ATI ASN Fundamentals NSG 1550 Exam 2

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Free ATI ASN Fundamentals NSG 1550 Exam 2 Questions

1. A nurse is preparing a client for a computed tomography (CT) scan of the abdomen using IV contrast. Which of the following actions should the nurse take before the scan? Select all that apply.
  • Administer an oral barium preparation before the scan.

  • Inform the client they may feel a warm sensation or metallic taste during contrast injection.

  • Verify the client’s allergy history, especially for iodine or shellfish.

  • Keep the client NPO for 4 hours prior to the procedure.

  • Ensure renal function is assessed before administering contrast.

Explanation

Explanation
Correct Answer: B, C, D, E
B) Inform the client they may feel a warm sensation or metallic taste during contrast injection: This is an important part of patient education. It prepares the client for common sensations during the CT scan procedure, ensuring they are not alarmed.
C) Verify the client’s allergy history, especially for iodine or shellfish: This is critical as patients who are allergic to iodine or shellfish are at an increased risk for allergic reactions to contrast media, which often contains iodine.
D) Keep the client NPO for 4 hours prior to the procedure: Keeping the client NPO (nothing by mouth) before the procedure minimizes the risk of aspiration and ensures that the stomach is empty for accurate imaging.
E) Ensure renal function is assessed before administering contrast: Kidney function is crucial when administering IV contrast because contrast agents are excreted through the kidneys. Renal impairment can increase the risk of contrast-induced nephropathy.
2. A nurse is preparing a client for a barium swallow test to diagnose a suspected gastrointestinal condition. Which of the following nursing interventions should be prioritized after the procedure to prevent complications?
  • Administer a stool softener immediately after the test to avoid constipation.

  • Instruct the client to increase fluid intake and use prescribed cathartics to facilitate barium elimination.

  • Withhold oral intake for 24 hours post-test to prevent nausea and vomiting.

  • Encourage the client to maintain a supine position for 6 hours post-procedure to reduce aspiration risk.

Explanation

Explanation
Correct Answer: B) Instruct the client to increase fluid intake and use prescribed cathartics to facilitate barium elimination.

After a barium swallow study, the primary nursing priority is to prevent constipation or bowel obstruction caused by the remaining barium in the gastrointestinal tract. Barium is a thick contrast material that can harden in the intestines if it is not eliminated efficiently. Increasing fluid intake helps soften the stool and promotes bowel movement, while prescribed cathartics or mild laxatives assist in clearing the barium from the intestines more quickly.

Clients should also be informed that their stools may appear light or chalky in color for a short time following the procedure, which is normal as the body eliminates the barium. Encouraging adequate hydration and bowel elimination reduces the risk of complications such as fecal impaction or obstruction and supports safe recovery after the diagnostic test.
3. Which of the following instructions should the nurse provide to promote safe use of a cane as an assistive device for a client recovering from an injury to the left lower extremity (LLE)?
  • Adjust the height of the cane so the arm is straight.

  • Instruct the patient to move the LLE first while supporting the RLE.

  • Hold the cane on the injured side of the body.

  • The cane is held on the patient’s stronger side.

Explanation

Explanation
Correct Answer: D) The cane is held on the patient’s stronger side.
When using a cane, it should be held on the side opposite the injured limb (the stronger side). This positioning helps to provide support and balance, promoting a more stable and effective walking pattern. Holding the cane on the stronger side ensures that the patient can bear weight on the injured side while maintaining balance.
4. A nurse is caring for a client who uses a rosary during prayer before meals. Which of the following is an appropriate intervention by the nurse?
  • Interrupt the prayer to give medications on time

  • Remove the rosary to prevent infection risk

  • Tell the client prayer is not necessary in the hospital

  • Allow time for prayer before serving meals

Explanation

Explanation
Correct Answer: D) Allow time for prayer before serving meals

Respecting a client’s spiritual and religious practices is an important aspect of culturally competent and patient-centered care. If a client prays before meals using a rosary, the nurse should support this practice by allowing time for prayer whenever possible. Accommodating spiritual rituals promotes emotional comfort, dignity, and respect for the client’s beliefs. Unless the practice interferes with urgent care or safety, nurses should facilitate the client’s ability to practice their faith during hospitalization.
5. A nurse is caring for a client who just underwent a lumbar puncture to collect cerebrospinal fluid (CSF) for analysis. Which of the following post-procedure interventions should the nurse implement? Select all that apply.
  • Encourage increased fluid intake to replenish CSF volume

  • Monitor for headache and provide prescribed analgesics

  • Inspect the puncture site for drainage or bleeding

  • Keep the client flat for 4–8 hours

  • Ambulate the client immediately to prevent stiffness

Explanation

Explanation
Correct Answer: A) Encourage increased fluid intake to replenish CSF volume, B) Monitor for headache and provide prescribed analgesics, C) Inspect the puncture site for drainage or bleeding, D) Keep the client flat for 4–8 hours
After a lumbar puncture, the nurse must ensure the client’s recovery and prevent complications. Encouraging fluid intake is important because it helps replenish cerebrospinal fluid (CSF) volume lost during the procedure.

Monitoring for headaches and providing analgesics helps manage common post-procedure symptoms, as a headache is a common side effect of a lumbar puncture. Inspecting the puncture site for any drainage or bleeding helps identify any complications, such as infection or hematoma formation.

Keeping the client flat for 4–8 hours reduces the risk of post-procedure headache and CSF leakage. Ambulation should not be initiated immediately, as the client needs to rest to prevent complications and ensure proper healing of the puncture site.
6. A nurse is providing education to a client for a newly prescribed antihypertensive medication. The client nods but avoids eye contact and folds the paper without reading it. Which of the following is the best way to assess the client's health literacy?
  • Repeat the instructions louder and slower

  • Ask the client to explain the instructions in their own words

  • Provide more written material with simplified terms

  • Ask the client if they have any questions

Explanation

Explanation
Correct Answer: B) Ask the client to explain the instructions in their own words
The most effective method for assessing a client’s health literacy and understanding of instructions is the teach-back method, which involves asking the client to restate the information in their own words. This approach allows the nurse to determine whether the client truly understands the medication instructions rather than simply agreeing or nodding. Clients with limited health literacy may appear to understand information but may actually feel embarrassed or uncomfortable admitting confusion.
By asking the client to explain the instructions in their own words, the nurse can identify misunderstandings and clarify information immediately. This method promotes patient engagement, improves communication, and ensures the client can safely follow medication instructions at home. It is widely recommended in healthcare as an evidence-based strategy to confirm comprehension and support safe medication management.
7. A nurse is preparing to discharge an elderly client who lives alone following hospitalization for pneumonia. The client takes multiple medications for chronic conditions, reports having a limited income, and expresses concern about preparing meals. Which of the following actions should the nurse take to best promote the client's nutritional status after discharge?
  • Encourage the client to fast intermittently to improve metabolic health and appetite.

  • Instruct the client to avoid high-fat and high-calorie foods to prevent weight gain.

  • Refer the client to a social worker to discuss access to community meal support services.

  • Recommend the client shop for groceries in bulk to reduce overall food expenses.

Explanation

Explanation
Correct Answer: C) Refer the client to a social worker to discuss access to community meal support services.
Given the client's limited income and difficulty preparing meals, connecting the client with community resources, such as meal support services, ensures that they have access to nutritious food without the burden of meal preparation. A social worker can help assess the client's eligibility for programs that provide affordable or free meals, which is essential for promoting long-term nutritional health.
Other options, like encouraging fasting or avoiding certain foods (Options A and B), are not practical or beneficial in addressing the client's current challenges. Additionally, while shopping in bulk (Option D) could reduce costs, it may not be the most immediate or effective solution for someone with limited resources or difficulty preparing meals.
8. An older adult client with impaired mobility is recovering at home after surgery. Which adjustment to the home environment will most effectively reduce the risk of falls?
  • Replacing all furniture with low-profile pieces.

  • Removing throw rugs and securing loose wires.

  • Restricting the client’s activity to one area of the house.

  • Installing dimmer lighting to prevent glare.

Explanation

Explanation
Correct Answer: B) Removing throw rugs and securing loose wires.
Removing throw rugs and securing loose wires are critical safety measures for preventing falls in the home environment, especially for clients with impaired mobility. Throw rugs can easily cause tripping, and unsecured wires present a significant hazard as they may be difficult to notice or avoid.

Ensuring the environment is free from these hazards reduces the risk of falls, making it easier for the client to move safely. This intervention helps create a more stable and safe living space for recovery.
9. A nurse is caring for several clients on a medical-surgical unit. Which of the following clients is at the highest risk for developing constipation?
  • A client on a low-fat diet following gallbladder removal 6 months ago.

  • A client taking a stool softener daily and walking 30 minutes each evening.

  • A client who eats three balanced meals per day and drinks 2,000 mL of fluid daily.

  • A client recovering from a cerebrovascular accident (stroke) who requires assistance with ambulation.

Explanation

Explanation
Correct Answer: D) A client recovering from a cerebrovascular accident (stroke) who requires assistance with ambulation.

Clients who have had a stroke often experience decreased mobility, muscle weakness, and possible neurological impairment affecting bowel function. Reduced physical activity slows intestinal motility, which increases the risk of constipation.

In addition, stroke clients may have difficulty with adequate fluid intake, dietary changes, or medications that further contribute to constipation. Limited mobility is one of the most significant risk factors for constipation in hospitalized patients, making this client the highest risk among the options.
10. A nurse educator is preparing a presentation for catheter-associated urinary tract infections (CAUTIs). Which of the following information should be included as risk factors? (Select All that Apply.)
  • Frequent urination

  • Prolonged use of an indwelling urinary catheter

  • Using a catheter securement device

  • Maintaining proper perineal hygiene

  • Lack of perineal care

  • Opening the closed urinary drainage system

  • Routine changes of indwelling urinary catheter

Explanation

Explanation
Correct Answer: B) Prolonged use of an indwelling urinary catheter, E) Lack of perineal care, F) Opening the closed urinary drainage system
Risk factors for catheter-associated urinary tract infections (CAUTIs) include several aspects related to the use and maintenance of indwelling catheters. Prolonged use of an indwelling urinary catheter increases the risk of bacterial colonization in the urinary tract, which can lead to infection.

Lack of perineal care can also contribute to the risk by allowing bacteria to migrate along the catheter, increasing the likelihood of infection. Opening the closed urinary drainage system provides a route for bacteria to enter the sterile system, leading to possible contamination and infection.

Regular, careful care and maintenance of urinary catheters, including preventing unnecessary catheter use and ensuring proper hygiene, are critical in reducing the risk of CAUTIs

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