ATI RN
ATI Comprehensive Predictor 2023 Exit Exam B Questions
Extract:
Question 1 of 5
A nurse is caring for a client who is in the second stage of labor. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: Encouraging the client to push with each contraction during the second stage of labor (from full cervical dilation to delivery) is appropriate, as it facilitates fetal descent and delivery, aligning with the client's natural urges to push.
Choice B is wrong because positioning the client supine with legs elevated is not recommended; it can compress the inferior vena cava, reduce uterine blood flow, and impede pushing efforts. Upright or lateral positions are preferred.
Choice C is wrong because applying fundal pressure is not a standard practice and can cause maternal or fetal injury, such as uterine rupture or shoulder dystocia.
Choice D is wrong because instructing the client to hold her breath while pushing (Valsalva maneuver) can decrease oxygen to the fetus and increase maternal fatigue; open-glottis pushing (exhaling while pushing) is preferred.
Question 2 of 5
A nurse is reinforcing teaching with a client who has a new prescription for spironolactone. Which of the following instructions should the nurse include?
Correct Answer: B
Rationale: Reporting signs of hyperkalemia is critical with spironolactone due to potassium-sparing effects. Potassium intake should not increase, it's taken in the morning, and diuresis is not immediate.
Question 3 of 5
A nurse is assisting with the care of a client who is receiving chemotherapy. Which of the following laboratory values should the nurse monitor?
Correct Answer: A
Rationale: Monitoring white blood cell count is critical during chemotherapy due to immunosuppression risk. Potassium, glucose, and creatinine are less directly affected.
Question 4 of 5
A nurse is assessing a client who has a spinal cord injury at the C5 level. Which of the following findings should the nurse expect?
Correct Answer: D
Rationale: A spinal cord injury at the C5 level typically preserves the function of the diaphragm (innervated by C3-C5) and shoulder muscles (deltoid and rotator cuff, innervated by C5), allowing the client to shrug shoulders.
Choice A is incorrect because a C5 injury affects the lower extremities, causing paraplegia or quadriplegia, depending on the extent.
Choice B is incorrect because, while respiratory function is partially preserved (diaphragm intact), the client may still have impaired accessory muscle function, leading to reduced respiratory capacity.
Choice C is incorrect because sensation loss typically occurs below the level of injury (below C5), not necessarily below the clavicles, and may vary in completeness.
Question 5 of 5
A nurse is caring for a client who is postoperative following a coronary artery bypass graft (CABG). Which of the following findings should the nurse report to the provider?
Correct Answer: C
Rationale: ST-segment elevation on ECG is a critical finding post-CABG, indicating possible myocardial ischemia or infarction, requiring immediate reporting to the provider for intervention.
Choice A is incorrect because incisional pain rated 4/10 is expected post-CABG and can be managed with analgesics; severe or worsening pain would be more concerning.
Choice B is incorrect because a temperature of 37.8°C is a low-grade fever, common in the first 48 hours post-surgery, and does not require immediate reporting unless persistent or higher.
Choice D is incorrect because drainage of 50 mL/hr from chest tubes is within the expected range for the first 24 hours post-CABG; excessive drainage (>100 mL/hr) would be concerning.