ATI RN
ATI Comprehensive Predictor 2023 Exit exam A Questions
Extract:
Exhibit 1
Postoperative day 2
0600:
Urine output over 12 hr was 750 mL pink urine.
Fluid intake over 12 hr was 800 mL
1800:
Urine output over 12 hr was 500 mL pink urine.
Fluid intake over 12 hr was 1500 mL.
Question 1 of 5
For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.
| Options | Anticipated | Contraindicated |
|---|---|---|
| Applying warm compresses to the incision site. | ||
| Maintaining bed rest for 2 days postoperatively. | ||
| Irrigating indwelling urinary catheter with 50 mL of normal saline. | ||
| Administering enema to relieve constipation. | ||
| Placing a blanket roll under the client's knees while in bed. |
Correct Answer: A
Rationale: Applying warm compresses to the incision site is anticipated for the client, as it can help reduce swelling and pain.
Choice B is contraindicated as it increases the risk of complications like deep vein thrombosis, pulmonary embolism, and pneumonia; early ambulation is preferred.
Choice C is contraindicated because irrigating the catheter can introduce bacteria, risking infection, unless specifically ordered.
Choice D is contraindicated as an enema can increase pelvic pressure, risking bleeding or surgical site damage; stool softeners or laxatives are safer.
Choice E is contraindicated as it impairs circulation, increasing the risk of thrombophlebitis; legs should be slightly elevated without knee flexion.
Extract:
Laboratory Results
Vital Signs
0900:
Client reports, "I'm bloated and my stomach hurts."
History of prior illness: Client reports a 3-week history of gnawing abdominal pain. Client states, "It's a burning sensation that radiates to my back. I think I've lost a little weight too." Reports one episode of dark, tarry stool. No vomiting. Client reports pain is worse about 1 hr after eating a meal.
Past medical history: Osteoarthritis.
Social history: Recently divorced, drinks in moderation (3 to 4 drinks per week), smokes tobacco.
Current medications: Ibuprofen 800 mg three times daily PRN arthritis pain.
Physical Examination:
General: client appears uncomfortable, diaphoretic.
Head, ears, eyes, nose, and throat (HEENT): oropharynx clear, mucous membranes moist and pale.
Respiratory: bilateral breath sounds clear.
Gastrointestinal: epigastric tenderness to palpation, no rebound tenderness or guarding
Neurological: oriented x 3 (person, place, and time).
Question 2 of 5
The nurse is ready to begin the blood transfusion. For each potential nursing action, click to specify if the action is indicated or not indicated for the client.
| Options | Indicated | Not Indicated |
|---|---|---|
| Stay with the client for the first 15 min of the transfusion. | ||
| Document the blood product transfusion in the client's medical record. | ||
| Obtain the first unit of packed RBCs from the blood bank. | ||
| Titrate the rate of infusion to maintain the client's blood pressure at least 90/60 mm Hg. | ||
| Start an IV bolus of lactated Ringer's solution. |
Correct Answer: A,B,C
Rationale: Staying with the client for the first 15 min is indicated to monitor for adverse reactions, which are most likely during this period. Documenting the transfusion is indicated for legal and ethical accountability, recording type, amount, duration, and outcome. Obtaining the blood unit is indicated but should occur before starting the transfusion to ensure compatibility and availability. Titrating the infusion rate to maintain blood pressure is not indicated, as it risks fluid overload or hemolysis; the rate should be based on the client's condition and response. Starting lactated Ringer's is not indicated, as it may cause electrolyte imbalances or hemolysis; only 0.9% NaCl is compatible with blood products.
Extract:
Vital Signs
Nurses' Notes
Laboratory Results
0400:
57-year-old male client presents to the emergency department with severe abdominal and epigastric pain that began about 12 hr ago. Client rates pain as a 7 on a 0 to 10 pain scale. Client reports pain worsens after eating and radiates into his back. States is nauseous and has had several episodes of vomiting, i Reports some shortness of air and increased pain when lying । flat.
Client is alert and oriented x4 but appears ill. Sclera and palate noted to be yellow. Abdomen distended, rigid, and tender to palpation. Skin turgor poor.
Client reports consuming 3 to 4 alcoholic drinks per day, denies use of other substances. No known allergies.
0730:
Will admit to medical-surgical unit for treatment of pancreatitis. Treatment plan discussed with client
Question 3 of 5
For each potential provider prescription click to specify if the prescription is anticipated or contraindicated for the client.
| Options | Anticipated | Contraindicated |
|---|---|---|
| Insert an indwelling urinary catheter. | ||
| Insert a nasogastric tube and maintain low intermittent suction. | ||
| Administer lactated Ringer's 1 L via IV bolus. | ||
| Administer famotidine 20 mg via intermittent IV infusion twice daily. |
Correct Answer: A,B,C,D
Rationale: Inserting a urinary catheter is anticipated to monitor urine output and fluid status due to possible oliguria or anuria from pancreatitis-related dehydration or renal impairment. A nasogastric tube with suction is anticipated to decompress the stomach, reduce pancreatic stimulation, and prevent aspiration due to nausea and vomiting. Administering lactated Ringer's is anticipated to correct hypovolemia, hypotension, and electrolyte imbalances, improving perfusion and preventing shock. Famotidine is anticipated to reduce gastric acid production, protecting the mucosa and promoting ulcer healing in pancreatitis-associated gastric hypersecretion.
Extract:
Nurses' Notes
Vital Signs
Adult child accompanying parent reports cognitive and physical decline in the client, expressing concern over memory loss, thought processes, appetite, and self-care. Adult child states, "My sibling and I hired help at home for my parent. We thought that might help, but it has not. I found the title to the car today, signed over to me."
Client makes poor eye contact, speaks in a monotone voice, and has a lack of facial expression
Client reports sleeping 7 hr a night and getting up "once or twice per night to go to the bathroom." Client reports not wanting to eat anymore. Client's child reports their parent has lost about 8 lb in the past month
1030:.
Client found sitting in waiting room, head in hands. Client says, "Why don't you just leave me? I am of no use.”
Question 4 of 5
Click to highlight the findings that require immediate follow-up.
| Adult child reports decline in memory, thought process, appetite, and self-care; hired help ineffective; car title signed over. |
| Client makes poor eye contact, speaks in monotone, lacks facial expression. |
| Client says, 'Why don't you just leave me? I am of no use.' |
| Client reports not wanting to eat anymore. |
| Client's child reports 8 lb weight loss in the past month. |
Correct Answer: A,B,C,D,E
Rationale: These findings suggest cognitive impairment, depression, and/or malnutrition, requiring immediate follow-up. The adult child's report indicates significant decline and potential legal/financial concerns (car title transfer). Poor eye contact, monotone speech, and flat affect are signs of depression or cognitive issues. The statement of being 'no use' suggests suicidal ideation or severe low self-esteem. Not wanting to eat and 8 lb weight loss indicate malnutrition and potential worsening of physical health. A comprehensive assessment of cognitive, behavioral, and nutritional status is needed, along with interdisciplinary collaboration and monitoring.
Extract:
Question 5 of 5
A nurse is admitting an adolescent who has rubella. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: Isolating the client from pregnant staff is critical because rubella is highly contagious and can cause congenital rubella syndrome, leading to severe fetal harm. Aspirin is contraindicated due to the risk of Reye's syndrome in viral infections. Airborne precautions are unnecessary; rubella spreads via droplets, requiring only standard and droplet precautions. Koplik spots are specific to measles, not rubella, which presents with a pink/red rash.