ATI RN
ATI Comprehensive Predictor 2023 Exit Exam B Questions
Extract:
Question 1 of 5
A nurse is admitting a client who has schizophrenia. The client states, “I'm hearing voices.†Which of the following responses is the priority for the nurse to state?
Correct Answer: C
Rationale: The nurse should not assume that the client's hallucinations are related to medication noncompliance, as this can be perceived as accusatory and judgmental. The nurse should not focus on the duration of the hallucinations, as this is not the priority at this time. The nurse should ask the client what the voices are telling them, because this can help assess the client's risk for harm to self or others, and also show empathy and respect for the client's experience. The nurse should not invalidate the client's reality by stating that they do not hear anything, as this can cause mistrust and alienation.
Question 2 of 5
Complete the following sentence by using the list of options: After notifying the provider, the nurse should first:
Correct Answer: C
Rationale:
Choice A is wrong because checking a STAT cardiac troponin is not the first priority. Cardiac troponin is a biomarker that indicates myocardial injury, but it may not rise until several hours after the onset of chest pain.
Therefore, it is not useful for immediate diagnosis or treatment of acute coronary syndrome.
Choice B is wrong because requesting a prescription for a beta-blocker is not the first priority. Beta-blockers are medications that can lower blood pressure and heart rate, and reduce the oxygen demand of the heart. They can prevent or reduce the recurrence of chest pain and complications of acute coronary syndrome, but they are not indicated for immediate relief of chest pain. Nitroglycerin is a vasodilator that can relieve chest pain caused by myocardial ischemia. The nurse should administer it as soon as possible to improve blood flow to the heart and reduce the risk of myocardial infarction. The nurse should also monitor the client's blood pressure and heart rate after giving nitroglycerin, as it can cause hypotension and reflex tachycardia.
Choice D is wrong because administering oxygen is not the first priority. Oxygen therapy can increase the oxygen supply to the heart and reduce ischemia, but it is not necessary for all clients with chest pain. Oxygen therapy should be based on the client's oxygen saturation level and clinical condition. If the client's oxygen saturation is normal or high, oxygen therapy may not be beneficial and may even be harmful.
Question 3 of 5
A nurse is providing teaching to the parents of a newborn about newborn genetic screening. Which of the following statements should the nurse include in the teaching?
Correct Answer: D
Rationale:
Choice A is wrong because the blood sample is not drawn from the baby's inner elbow, but from the heel.
Choice B is wrong because the baby does not need to drink water prior to the test, as this could dilute the blood sample and affect the results.
Choice C is wrong because the test does not need to be repeated when the baby is 2 months old, unless there is a positive or inconclusive result from the first test. Newborn genetic screening is important for early detection and intervention. This test should be performed after your baby is 24 hours old. This is because newborn genetic screening is a set of laboratory tests that detect a set of known genetic diseases that can affect a child's long-term health or survival. The test is performed on a blood sample obtained from a heel prick when the baby is two or three days old. Performing the test after 24 hours ensures that the baby has had enough time to metabolize certain substances that could interfere with the accuracy of the test.
Question 4 of 5
A nurse is caring for a client who has a new prescription for sumatriptan for cluster headaches. Which of the following findings should the nurse monitor for as an adverse effect?
Correct Answer: A
Rationale: Chest tightness is a potential adverse effect of sumatriptan, a triptan used for cluster headaches, due to its vasoconstrictive effects, which may mimic angina and require immediate evaluation.
Choice B is incorrect because weight gain is not associated with sumatriptan; it is more typical of other medications like antidepressants.
Choice C is incorrect because fever is not a common side effect unless an infection is present.
Choice D is incorrect because tachycardia, not bradycardia, may occur due to sumatriptan's stimulatory effects.
Question 5 of 5
A nurse is providing teaching to a client who has a new prescription for prednisone for adrenal insufficiency. Which of the following instructions should the nurse include?
Correct Answer: C
Rationale: Monitoring for signs of infection is critical, as prednisone, a corticosteroid, suppresses the immune system, increasing infection risk in clients with adrenal insufficiency.
Choice A is incorrect because prednisone should be taken with food to reduce gastrointestinal irritation, not on an empty stomach.
Choice B is incorrect because prednisone for adrenal insufficiency is typically a lifelong therapy, not limited to a few weeks.
Choice D is incorrect because reducing the dose without medical guidance can precipitate an adrenal crisis; dose adjustments must be supervised by the provider.