ATI Fundamentals Proctored Exam | Questions and Answers with Rationales | LATEST 2023 GRADED A+
⦁ A nurse is performing an admission assessment
... [Show More] for a client. Which of the following responses by the nurse reflects the communication technique of clarifying?
⦁ “Now that we have talked about your medications, let’s talk about your pain.”
-incorrect: This is an example of the communication technique of focusing. The nurse can use this technique to keep the conversation moving in an organized direction.
⦁ “Are you having other symptoms?”
-incorrect: This is an example of the communication technique of asking a relevant question. These kinds of questions are open-ended and allow the client to offer more information to the nurse.
⦁ “It sounds like your pain is intermittent.”
-This response by the nurse reflects communication technique of clarifying. The nurse should use this technique to ensure an understanding of the client’s message.
⦁ “It seems as though you have really had a rough time these past few weeks.”
-incorrect: This is an example of the communication technique of sharing empathy. With this technique, the nurse is able to convey understanding and acceptance of what the client is or has been experiencing.
⦁ A nurse is preparing to assess the function of the client’s trigeminal nerve (cranial nerve V). Which of the following items should the nurse gather for the test?
⦁ Sugar
-incorrect: The nurse should use sugar to test the function of the olfactory nerve (CN VII).
⦁ Coffee
-incorrect: The nurse should use coffee to test the function of the olfactory nerve (CN I).
⦁ Cotton wisps
-The trigeminal nerve has both sensory and motor capabilities. To assess its sensory function, the nurse uses a safety pin to assess for recognition of pain and a cotton wisp to evaluate recognition of touch sensations. To test motor abilities of cranial nerve (CN V), the nurse should ask the client to clench the teeth.
⦁ Snellen Chart
-incorrect: The nurse should use the Snellen chart to test the function of the optic nerve (CN II)
⦁ A nurse is planning to collect a stool specimen for ova and parasites from a client who has diarrhea. Which of the following actions should the nurse take when collecting the specimen?
⦁ Instruct the client to defecate into the toilet bowl
-incorrect: The nurse should have the client defecate into a bedpan or a container for stool collection. The toilet water can dilute and contaminate the liquid specimen.
⦁ Transfer the specimen to a sterile container
-incorrect: The nurse should place the stool specimen in a clean container using a tongue depressor.
⦁ Refrigerate the collected specimen
-incorrect: The nurse should send the collected stool specimen immediately to the laboratory after labeling the specimen properly to prevent contamination with microorganisms and keep the specimen from getting cold.
⦁ Place the stool specimen collection container in a biohazard bag
-The nurse should place the specimen collection container in a biohazard bag with the client label on the container and the bag for easy identification. This will also prevent contamination with microorganisms.
⦁ A nurse is caring for a client who has a tracheostomy and requires suctioning. Which of the following actions should the nurse take?
⦁ Hyper oxygenate the client before suctioning
-The nurse should use a manual resuscitation bag to hyper oxygenate the client for several minutes prior to suctioning.
⦁ Insert the catheter during exhalation
-incorrect: The nurse should insert the catheter during inhalation
⦁ Apply suction during insertion of the catheter
-incorrect: Applying suction while inserting the catheter increases the risk of damage to the tracheal mucosa and removes oxygen from the airways.
⦁ Apply suction for no more than 15 secs
-incorrect: The nurse should apply suction for no more than 10 seconds
⦁ A nurse is providing teaching to a client regarding protein intake. Which of the following foods should the nurse include as an example of an incomplete protein?
⦁ Eggs
-incorrect: this is a complete protein, contains all of the essential amino acids necessary for the synthesis of protein in the body.
⦁ Soybeans
-incorrect: this is a complete protein, contains all of the essential amino acids necessary for the synthesis of protein in the body.
⦁ Lentils
-Incomplete proteins are missing 1 or more of the essential amino acids necessary for the synthesis of protein in the body. Examples of incomplete proteins include lentils, vegetables, grains, nuts, and seeds.
⦁ Yogurt
-incorrect: this is a complete protein, contains all of the essential amino acids necessary for the synthesis of protein in the body. [Show Less]