ATI RN
ATI Comprehensive Predictor 2023 Exit Exam B Questions
Extract:
Question 1 of 5
A nurse is assisting with the care of a client who is postoperative following a thyroidectomy. Which of the following findings should the nurse report to the provider?
Correct Answer: C
Rationale: Tingling around the mouth suggests hypocalcemia, a risk post-thyroidectomy, requiring provider notification. Pain, hoarseness, and mild fever are expected.
Question 2 of 5
A nurse is instructing a school-age child who has asthma about the use of a peak expiratory flow meter. Which of the following instructions should the nurse include in the teaching?
Correct Answer: C
Rationale:
Choice A is wrong because maintaining a semi-Fowler's position during testing is not necessary. You can sit or stand up straight, but make sure you do it the same way each time.
Choice B is wrong because placing tongue on the mouthpiece of the meter can block the air flow and affect the accuracy of the measurement. You should close your lips tightly on the mouthpiece instead. This is because a peak flow meter measures how fast you can push air out of your lungs when you blow out as hard and as fast as you can. This is called peak expiratory flow rate (PEFR) or peak expiratory flow (PEF). It shows how open the airways are in the lungs and can help detect early signs of worsening asthma.
Choice D is wrong because recording the average of the readings is not recommended. You should record the highest of the three readings on a sheet of paper, calendar, or in your asthma diary. This is your daily peak flow.
Question 3 of 5
A nurse is caring for an infant who has coarctation of the aorta. Which of the following should the nurse identify as an expected finding?
Correct Answer: C
Rationale:
Choice A is not a typical sign of coarctation of the aorta. Nosebleeds can be caused by many factors, such as dry air, allergies, trauma, or bleeding disorders.
Choice B is also not a common finding in coarctation of the aorta. In fact, patients with this condition may have high blood pressure in the upper extremities due to the increased resistance of the narrowed aorta. This is because coarctation of the aorta is a congenital condition where the aorta is narrow, usually in the area where the ductus arteriosus inserts. This causes a decrease in blood flow to the lower body, resulting in weak or absent pulses in the femoral arteries.
Question 4 of 5
A nurse is caring for a client who has a new prescription for sertraline for depression. Which of the following findings should the nurse monitor for as an adverse effect?
Correct Answer: B
Rationale: Insomnia is a common adverse effect of sertraline, an SSRI, due to its stimulating effect on serotonin levels, and should be monitored, as it may require dose adjustment or bedtime avoidance.
Choice A is incorrect because sertraline is more likely to cause weight gain, not weight loss, over time.
Choice C is incorrect because hypotension is not a common side effect; orthostatic hypotension may occur but is less frequent.
Choice D is incorrect because bradycardia is not typically associated with sertraline; tachycardia may occur with anxiety or overstimulation.
Question 5 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.
| 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
Rationale: Stay with the client for the first 15 min of the transfusion and Document the blood product transfusion in the client's medical record are indicated nursing actions for the client. Obtain the first unit of packed RBCs from the blood bank is also indicated, but it should be done before starting the transfusion. Titrate the rate of infusion to maintain the client's blood pressure at least 90/60 mm Hg and Start an IV bolus of lactated Ringer's solution are not indicated nursing actions for the client. Explanation: Staying with the client for the first 15 min of the transfusion is indicated because this is when most adverse reactions occur and the nurse should monitor the client's vital signs and symptoms closely. Documenting the blood product transfusion in the client's medical record is indicated because this is part of the legal and ethical responsibility of the nurse and it provides a record of the type, amount, duration, and outcome of the transfusion. Obtaining the first unit of packed RBCs from the blood bank is indicated because this is part of the preparation for the transfusion and it ensures that the blood product is compatible, fresh, and available. However, this should be done before starting the transfusion, not after. Titrating the rate of infusion to maintain the client's blood pressure at least 90/60 mm Hg is not indicated because this may cause fluid overload: This may cause fluid overload or hemolysis in the client who already has a low blood pressure and a high heart rate. The rate of infusion should be based on the client's condition, weight, and response to the transfusion, not on a fixed target. Starting an IV bolus of lactated Ringer's solution is not indicated because this may cause electrolyte imbalance or hemolysis in the client who already has a positive H. pylori test and a history of gastrointestinal bleeding. The only fluid that should be infused with blood products is 0.9% NaCl (normal saline) because it has a similar osmolarity and pH as blood and it prevents clotting or hemolysis.