ATI RN
RN ATI Comprehensive Assessment Exam Retake 2023 V2 Questions
Extract:
Question 1 of 5
A nurse is planning care for a client who has acute appendicitis. Which of the following actions should the nurse plan to take?
Correct Answer: C
Rationale:
Correct Answer: C - Keep the client on NPO status
Rationale: In acute appendicitis, the client may require urgent surgery to remove the inflamed appendix. Keeping the client NPO (nothing by mouth) is essential to avoid potential complications during surgery, such as aspiration of stomach contents. This action also helps prevent delays in the surgical intervention and minimizes the risk of infection.
Incorrect
Choices:
A: Placing the client's head of bed flat can increase intra-abdominal pressure and worsen the client's condition.
B: Applying heat to the client's abdomen can exacerbate inflammation and may mask the symptoms, delaying appropriate treatment.
D: Administering a laxative can be dangerous as it may cause the appendix to rupture due to increased pressure from fecal matter.
Extract:
Nurses' Notes
Day 1, 0900:
Client is at 31 weeks of gestation and presents with a severe headache unrelieved by acetaminophen. Client also reports urinary frequency and decreased fetal movement. Client is a G3 P2 with one preterm birth.
Vital Signs
Day 1, 0900:
Temperature (oral) 36.9°C (98.4°F)
Heart rate 72/min
Respiratory rate 16/min
BP 162/112 mm Hg
Oxygen saturation 97% on room air
Diagnostic Results
Day 1, 1000:
Appearance cloudy (clear)
Color yellow (yellow)
pH 5.9 (4.6 to 8)
Protein 3+ (negative)
Specific gravity 1.013 (1.005 to 1.03)
Leukocyte esterase negative (negative)
Nitrites negative (negative)
Ketones negative (negative)
Crystals negative (negative)
Casts negative (negative)
Glucose trace (negative)
WBC 5 (0 to 4)
WBC casts none (none)
RBC 1 (less than or equal to 2)
RBC casts none (none)
Question 2 of 5
The nurse is reviewing the client's medical record. Select 4 findings that indicate a potential prenatal complication.
Correct Answer: A, B, C, F
Rationale:
Correct Answer: A, B, C, F
Rationale:
A: Urine protein indicates possible preeclampsia, a serious prenatal complication.
B: Decreased fetal activity can signal fetal distress or other issues.
C: Abnormal blood pressure levels may indicate gestational hypertension or preeclampsia.
F: Headaches can be a symptom of preeclampsia, requiring immediate attention to prevent complications.
Incorrect
Choices:
D: Urine ketones usually indicate dehydration or inadequate nutrition, not a prenatal complication.
E: Respiratory rate is not typically used to assess prenatal complications.
G: Gravida/parity information is important but does not directly indicate a prenatal complication.
Extract:
Question 3 of 5
A nurse enters a client's room and sees a small fire in the client's bathroom. Identify the sequence of steps the nurse should take.
Correct Answer: B, A, C, D
Rationale: B: Activating the facility's fire alarm system is crucial to alert other staff members and ensure the safety of all individuals in the building. A: Transporting the client to another area is necessary to move them away from the fire hazard. C: Closing windows and doors helps contain the fire and prevent it from spreading. D: Using the fire extinguisher should only be done if it's safe to do so and if the nurse has been trained in its proper use.
Choices E, F, and G are incorrect as they do not prioritize the immediate safety of the client and others in the building.
Question 4 of 5
A nurse in an emergency department is caring for a 3-year-old child who has suspected epiglottitis. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Prepare to assist with intubation. Epiglottitis is a serious condition that can rapidly progress to airway obstruction. Intubation may be necessary to secure the airway and maintain oxygenation. This intervention takes precedence over other actions such as obtaining a throat culture, suctioning the oropharynx, or preparing a cool mist tent, which are not immediate life-saving measures. Intubation ensures a patent airway and adequate gas exchange, which are essential in managing a child with suspected epiglottitis.
Therefore, preparing to assist with intubation is the priority in this situation to prevent respiratory compromise and potential respiratory arrest.
Question 5 of 5
A nurse is caring for a client whose child died from cancer. The client states, 'It's hard to go on without him.' Which of the following questions should the nurse ask the client first?
Correct Answer: D
Rationale: The correct answer is D: "Are you thinking about ending your life?" This question is crucial as it directly addresses the client's statement about finding it hard to go on without their child, indicating potential suicidal ideation. By asking this question first, the nurse can assess the client's risk of harm and provide appropriate interventions if necessary.
Option A: "What has helped you through difficult times in the past?" - While this is a supportive question, it does not address the immediate concern of suicidal ideation.
Option B: "Has anyone in your family committed suicide?" - This question may be relevant but is not as urgent as directly asking about the client's current thoughts of ending their own life.
Option C: "Is there anyone you would like involved in your care?" - This question focuses more on the client's support system rather than addressing the potential risk of harm.
In summary, asking about suicidal thoughts first is crucial in ensuring the client's safety and well-being in this scenario.