ATI FUNDAMENTALS RN EXAM TESTBANK
AND ANSWERS WITH NGN RATIONALES Latest
Update 2023/2024GRADED A+ SCORE
A nurse on a medical-surgical unit observes
... [Show More] smoke billowing from a client’s room.Which of the
following actions should the nurse take first?
A. Close the door to the client’s room
-incorrect: The nurse should close the doors and windows in the immediate vicinity
to help contain the fire; however, this is not the first action the nurse should take.
B. Evacuate the client from the room
-The acronym RACE can help nurses remember the order of the actions to take in the event
of a fire. The components of RACE are rescue, activate, confine, and extinguish. The first
priority is rescuing or removing the client from immediate danger. The second action is
activation of the fire alarm system. The third action is confining the fire by closing doors
and windows. The final action is extinguishing the fire, if possible, using an available fire
extinguisher. If attempts to extinguish a fire could compromise the safety of clients or staff
members, the nurse should await the arrival of emergency fire personnel.
C. Sound the fire alarm
-incorrect: The nurse should sound the fire alarm to summon fire professionals to put out
the fire and ensure safety in the facility; however, this is not the first action the nurse
should take.
D. Activate the fire extinguisher
-incorrect: The nurse should attempt to extinguish the fire safely if possible; however, this
is not the first action the nurse should take.
A nurse is admitting a client who will undergo a craniotomy. During the planning
phase of the nursing process, which of the following actions should the nurse take?
A. Establish client outcomes
-The planning phase of the nursing process includes developing goals and outcomes that
help the nurse create the client’s plan of care.
B. Collect information about past health problems
-incorrect: The nurse should collect information about the client’s past health problems
during the assessment phase of the nursing process.
C. Determine whether the client has met specific goals
-incorrect: The nurse should determine whether the client has met goals during the
evaluation phase of the nursing process.
D. Identify the client’s specific health problems
-incorrect: The nurse should identify the client’s specific health problems during the
analysis phase of the nursing process.
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?
A. 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.
B. Transfer the specimen to a sterile container
-incorrect: The nurse should place the stool specimen in a clean container using a
tongue depressor.
C. 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.
D. 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?
A. 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.
B. Insert the catheter during exhalation
-incorrect: The nurse should insert the catheter during inhalation
C. 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.
D. 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?
A. Eggs
-incorrect:this is a complete protein, contains all of the essential amino acids necessary
for the synthesis of protein in the body.
B. Soybeans
-incorrect: this is a complete protein, contains all of the essential amino acids necessary
for the synthesis of protein in the body.
C. 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.
D. Yogurt
-incorrect: this is a complete protein, contains all of the essential amino acids necessary
for the synthesis of protein in the body.
A nurse is caring for a client who was admitted to a long-term care facility for
rehabilitation after a total hip arthroplasty. At which of the following times should the
nurse begin discharge planning?
A. One week prior to the client’s discharge
-incorrect: Beginning to plan for the client’s discharge a week prior to the event might not
allow sufficient time for planning. The nurse should begin discharge planning at the time of
admission. B. Upon the client’s admission to the care facility
-The nurse should begin discharge planning at the time that the client is admitted to the
facility.
C. Once the discharge date is identified
-incorrect: Beginning to plan for the client’s discharge once the discharge date is identified
might not allow sufficient time for planning. The nurse should begin discharge planning at
the time of admission.
D. When the client addresses the topic with the nurse
-incorrect: Beginning to plan for the client’s discharge once the discharge date is identified
might not allow sufficient time for planning. The nurse should begin discharge planning at
the time of admission.
A nurse is preparing to administer a cleansing enema to a client. Which of the
following actions should the nurse plan to take?
A. Insert the rectal tube 15.2 cm (6 in)
-incorrect: The nurse should insert the rectal tube 7 to 10 cm (3 to 4 in)
B. Wear sterile gloves to insert the tubing
-incorrect: The nurse should wear clean (nonsterile) gloves to prevent contamination.
C. Position the client on his left side
-Positioning is an important aspect of administering an enema. Having the client lie on [Show Less]