Fundamentals ATI

A nurse is admitting a client who reports anorexia and is experiencing malnutrition. Which of the following laboratory findings should the nurse expect to be altered?

Albumin

A nurse is caring for a client who has impaired mobility. Which of the following support devices should the nurse plan to use to prevent the client from developing plantar flexion contractures?

Footboard

A nurse is caring for an older adult client who was alert and oriented at admission, but now seems increasingly restless and intermittently confused. Which of the following actions should the nurse take to address the client's safety needs?

Move the client to a room closer to the nurses' station

A nurse in a long-term facility enters the day room and finds the window curtains on fire. Clients are panicking and the room is filling with smoke. Indicate the emergency actions the nurse must take.

Remove the clients from the room, activate the fire alarm, close the door, extinguish the fire

A nurse is caring for a client who has fallen while getting out of bed and states, "I'm okay! I guess I should have called for help to the bathroom." After assessing the client, the nurse notifies the provider. Which of the following documentation should the nurse include in the client's medical record?

The provider was notified

A nurse is assessing an older adult client who has osteoporosis. Which of the following spinal deformities should the nurse expect to find in this client?

kyphosis

A nurse is preparing to exit the room of a client who has MRSA in a draining wound. Identify the sequence the nurse should follow before leaving the client's room.

remove gloves, remove eye wear, remove gown, remove mask, perform hand hygiene

A nurse is planning to discharge a client who has quadriplegia to his home. The nurse suggests that the family might need respite care services. When a family member asks how respite care can help, which of the following responses should the nurse provide?

Respite care allows the primary caregiver time away from day-to-day care responsibilities

A charge nurse is anticipating the admission of four clients and planning their room assignments. Which of the following clients should the nurse assign to the room closest to the nurses' stations?

A client who sustained a head injury and is having periods of confusion

A nurse is caring for a client who has active pulmonary tuberculosis. The client requires airborne precautions and is receiving multidrug therapy. Which of the following precautions should the nurse take to transport the client safely to the radiology department for a chest x-ray?

Have the client wear a mask

A nurse is caring for a client who has peripheral vascular disease and reports difficulty sleeping because of cold feet. Which of the following nursing actions should the nurse take to promote the client's comfort?

Obtain a pair of slipper-socks for the client

A nurse is preparing a sterile field. Which of the following actions should the nurse identify as contaminating the field?

Opening a sterile package over the middle of the sterile field

A nurse is receiving a provider's prescription for a client via telephone. Which of the following actions should the nurse take to ensure the accuracy of the telephone prescription?

Repeat the order back to the provider, question any part of the order that is unclear or inappropriate, transcribe the order into the client's health record

A nurse is preparing to administer an IM injection of meperidine to a client. Which of the following is the priority assessment the nurse should complete?

Respiratory rate

A nurse in a long-term care facility is caring for an older adult client who has dementia and begins to have frequent episodes of urinary incontinence. After the provider determines no medical cause for the client's incontinence, which of the following interventions should the nurse initiate to manage this behavior?

Take the client to the bathroom every 2 hours

A nurse is reviewing the goals of the nurse-client therapeutic relationship with a client who is seeking counseling. Which of the following information should the nurse include in this discussion?

The client achieves optimal personal growth

A nurse enters an older adult client's room to insert a saline lock. The client asks the nurse, "why do I need that? I am drinking plenty of fluids." Which of the following responses should the nurse provide?

"your provider has prescribed antibiotic therapy to be administered intravenously every 6 hours."

A client tells the nurse that he suspects that he grinds his teeth at night. The nurse should explain that the client should see a dentist for this problem, which she should document as which of the following disorders?

Bruxism

A nurse is preparing an educational program for a group of newly licensed nurses about client confidentiality. The nurse should explain that nurses may share a client's protected health information with which of the following groups?

Healthcare team members caring for the client

A nurse in a clinic is caring for a client who reports pain, crepitus, and a popping sound in his temporomandibular joint. Based on these findings, to which of the following providers should the nurse request a referral for the client?

Oral surgeon

While auscultating a client's heart sounds, the nurse hears turbulence between S1 and S2 heart sounds. The nurse should document this finding as which of the following?

A systolic murmur

A nurse on a medical unit is caring for a client who suddenly becomes confused and drowsy. Additional data includes pulse 100/min, respiratory rate 24/min, BP 132/76 mm Hg, and temperature 98.2. Which of the following actions should the nurse perform?

Complete a neurological check

The family of an older adult client brings him to the emergency department after finding him wandering outside. During the initial assessment, the nurse notes that the client flinches when she palpates his abdomen yet responds to questions by nodding and smiling. Which of the following factors should the nurse identify as a likely explanation for the client's behavior?

Confusion

A nurse is teaching a client about the physical effects of chemotherapy. Following the teaching, the nurse asks the client to describe one physical effect. The nurse is focusing on which of the following elements of the communication process?

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