ATI RN
RN ATI Comprehensive Assessment Exam Retake 2023 V2 Questions
Extract:
Question 1 of 5
A nurse is teaching a newly licensed nurse about caring for clients in the emergency department. Which of the following actions should the nurse include when teaching about interacting with a client who is aggravated, pacing, and speaking loudly?
Correct Answer: C
Rationale: The correct answer is C: Tell the client, 'You seem to be very upset.' This response demonstrates empathy and acknowledgment of the client's emotional state, which can help de-escalate the situation. By acknowledging the client's feelings, the nurse shows understanding and may help the client feel heard and understood. This can also open the door for further communication to address the client's concerns.
Incorrect answers:
A: Initiating seclusion protocol is not appropriate in this situation as it may escalate the client's agitation.
B: Using a face shield with a mask does not address the client's emotional state and may further alienate the client.
D: Engaging the panic alarm is an extreme response and should only be used in cases of imminent danger, which is not indicated here.
Extract:
Nurses' Notes
0900:
Contractions occurring every 3 to 4 min, lasting 80 to 90 seconds. Client rates pain with contractions as 10 on a scale of 0 to 10 and requests an epidural. Contractions approximately 4 min apart. Vaginal examination reveals cervix dilated 5 cm, 80% effaced, -1 station, vertex presentation. FHR baseline 142/min with moderate variability, IV fluid bolus initiated
0930:
Epidural inserted by anesthesiology. Client reports pain as 2 on a scale of 0 to 10,
0950:
Spontaneous rupture of membranes with clear fluid
1000:
Variable decelerations noted on the electronic fetal heart rate monitor tracing. FHR baseline 140/min. Deceleration 90/min, lasting 30 seconds. Loop of umbilical cord visible at vaginal introitus.
Vital Signs
0900:
Temperature 36.5°C (97.7°F)
BP 130/84 mm Hg
Heart rate 108/min
Respiratory rate 18/min
Oxygen saturation 98% on room air
0930:
BP 120/78 mm Hg
Heart rate 96/min
Respiratory rate 18/min
Oxygen saturation 98% on room air
1000:
BP 118/84 mm Hg
Heart rate 95/min
Respiratory rate 19/min
Oxygen saturation 97% on room air
Question 2 of 5
Select the 5 actions the nurse should take.
Correct Answer: B, C, D, E, F
Rationale: The correct actions are B, C, D, E, and F. B is crucial for timely provider notification. C helps improve placental perfusion. D can alleviate cord compression. E can prevent cord prolapse complications. F ensures adequate oxygenation. A is incorrect as it doesn't address the immediate issue. G is omitted.
Extract:
Question 3 of 5
A nurse is providing teaching about home safety to the adult child of an older adult client who is postoperative following hip replacement surgery. Which of the following instructions should the nurse include?
Correct Answer: D
Rationale: The correct answer is D: Ensure that area rugs have rubber backs. This instruction is important because rubber-backed area rugs can prevent slipping and falling accidents, which is crucial for a postoperative hip replacement patient. It provides stability and reduces the risk of injuries.
Choice A is incorrect because wearing shoes at home can actually increase the risk of falls due to potential slipping hazards.
Choice B is incorrect as placing a throw rug over electrical cords can create a tripping hazard.
Choice C is incorrect as marking the edges of the doorway with tape does not address the main safety concern of preventing falls related to the rugs.
By selecting choice D, the nurse addresses the specific safety need of the postoperative hip replacement patient and promotes a safer home environment.
Question 4 of 5
A nurse is providing discharge instructions to a client who has a new prescription for haloperidol. Which of the following adverse effects should the nurse instruct the client to report to the provider?
Correct Answer: C
Rationale: The correct answer is C: Shuffling gait. Haloperidol is an antipsychotic medication that can cause extrapyramidal symptoms like shuffling gait, which is a serious adverse effect requiring immediate medical attention to prevent further complications. A: Weight gain is a common side effect but not urgent. B: Dry mouth is a common side effect that can be managed with oral hygiene. D: Sedation is a common side effect that may resolve over time.
Question 5 of 5
A nurse is planning teaching for a client who has a newly implanted implantable cardioverter/defibrillator. Which of the following information should the nurse include?
Correct Answer: B
Rationale: The correct answer is B: Wear loose-fitting clothing. This is important because tight clothing can rub against the implantable cardioverter/defibrillator site, leading to irritation or damage. It is crucial to protect the device and the incision site to prevent complications.
A: Expecting to have a rapid pulse rate for the first few weeks is incorrect as it does not relate to the care of the implantable cardioverter/defibrillator.
C: Returning in two weeks for a follow-up MRI is not necessary for routine follow-up care after implantation.
D: Resuming tub baths and swimming after 74 hours is incorrect as water exposure should be avoided initially to prevent infection.