*NURSING > ATI > ATI FUNDAMENTALS (HEALTH ASSESSMENT) COMPLETE EXAM COMPLETE PRACTICE QUESTIONS AND ANSWERS A GRADED (All)

ATI FUNDAMENTALS (HEALTH ASSESSMENT) COMPLETE EXAM COMPLETE PRACTICE QUESTIONS AND ANSWERS A GRADED EXAM

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A nurse is admitting a client who has decreased circulation in his left leg. Which of the following actions should the nurse take first? A) Evaluate pedal pulses B) Obtain medical Hx C) Measure v... ital signs D) Assess for leg pain - CORRECT ANSWER A) Evaluate pedal pulses For a client w/ decreased circulation in the leg, evaluating pedal pulses is critical in order to determine adequate blood supply to the foot. THe nurse should apply the safety and risk reduction priority-setting framework. This framework assigns priority to the factor posing the greatest safety risk to the client. When there are several risks to client safety, the one posing the greatest threat is the highest priority. The nurse should use Maslow's Hierarchy of Needs, the ABC priority setting framework, and/or nursing knowledge to ID which risk poses the greatest threat to the client. The nurse is performing a neuro assessment of a client. To promote safety during the exam, the nurse stands nearby as the client follows instructions for which of the following tests? A) Romberg B) Kinesthetic sensation C) 2-point discrimination D) Weber - CORRECT ANSWER A) Romberg A Romberg test evaluates standing balance, first with the client's eyes open and then with them closed. The nurses should remain nearby because the client could fall during this test. A nurse is performing an admission assessment for a client who has asthma and reports several food allergies. Which of the following actions should the nurse take first? A) Document the client's food allergies in the medical record B) Ask the client to ID the specific food allergies C) Monitor the client for indications for anaphylaxis D) Have epinephrine available for administration - CORRECT ANSWER B) Ask the client to ID the specific food allergies The nurse should apply the nursing process for priority-setting framework in order to plan client care and prioritize nursing actions. Each step of the nursing process builds on the previous step, beginning with an assessment or data collection. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify the provider of a change in the client's status, the nurse must first collect adequate data from the client. Assessing or collecting additional data will provide the nurse with the knowledge to make an appropriate decision. Therefore, the nurse should first assess the clients allergies and ID the specific allergens to ensure the specific foods are not offered to the client during meals. Purchase to score an A+ [Show More]

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