ATI FUNDAMENTALS MID TERM EXAM Questions and Answers (latest Update), 100% Correct,

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1. A nurse is reviewing information about the Health Insurance Portability and

Accountability Act (HIPAA) with a newly licensed nurse. Which of the following statements by

the newly licensed nurse indicates a need for further teaching?

A. "Information about a client can be disclosed to family members at any time." ANSWER

B. "HIPAA established regulations of individually identifiable health information in verbal,

electronic, or written form."

C. "A client's address would be an example of personally identifiable information."

D. "HIPAA is a federal law, not a state law."

2. A nurse is preparing to perform hand hygiene. Which of the following actions should the

nurse take?

A. Adjust the water temperature to feel hot.

B. Apply 4 to 5 mL of liquid soap to the hands. ANSWER

C. Hold the hands higher than the elbows.

D. Rub hands and arms to dry.

3. A nurse is administering nasal decongestant drops for a client. Which of the following

actions should the nurse take?

A. Tell the client to blow her nose gently before the instillation. ANSWER

B. Assist the client to a side-lying position.

C. Hold the dropper 2 cm (1 in) above the naris.

D. Instruct the client to stay in the same position for 2 min.

4. A newly licensed nurse is applying prescribed wrist restraints on a client. Which of the

following actions should the nurse take?

A. Secure the restraints using a quick-release tie. ANSWER

B. Ensure four fingers fit under the restraints to prevent constriction.

C. Secure the restraints to the lowest bar of the side rail.

D. Anticipate removing the restraints every 4 hr.

5. 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 only by nodding and smiling. Which

of the following factors should the nurse identify as a likely explanation for the client's

behavior?

A. He is hard of hearing.

B. Pain ANSWER

C. Confusion

D. Language barrier

6. A nurse is preparing a client for outpatient surgery. After the nurse inserts the IV

catheter, the client reports pain in the insertion area. Which of the following actions should the

nurse take?

A. Remove the catheter and insert another into a different site. ANSWER

B. Administer an analgesic PO.

C. Request a prescription for placement of a central venous access device.

D. Administer a local anesthetic.

7. A client smoking in his bathroom has dropped a cigarette butt into a wastepaper basket,

which begins to smolder. Which of the following actions is the nurse’s priority?

A. Close the fire doors on the unit.

B. Activate the fire alarm.

C. Move any clients in the immediate vicinity. ANSWER

D. Use a fire extinguisher to put out the fire.

8. A nurse is caring for a client who refuses treatment and asks to be discharged from the

hospital against medical advice. The nurse notifies the client's provider, who tells the nurse to

restrain the client, if necessary, to keep her from leaving the hospital. The nurse understands

that restraining this client would be considered which type of civil action by the nurse?

A. Invasion of privacy

B. Assault

C. Battery

D. False imprisonment ANSWER

9. A nurse is performing tracheostomy care for a client and suctioning to remove copious

secretions. Which of the following actions should the nurse take?

A. Suction two to three times with a 60-second pause between passes. ANSWER

B. Perform chest physiotherapy prior to suctioning.

C. Lubricate the suction catheter tip with sterile saline.

D. Hyperventilate the client on 100% oxygen prior to suctioning