ATI RN
ATI Comprehensive Predictor 2023 Exit Exam B Questions
Extract:
Question 1 of 5
A nurse is caring for a client who is postoperative following a cholecystectomy. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: Encouraging the client to ambulate within 4 hours after a cholecystectomy promotes circulation, prevents complications like deep vein thrombosis, and aids in recovery of bowel function.
Choice B is incorrect because morphine should be administered as needed (PRN) for pain, not on a fixed every-6-hour schedule, to avoid overmedication.
Choice C is incorrect because a supine position with legs elevated is not necessary and may be uncomfortable; a semi-Fowler's position is preferred to reduce abdominal strain.
Choice D is incorrect because a high-fat meal should be avoided post-cholecystectomy, as it can cause discomfort or diarrhea due to altered bile metabolism; a low-fat diet is recommended initially.
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.
| 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.
Question 3 of 5
A nurse is assessing a client who has a new diagnosis of otitis media. Which of the following findings should the nurse expect?
Correct Answer: A
Rationale: Ear pain is a hallmark symptom of otitis media, caused by inflammation and pressure from fluid buildup in the middle ear.
Choice B is incorrect because clear ear drainage is not typical; purulent or bloody drainage may occur if the eardrum ruptures.
Choice C is incorrect because a fever of 37.2°C is not significant; otitis media often causes higher fevers (e.g., >38°
C) in acute cases.
Choice D is incorrect because otitis media typically causes hearing loss due to fluid in the middle ear, not improved hearing.
Question 4 of 5
A nurse is caring for a client who is experiencing alcohol withdrawal. Which of the following medications should the nurse anticipate administering?
Correct Answer: C
Rationale: Lorazepam, a benzodiazepine, is commonly administered during alcohol withdrawal to manage symptoms like tremors, seizures, and agitation by calming the central nervous system.
Choice A is incorrect because naltrexone is used for maintenance therapy to reduce alcohol cravings, not for acute withdrawal.
Choice B is incorrect because disulfiram is used to deter alcohol consumption, not to treat withdrawal symptoms.
Choice D is incorrect because acamprosate is used to maintain abstinence in alcohol use disorder, not for managing acute withdrawal.
Question 5 of 5
A nurse is caring for a client who has atrial fibrillation and is receiving warfarin. Which of the following laboratory results should the nurse report to the provider?
Correct Answer: A
Rationale: An INR of 4.5 is above the therapeutic range for atrial fibrillation (typically 2.0-3.0) and indicates an increased risk of bleeding, requiring immediate reporting to the provider for potential dose adjustment or vitamin K administration.
Choice B is wrong because a platelet count of 200,000/mm3 is within the normal range (150,000-400,000/mm3) and does not require reporting.
Choice C is wrong because aPTT is not used to monitor warfarin therapy (it monitors heparin); an aPTT of 40 seconds is within normal limits (30-40 seconds) and not concerning.
Choice D is wrong because a hemoglobin of 13 g/dL is within the normal range for males (13-17 g/dL) and females (12-16 g/dL) and does not indicate bleeding or anemia.