 RETAKE
Page 5 I can pin it to your hospital gown so you won’t lose it.” “I will hold onto it until a family member can take it home.” “I can put it in a locked storage unit for you.”
- A charge nurse is teaching a group of newly licensed nurses about the use of restraints.
Inwhich of the following clinical situations should the nurse apply restraints? If the client is pacing in the hallway As a part of a fall prevention program At the request of the client’s family When the client poses a threat to self
- To ensure client safety, a nurse manager is planning to observe a newly licensed nurse
perform a straight catheterization on a client. In which of the following roles is the nurse manager functioning? Case manager Client educator Client care provider Client advocate
- A charge nurse in a long-term care facility is preparing an educational program about
delirium for newly hired nurses. Which of the following statements should the nurse plan toinclude? “Delirium does not affect a client’s perception of her environment.” “Delirium does not affect a client’s sleep cycle.” “Delirium has an abrupt onset.” “Delirium has a slow progression.”
- A nurse is speaking with a client who has recently received a diagnosis of a chronic
illness. The client states, “ The doctor must be wrong. I can't be that sick”. The nurse should inform the client that their reaction is an example of which of the following expected responses to grief? Acceptance Denial Anger Depression
- A Nurse on a medical-surgical unit is providing care for four clients. The nurse
shouldidentify which of the following situations as an ethical dilemma? A surgeon who removed the wrong kidney during a surgical procedure refuses to take responsibility for her actions Aclient who has Crohn’s disease reports that his prescription drug plan will not pay for his medications. A client who has a new colostomy refuses to take instructions from the ostomy therapist because she “doesn't like him.” The family of a client who has a terminal illness asks that the provider not tell the client the diagnosis
- A nurse is teaching a client about performing breast self-examinations. Which of
thefollowing statements by the clients indicates an understanding of the teaching?
ATI FUNDAMENTALS PROCTORED EXAM 2019 RETAKE
Page 7 Suction the client’s airway for 20 seconds with each pass Hyperoxygenate the client manually for 30 to 60 seconds before suctioning Decrease suction pressure to 150 mm Hg if the oxygen saturation level drop during suctioning (???)
- A nurse is assessing a client who received morphine for severe pain 30 mins ago. Which
ofthe following finding is the nurse’s priority? Last bowel movement was 3 days ago Reports pain of 8 on a scale of 0 to 10 Distended bladder Respiratory rate 7/min
- A nurse is caring for a client who has been treated multiple times for STIs. Which of
thefollowing responses should the nurse take? “You must have too many sexual partners” “Why do you keep letting this happen?” “Let's explore why this might be reoccuring” “Don’t you have access to condoms?”
- A nurse enters the room of a client who has a seizure disorder. The client is sitting in a
chairand begins to experience a seizure. Which of the following actions should the nurse take first? Move items in the room away from the client Turn the client onto their side Help the client lie on the floor Loosen the client’s clothing
- A nurse is testing a client for conduction deafness by performing Weber’s test. Which of
thefollowing actions should the nurse take when performing this test? Move a vibrating tuning form in front of the client’s ear canals one after the other Place the base of a vibrating tuning fork on the client’s mastoid process Place the base of a vibrating tuning fork on the top of the client’s head Count how many seconds a client can hear a tuning fork after it has been struck
- A nurse is obtaining the medication history of a client who asks about taking ginkgo
biloba.The nurse should identify which of the following medications can interact adversely with this supplement? Warfarin Albuterol Levothyroxine Atorvastatin
- A nurse is obtaining informed consent from a client who is scheduled for surgery. The client
states, “I don’t want to go through with the procedure.” Which of the following actions should the nurse take? Discuss alternative treatments with the client Explain to the client the risks involved with not having the procedure Express approval of the client’s decision to not have the procedure Document the client’s decision in the medical record
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- A nurse is providing teaching to a client about reducing the adverse effects of immobility.
Which of the following statements by the client indicates an understanding of the teaching? · “ I will have my partner help me change position every 4 hours” · “ I will remove my antiembolic stockings while I am in bed” · “ I will hold my breath when rising from a sitting position” · “ I will perform ankle and knee exercises every hour.”
- A nurse is caring for a client who is postoperative and has a new prescription to advance
herdiet to full to full liquids. Which of the following foods should the nurse offer the client as a partof a full liquid diet? · Oatmeal · Applesauce · Scrambled eggs · Plain Yogurt
- A nurse is preparing a client who has terminal cancer for discharge. Which of the
followingquestions should the nurse ask when assessing the client’s psychosocial history? · “ What medications are you currently taking?” · “ Are you experiencing any Pain?” · “ Have any of your relatives been diagnosed with cancer?” · “ What Techniques do you use to cope with stress?”
- A nurse is performing a skin assessment on an older adult client. Which of the
followingfindings should the nurse expect? · Thickened outer layer of skin · Increased skin elasticity · Reduced sweat production · Increased Production of oils
- A nurse is caring for a client who begins to cry after receiving a diagnosis of cancer.
Whichof the following responses should the nurse make? · “ I would get a second opinion if I were you.” · “ it might seem bad now, but things will get better.” · “ it must be difficult for you to receive this kind of news.” · I think you would benefit from speaking with our chaplain.”
- A nurse is preparing to obtain a health history from a client. Which of the following actions
should the nurse take? · Use the client’s first name when initially meeting the client. · Tell the client the purpose for collecting the information. · Explain to the client the necessity of full disclosure of information. · · Avoid documenting direct quotes from the client as part of subjective data.
- A nurse is caring for a client who has brain cancer and is transferring to hospice care. The
client’s son tells the nurse, “ I don’t know what to tell my dad if he asks how he is going to die.” Which of the following is an appropriate response by the nurse? · “ Let’s talk more about your dad’s condition.”
ATI FUNDAMENTALS PROCTORED EXAM 2019 RETAKE
Page 10 · “OJ” for orange juice
- A nurse is preparing to bathe a client who has dementia. Which of the following
actionsshould the nurse take? · Give detailed instructions for the client to follow. · Complete the bath even if the client is in distress. · Use distractions when bathing the client. · Allow the client to select the temperature of the bath water.
- A hospice nurse is caring for a client who has end stage cancer. Which of the
followinginterventions should the nurse include to promote the client’s dignity? · Provide guided imagery exercises to the client. · Refrain from discussing the client’s prognosis · Suggest that the client keep a journal. · Encourage the client to share their life story.
- A nurse is caring for a client who has a closed wound drainage system. Which of
thefollowing actions should the nurse take? · Wear sterile gloves when emptying the container. · Reset the container with the drainage port closed · Connect the drain to high pressure suction. · Press straight down on the container to create vacuum.
- A nurse receives a telephone prescription from a provider for a client who is
experiencingpain. Which of the following responses should the nurse make? · “ Will you please spell the name of that medication for me?” · “Let me clarify that you want the medication given qid, correct?” · “ I will sign my name now and leave a space for you to sign your name.” · “Let me provide you with the client’s medical record number for identification.”
- During change of shift report, a nurse discovers she overlooked a prescription for a type
andcross-match of a client who is to have surgery the next day. Which of the following actions should the nurse take first? · Inform the provider of the delay in obtaining the type and cross-match. · Obtain the client’s type and cross-match. · Prepare an incident report for risk management. · Document the incident in the client’s medical record.
- A Nurse is caring for client who has pneumonia. The nurse should recognize which of
thefollowing should be discarded in a biohazard bag? · An emesis basin filled with blood from severe coughing · A bedpan containing diarrhea from a client who was receiving antibiotics · A disposable tissue containing expectorated sputum · A calibrated toilet insert filled with urine.
- A nurse is caring for a client who is receiving enteral feedings via NG tube. Which
following actions should the nurse take prior to administering the formula? · Check for gastric residual volume
ATI FUNDAMENTALS PROCTORED EXAM 2019 RETAKE
Page 11 · Encourage the client to breathe deeply and cough. · Flush the tube with sterile 0.9% sodium chloride irrigation. · Encourage the client to take sips of water.
- A nurse is caring for a client immediately following the insertion of an NG tube. Which
ofthe following indingd should indicate to the nurse that the tube is placed incorrectly? The client has a dry mouth The client is coughing The client has active bowel sounds The client is hiccuping
- A nurse is inserting an NG tube for a client who requires gastric decompression. Which
ofthe following actions should the nurse take to verify proper placement of the tube? Assess the client for a gag reflex Measure the pH of the gastric Place the end of the NG tube in the water to observe for bubbling Asculatate 2.5 cm above the umbilicus while injecting 15 ml of water
- A nurse is caring for a client who reports a ptain level of 5 on a scale from 0-10. The
client informs the nurse that pain meds are not an option for managing pain. Which of the following isan appropriate response by the nurse? Would you like to get you a back massage? Why do you think pain med is not going to help you? You may take any herbal remedies you bring from home I’m sure it will work if you just give it a chance nurse is caring for a client who has an extracellular fluid volume deficit. Which of thefollowing findings should the nurse expect? Bradycardia Postural hypotension Distended neck vein Dependent edema
- A nurse is caring for a client who is immunocompromised which of the following actions
should the nurse take? Use sterile gloves to provide perineal care Cleanse hands with an alcohol based hand rub before client contact Have the client apply a mask when children are visiting Place the client in a semi-private room
- A nurse is preparing to insert an iv catheter for a client following a right mastectomy. Which
of the following veins should the nurse select when initiating iv therapy? The radial vein on the left arm The cephalic vein in the left distal forearm The cephalic within on the back of the right hand The basilic vein in the right antecubital fossa
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Page 13 ATI FUNDAMENTALS PROCTOR… What came out when I took it on 4/4/
1. A nurse is teaching the assistive personnel about upper body mechanics to prevent injury. Which of
the following actions by the AP demonstrate an understanding of the teaching? The AP keeps the object he is lifting close to his body …the question was worded differently but “holding the object close to body” is a correct answer for one question.
2. A nurse is assessing a client who is immobile and notices a red area over the client’s coccyx. Which
of the following actions should the nurse take? Change the clients position every 4 hours Apply petroleum base ointment in the red area Assess the red area for blanching Use friction when cleansing the client’s skin …same thing for this question, wording is different, but an answer is “assess for blanching.”
6. A nurse is planning care to prevent skin breakdown for a client who is immobile and has urinary
incontinence. Which of the following actions should the nurse include in the plan of care. Ans: request a prescription for an indwelling urinary catheter
8. A nurse is teaching a client who had an enucleation about care of an artificial eye. Which of the
following information should be included in the teaching? (select all that apply) Store the artificial eye in the label container filled with 0.9% sodium chloride irrigation Remove from the artificial eye by retracting the upper eyelid Apply pressure just below artificial eye to break the suction Clear the artificial eye with hydrogen peroxide before storing Retract the upper and lower lids to reinsert the artificial eye …this exact question came out, I chose the 3 bolded answers.
10. A nurse is caring for a client who is 2 days postoperative following bowel resection and reports
sudden severe abdominal pain. Which of the following actions should the nurse take first? Determine areas of resonance across the abdomen using a systematic approach Expose the client’s abdomen to look for changes in appearance Perform abdominal palpation by pressing gently with the finger pads Use the diaphragm of the stethoscope to listen for bowel sounds
11. A nurse is providing care for a client who is to undergo a total laryngectomy. Which of the
following interventions is the nurses priority?
ATI FUNDAMENTALS PROCTORED EXAM 2019 RETAKE
Page 14 Determine the client’s reading ability Review the use of an artificial larynx With the client schedule a support session For the client explain the techniques of esophageal speech …exact question and answer.
12. A home care nurse is teaching a client about home safety. Which of the following statements by
the client indicates an understanding of the teaching? (select all that apply) I will use the bars when getting in and out of the bath tub I need to check my medications for expiration dates I need to have a fire escape plan with my family I will apply tape over frayed areas of electrical cords I need to set my hot water heater to 140 degrees Fahrenheit …this SATA was exactly the same as well, I chose the bolded 3.
14. a nurse in an emergency department is assessing a client who reports a right lower quadrant pain,
nausea and vomiting for the past 48 hours? Which of the following actions should the nurse take first? Offer pain medication Palpate the abdomen Auscultate bowel sounds Administer an antiemetic
15. A nurse is caring for a client who recently received a diagnosis of terminal cancer. Which of the
following statement by the client partner indicates maladaptive coping? Ans: I don't know of if I will be able to meet his physical needs.
16. A nurse is planning care for a client who has a stage 1 pressure ulcer on the right heel. The nurse
should anticipate application of which of the following dressings? Dry gauge Transparent Calcium alginate Hydrogel …this question was different but a question was asked about a Stage 1 pressure ulcer and “transparent self-adhesive” dressing was the answer I chose.
17. A nurse is caring for a client who has brain cancer and is transferring to hospice care. The client’s
son tells the nurse “I don’t know what to tell my dad if he asks how he is going to die”. Which of the following is an appropriate response from the nurse?
ATI FUNDAMENTALS PROCTORED EXAM 2019 RETAKE
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22. A nurse is providing discharge teaching to a client who does not speak the same language as the
nurse. Which of the following action should the nurse take? Ans Direct verbal discharge instruction to the interpreter.
23. A nurse is teaching a client how to self-administer daily low dose heparin injections. Which of the
following factors is most likely to increase the clients motivation to learn? The client’s belief that his needs will be met through education The nurse explaining the need for education to the client The client seeking family approval by agreeing to a teaching plan The nurse’s empathy about the client having to self-inject …exact question and answer.
25. A nurse is caring for a client who is receiving continuous enteral feedings through gastrostomy
tubes. Which of the following actions should the nurse take? Heat the formula to 105 degrees Fahrenheit Flush the tubing with 10 ml of water every 2 hours Change the tubing every 72 hours Aspirate residual volume every 4 hours (Every 4 - 8 hours is correct) …not this exact question but there was a Q about giving medications when patient is receiving continuous enteral feeding.
26. A nurse is caring for a client who has an incisional wound and a prescription for wound care.
Which of the following images indicates the proper method of cleaning a wound site? …there was a question about incisional wound care, I picked something like “use a different sterile swab for each stroke.”
28. A nurse is teaching a client who requires maximum support about how to use a two wheeled
walker. Which of the following actions by the client indicates an understanding of teaching? The client picks up the walker with each step The client stoops slightly forward when moving the walker The client stands with her elbows slightly flexed while holding the walker The client moves the walker ahead 10 inches with each step (Incorrect b/c 6 inches max) …instead the question was about crutches. The patient could use one leg normally and got crutches. I chose “3-point gait.”
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29. A nurse is caring for a client who refuses to follow the providers prescription for bed rest. The
nurse over hears the assistive personnel tell the client that if she does not remain in bed he will place her in restraints. The nurse should identify that the AP is committing which of the following torts? Libel Defamation of character Assault Battery …very similar wording and same answer.
30. A nurse is preparing to insert an IV catheter for an older adult client who has fragile skin. Which of
the following actions should the nurse take? Stabilize the vein by applying traction above the insertion site Engorge the vein by placing the arm in the dependent position Use friction at the insertion site to increase venous distention Leave the tourniquet on for 30 to 60 seconds after initial insertion …exact question and answer.
31. A nurse is planning care for a client who has a new prescription for parental nutrition in 20%
dextrose and fat emulsion. Which of the following is the appropriate action to indicate in the plan of care? Prepare the client for a central venous line Change the PN infusion bag every 48 hours Administer the PN and fat emulsion separately Obtain a random blood glucose daily …exact question and answer.
32. A nurse is caring for a client who is schedule for surgery while witnessing the client signature.
While the client is saying I trust my doctor, but I don’t understand what he meant when he said he’ll reset my intestines. Which of the following actions should the nurse take? Provide brochures about the procedure Notify the provider Complete an incident report Describe the surgery to the client …didn’t come up, but there was a SATA about the nurse being a witness to a consent form being signed. Something like “what is the nurse authorizing when she signs off that she was witness to the patient giving/ signing their consent?”
