ATI RN
ATI Comprehensive 2024 Exit Exam with NGN Questions
Extract:
A nurse is caring for a client.
Question 1 of 5
Select the 5 findings that require immediate follow-up
Correct Answer: A,B,D,E,H
Rationale: The correct choices for immediate follow-up are A, B, D, E, and H. Stool results (
A) are crucial for detecting gastrointestinal issues. Hemoglobin and hematocrit (
B) levels indicate blood health. Heart rate (
D) reflects cardiovascular function. Current medications (E) help assess potential drug interactions. WIC count (H) is essential for monitoring infection. Respiratory rate (
C) and temperature (F) are important but not as urgent.
Extract:
A nurse reviews the entries in the medical record.
Question 2 of 5
For each potential nursing action, click to specify if the action is indicated or not indicated for the client.
Potential Prescription | Anticipated | Not Indicated |
---|---|---|
Document the blood product transfusion in the client's medical record. | ||
Stay with the client for the first 15 min of the transfusion | ||
Titrate the rate of infusion to maintain the client's blood pressure at least 91/60 mm. Hg | ||
Obtain the first unit of packed RBCS from the blood bank. | ||
Start an IV bolus of lactated Ringers solution. |
Correct Answer: A,B,D
Rationale: [A: 1, B: 1, C: 0, D: 1, E: 0, F: , G: ]
- A: Documenting blood product transfusion is crucial for legal and tracking purposes.
- B: Staying with the client ensures immediate response to any adverse reactions.
- C: Titration of infusion rate for BP is not within nursing scope without physician order.
- D: Obtaining packed RBCs precedes transfusion to verify compatibility.
- E: Starting IV bolus of LR is not indicated as it is unrelated to the transfusion process.
Extract:
Question 3 of 5
A nurse is assessing a client who is postoperative following abdominal surgery and has an indwelling urinary catheter that is draining dark yellow urine at 25 mL/hr. Which of the following interventions should the nurse anticipate?
Correct Answer: B
Rationale: The correct answer is B: Administer a fluid bolus. The dark yellow urine output at 25 mL/hr indicates concentrated urine and potential dehydration. Administering a fluid bolus would help improve hydration status and increase urine output. Continuous bladder irrigation (
A) is not indicated as there is no indication of bladder obstruction. Clamping the catheter tubing (
C) can lead to urinary retention and should not be done without a specific reason. Obtaining a urine specimen for culture (
D) is important, but addressing the dehydration issue takes priority.
Extract:
A nurse in an outpatient orthopedic clinic is caring for the client six weeks following surgical repair of a fractured radius.
Question 4 of 5
Which of the following information provided by the client indicates improvement? Select all that apply.
Correct Answer: B,C,D,E,F
Rationale: Improvement signs encompass hygiene, nutrition, weight gain, and social interaction.
Extract:
A nurse is caring for a client who is receiving total parenteral nutrition(TPN): The bag has 20 mL remaining to infuse, but a new bag is not readily available.
Question 5 of 5
Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Administer dextrose 10% in water. This action is appropriate for treating hypoglycemia, which can be a potential complication of TPN (
Total Parenteral Nutrition) therapy. Administering dextrose 10% in water can help raise the patient's blood sugar levels quickly and effectively.
Choice B is incorrect as lactated Ringers solution does not directly address hypoglycemia.
Choice C is not the best option as slowing the TPN infusion rate may further decrease the patient's blood sugar levels.
Choice D is also incorrect as temporarily discontinuing the TPN infusion may exacerbate the hypoglycemia.