ATI RN
Multi Dimensional Care | Exam | Rasmusson
1. Which among the following is NOT the cause of pressure ulcers?
- A. Immobility
- B. Poor nutrition
- C. Moisture
- D. Adequate perfusion
Correct answer: D
Rationale:
2. What device would be best to use for a client who is immobile?
- A. Standing assist device
- B. A mechanical lift
- C. Transfer board
- D. Gait belt
Correct answer: B
Rationale: A mechanical lift is the most suitable device for a client who is immobile as it provides safe and efficient assistance in moving the individual. A standing assist device is used for support during standing activities, not for transferring an immobile client. A transfer board is helpful for assisting a client in sliding from one surface to another but may not be the best option for someone who is completely immobile. A gait belt is used for providing support and stability during walking or transferring, which may not be effective for a client who is immobile and requires more comprehensive assistance.
3. A client with a bone cancer states that he is in too much pain to walk today. What should the nurse do first?
- A. Inquire about the frequency, quality and location of the pain
- B. Get the client pain medication
- C. Ensure the client knows he will have negative effects from immobility
- D. Review the client’s medication administration record
Correct answer: A
Rationale: Assessing the pain characteristics helps in managing the client’s pain effectively.
4. Which of the following clients are at an increased risk for deep vein thrombosis following a reduction and internal fixation of the hip? (Select all that apply)
- A. A client on birth control pills
- B. A client who is immobile
- C. A client on an anticoagulant
- D. A client with dementia who has been wandering
Correct answer: a
Rationale: Clients on birth control pills, immobile, and smokers are at increased risk of DVT after hip surgery.
5. A nurse is teaching a client who has out about dietary recommendations. The nurse should teach the client which of the following beverages can trigger an attack?
- A. Fruit juice
- B. Alcohol
- C. Milk
- D. Coffee
Correct answer: B
Rationale:
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