ATI-F ATI Fundamentals - Set 2 - Part 3

Correct Answer: Keep small objects out of reach

Infants explore by mouthing objects, so keeping small items out of reach prevents choking and aspiration. Removing accessible small objects is a key safety measure for this age. Option b is incorrect because offering popcorn gives the infant a hard food that can easily be aspirated. Small, hard foods are avoided because an infant cannot chew and swallow them safely. Option c is incorrect because propping the bottle lets formula flow while the infant cannot control it, raising the aspiration risk. Bottles should be held, not propped, during feedings to protect the infant. Option d is incorrect because placing an infant on the stomach to sleep raises the risk of suffocation, not aspiration prevention. Infants are placed on the back to sleep for safety reasons.

Correct Answer: Keep all smoking away from the oxygen

Oxygen makes materials ignite and burn rapidly, so no smoking is allowed near it. Keeping all smoking away from the oxygen, including by visitors, is essential to prevent a fire. Option a is incorrect because storing oxygen near a heater places it close to an ignition source and heat. Oxygen is kept away from flames and heat, not beside a heater, to avoid a fire. Option c is incorrect because wool blankets can generate static electricity that may spark near oxygen. Cotton bedding is used instead, so wool near oxygen adds a fire risk rather than removing it. Option d is incorrect because petroleum jelly is flammable and should not be used around oxygen near the face. A water-based product is safer, so this instruction would introduce a hazard for the client.

Correct Answer: It cannot be seen, smelled, or tasted

Carbon monoxide cannot be seen, smelled, or tasted, which is why a detector is essential. Because it gives no warning to the senses, families rely on an alarm to detect it. Option a is incorrect because describing a strong odor is inaccurate, since carbon monoxide has no smell at all. Believing it can be smelled gives a false sense of safety and delays escape. Option b is incorrect because carbon monoxide is a year-round hazard from fuel-burning appliances, not only a summer risk. Limiting concern to one season leaves families unprotected during the rest of the year. Option d is incorrect because carbon monoxide is dangerous even in small amounts because it binds with hemoglobin and reduces oxygen. Treating it as harmless underestimates a gas that can quickly become deadly.

Correct Answer: Apply direct pressure to the wound

Applying direct pressure to the wound is the first action to control external bleeding. Steady pressure slows blood loss while further help and treatment are arranged for the client. Option a is incorrect because elevating the leg may help, but waiting without applying pressure allows bleeding to continue. Direct pressure is the immediate action needed to control the active blood loss. Option c is incorrect because removing an object from a wound can worsen bleeding if it was helping to plug the vessel. Impaled objects are stabilized, not pulled out, during emergency first aid. Option d is incorrect because cleaning the wound with soap is not the priority while the client is actively bleeding. Controlling the bleeding with pressure comes before any cleaning of the wound area.

Correct Answer: Begin rapid cooling measures

Hot, dry skin with confusion and a very high temperature suggests heat stroke, an emergency. The nurse begins rapid cooling, such as removing clothing and applying cool measures, to lower the temperature quickly. Option b is incorrect because covering the client with warm blankets raises body temperature further in a heat emergency. The goal is to cool the client rapidly, so adding warmth is the opposite of what is needed. Option c is incorrect because encouraging the client to keep working ignores a life-threatening rise in body temperature. Heat stroke requires immediate cooling and rest, not continued exertion in the hot environment. Option d is incorrect because offering a hot beverage adds heat the body cannot release, since the client is no longer sweating. Cooling measures, not warm fluids, are the priority in heat stroke.

Correct Answer: Bend the knees and lift with the legs

Bending the knees and lifting with the strong leg muscles protects the back during a lift. Keeping the object close and using the legs distributes the load and prevents back strain. Option a is incorrect because bending at the waist places the strain on the back instead of the legs. This common error is a leading cause of back injury during lifting. Option b is incorrect because holding the object away from the body increases the load on the spine. The object is kept close to the center of gravity to reduce strain, not held at a distance. Option d is incorrect because twisting the back during a lift can injure the spine and muscles. The nurse faces the load and avoids twisting so the movement stays safe for the back.

Correct Answer: Use a mechanical lift and get help

When a client cannot bear weight or assist, a mechanical lift with additional staff is the safest method. Using equipment and help protects both the client and the nurse from injury. Option a is incorrect because lifting the client alone risks injury to the nurse's back and a fall for the client. A dependent client requires equipment and extra staff, not a rushed solo lift. Option b is incorrect because pulling the client up by the arms can dislocate joints and bruise the skin. This unsafe technique endangers the client and does not use the proper equipment or help. Option c is incorrect because asking a client who cannot bear weight to stand sets up a likely fall. The situation calls for a mechanical lift and assistance rather than an unsafe attempt to stand.

Correct Answer: Semi-Fowler's position

Placing the client in Semi-Fowler's position raises the head of the bed and uses gravity to keep the feeding down. This reduces regurgitation and the risk of aspiration during enteral feeding. Option b is incorrect because the supine position lays the client flat, which allows the feeding to flow back toward the throat. Lying flat raises the aspiration risk rather than lowering it during a feeding. Option c is incorrect because the Trendelenburg position tilts the head lower than the feet, encouraging the feeding to move upward. This promotes regurgitation and is unsafe during an enteral tube feeding. Option d is incorrect because the prone position places the client on the abdomen, which is not appropriate for a feeding. It does not protect the airway and makes monitoring the client difficult during the feeding.

Correct Answer: Expectant

In mass casualty triage, a client not expected to survive despite care is classified as expectant. These clients receive comfort measures so resources can save those most likely to live. Option a is incorrect because the immediate category is for clients with life-threatening injuries who have a good chance of survival once treated. A client not expected to survive does not fit this lifesaving priority. Option b is incorrect because the delayed category is for serious injuries that can safely wait a short time for care. A client expected to die needs comfort care, not a delayed treatment slot. Option d is incorrect because the minimal category is for minor injuries that need little care. A client with massive crush injuries who is not expected to live is far beyond this low-acuity group.

Correct Answer: A stable, ambulatory client needing minimal care

In a disaster, stable ambulatory clients who need minimal care are discharged or relocated first. Their departure frees beds for higher-priority clients without compromising their own safety. Option a is incorrect because a client receiving intravenous fluids needs ongoing nursing care and monitoring. Such a client is not among the first to leave, since their treatment cannot stop abruptly. Option b is incorrect because a client with a new chest tube requires close assessment and is not stable enough to discharge first. This client needs continued care rather than early release during the disaster. Option c is incorrect because a client who is unstable after surgery requires intensive nursing attention. Discharging this client would be unsafe, so they are not the appropriate choice to release first.