ATI RN
ATI Comprehensive Predictor 2023 Exit Exam B Questions
Extract:
Question 1 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 2 of 5
A nurse is collecting data from a client who has a history of bipolar disorder. Which of the following findings should the nurse expect during a manic episode?
Correct Answer: C
Rationale: Rapid speech is typical in a manic episode of bipolar disorder. Hypersomnia, weight gain, and flat affect are more associated with depression.
Question 3 of 5
A nurse is providing teaching to the parents of a newborn about newborn genetic screening. Which of the following statements should the nurse include in the teaching?
Correct Answer: D
Rationale:
Choice A is wrong because the blood sample is not drawn from the baby's inner elbow, but from the heel.
Choice B is wrong because the baby does not need to drink water prior to the test, as this could dilute the blood sample and affect the results.
Choice C is wrong because the test does not need to be repeated when the baby is 2 months old, unless there is a positive or inconclusive result from the first test. Newborn genetic screening is important for early detection and intervention. This test should be performed after your baby is 24 hours old. This is because newborn genetic screening is a set of laboratory tests that detect a set of known genetic diseases that can affect a child's long-term health or survival. The test is performed on a blood sample obtained from a heel prick when the baby is two or three days old. Performing the test after 24 hours ensures that the baby has had enough time to metabolize certain substances that could interfere with the accuracy of the test.
Question 4 of 5
A nurse is reviewing the laboratory results for a client who is at 12 weeks of gestation. Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: A hemoglobin level of 9.2 g/dL is below the normal range for pregnancy (11-12 g/dL in the first trimester) and indicates anemia, which can affect fetal growth and maternal health. The nurse should report this finding to the provider for further evaluation and management, such as iron supplementation.
Choice B is wrong because a fasting blood glucose of 92 mg/dL is within the normal range for pregnancy (less than 95 mg/dL) and does not indicate gestational diabetes.
Choice C is wrong because a WBC count of 10,000/mm3 is within the normal range for pregnancy (5,000-15,000/mm3) due to physiological leukocytosis.
Choice D is wrong because a platelet count of 200,000/mm3 is within the normal range for pregnancy (150,000-400,000/mm3) and does not indicate thrombocytopenia.
Question 5 of 5
A nurse is reinforcing teaching with a client who has a new prescription for enalapril. Which of the following instructions should the nurse include?
Correct Answer: A
Rationale: Reporting a persistent cough is important with enalapril due to potential intolerance. Grapefruit juice is unrelated, weight gain is not expected, and potassium intake needs monitoring.