ATI RN
RN Comprehensive Predictor 2023 Questions
Extract:
History and Physical
Vital Signs
Nurses' Notes
Laboratory Results
0700:
Majority of client's history is obtained from client's parent who presents with client today. According to the parent, client has been acting strangely for a few months. Client's symptoms have been progressively worsening.
In the last month, the client has been seeing things that are not present and believes that they are in a close relationship with "a powerful spirit." Client has not been bathing regularly for the last few weeks.
Client has no significant health history. Client reports that they do not take illicit substances or drink alcohol. Client's grandparent has a history of schizophrenia.
Question 1 of 5
For each potential action, click to specify if the action is indicated or contraindicated for the client.
| Options | Indicated | Contraindicated |
|---|---|---|
| Ask the client about the content of their hallucinations | ||
| Instruct the client on expected hygiene practices | ||
| Allow the client to watch TV at a high volume | ||
| Assess the client for suicidal ideation | ||
| Place the client in a room near the activity |
Correct Answer: A,B,C,D,E
Rationale: Ask about hallucinations: Indicated - Assesses severity. Instruct on hygiene: Indicated - Promotes well-being. Allow high volume TV: Contraindicated - May exacerbate symptoms. Assess for suicidal ideation: Indicated - Ensures safety. Place near activity: Contraindicated - Reduces overstimulation.
Extract:
Nurses' Notes
0945:
Adult child accompanying parent reports cognitive and physical decline in the client, expressing concern over memory loss, thought processes, appetite, and self-care. Adult child states, "My sibling and I hired help at home for my parent. We thought that might help, but it has not. I found the title to the car today, signed over to me."
Client makes poor eye contact, speaks in a monotone voice, and has a lack of facial expression.
Client reports sleeping 7 hr a night and getting up "once or twice per night to go to the bathroom." Client reports not wanting to eat anymore. Client's child reports their parent has lost about 8 Ib in the past month.
1030:
Client found sitting in waiting room, head in hands. Client says, "Why don't you just leave me? I am of no use."
Question 2 of 5
Click to highlight the findings that require immediate follow-up.
| I found the title to the car today, signed over to me. |
| Client makes poor eye contact, speaks in a monotone voice, and has a lack of facial expression. |
| Client says, 'Why don't you just leave me? I am of no use.' |
| Client reports not wanting to eat anymore. Client's child reports their parent has lost about 8 Ib in the past month. |
Correct Answer: A,B,C,D
Rationale: These findings suggest significant cognitive decline, potential depression, and possible suicidal ideation, requiring immediate attention.
Extract:
Nurses' Notes
Vital Signs
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.
Question 3 of 5
Select the 5 actions the nurse should take.
| Exert upward pressure on the presenting part. |
| Place the client in a Trendelenburg position. |
| Administer oxygen at 10 L/min via nonrebreather face mask. |
| Attempt to push the umbilical cord back into the cervix. |
| Have the charge nurse notify the provider. |
| Increase the flow rate of the maintenance IV fluid. |
Correct Answer: A,B,C,E,F
Rationale: Exert pressure: Relieves cord compression. Trendelenburg: Reduces cord pressure. Oxygen: Improves fetal oxygenation. Notify provider: Ensures timely intervention. Increase IV fluid: Supports maternal circulation.
Extract:
History and Physical
Laboratory Results
First office visit:
Client is 42 years old. Reports bilateral wrist and shoulder stiffness. Reports no history of trauma to upper extremities. Past surgical history includes appendectomy and two cesarean births.
Client takes cholesterol and diuretic medications. Family history of hypertension, hypercholesteremia, cerebrovascular accidents, stomach cancer.
6-month follow-up:
Reports bilateral wrist and shoulder stiffness that lasts for several hours after waking up in the morning. Reports fatigue
and loss of appetite
Question 4 of 5
Complete the following sentence by using the lists of options. The client is at highest risk for developing ___ evidenced by the client's ___ .
| gout |
| fibromyalgia |
| osteoarthritis |
| rheumatoid arthritis |
| family history |
| uric acid level |
| ESR level |
Correct Answer: D
Rationale: The client is at highest risk for developing rheumatoid arthritis evidenced by the client's ESR level. Symptoms and elevated ESR indicate rheumatoid arthritis.
Extract:
Nurses' Notes
Vital Signs
Diagnostic Results
Day 1
1400:
Client has paraplegia and reports, "I have had a cough the last few days. I haven't had an appetite either." Denies nausea, vomiting, or diarrhea. Alert and oriented to person, place, and time. Skin is intact. Vital signs stable.
Day 2 1830:
Client is experiencing tachycardia, productive cough, and confusion
Question 5 of 5
Complete the following sentence by using the list of options. The client is at risk for ___ as evidenced by ___ .
| hypostatic pneumonia |
| anemia |
| fluid volume overload |
| calorie deficiency |
| orthostatic hypotension |
| immobility |
Correct Answer: A
Rationale: The client is at risk for hypostatic pneumonia as evidenced by immobility. Immobility increases the risk of lung fluid accumulation.