ATI RN
ATI Comprehensive 2023 With NGN 180 Questions And Answers Questions
Extract:
A nurse is caring for a client who is pregnant. 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
t0 4)
WBC casts none (none)
RBC 1 (less than or equal to 2) RBC
casts none (none)
Question 1 of 5
The nurse is reviewing the client's medical record. Select 4 findings that indicate a potential prenatal complication.
Correct Answer: A,C,F,G
Rationale: The correct answers are A, C, F, and G. A high urine protein level indicates possible preeclampsia, a serious prenatal complication. Elevated blood pressure is also a sign of preeclampsia. Headaches can be a symptom of hypertension or preeclampsia. Gravida/parity helps assess the client's obstetric history, which can indicate potential complications. Fetal activity, urine ketones, and respiratory rate are not direct indicators of prenatal complications.
Extract:
The nurse is continuing to care for the child.
Assessment
1000:
Child is alert and appears developmentally appropriate for their age and well nourished.
Respirations easy and unlabored. Abdomen nondistended. Right forearm and fingers are
edematous. Ecchymotic area noted on outer aspect of the forearm. Radial pulse +2. Fingers
slightly cool to touch. Child can move fingers and reports a mild "tingling" sensation. Child
verbalizes a pain level of 4 on a scale of 0 to 10. Abrasion noted on right knee. No active
bleeding. Multiple areas of bruising noted on lower extremities in various stages of healing.
Question 2 of 5
Complete the sentence using the lists of options.The child is at highest risk for developing------------evidenced by the child's-----------
Correct Answer: B,D
Rationale: Circulatory impairment is evidenced by paresthesia (tingling), indicating compromised blood flow.
Extract:
Question 3 of 5
A nurse is performing a neurological examination on a client as part of a complete physical assessment. The nurse should identify that cranial nerve XI(11) is intact when the client performs which of the following actions?
Correct Answer: A
Rationale: The correct answer is A: Shrugs his shoulders. Cranial nerve XI, also known as the accessory nerve, controls the movement of the sternocleidomastoid and trapezius muscles. When the client shrugs his shoulders, the nurse is assessing the function of these muscles, which are innervated by cranial nerve XI. This action indicates the integrity of the nerve.
Other choices are incorrect because:
B: Smiling symmetrically is controlled by cranial nerve VII (facial nerve).
C: Closing eyes tightly is controlled by cranial nerve VII (facial nerve).
D: Identifying a familiar scent is controlled by cranial nerve I (olfactory nerve).
Extract:
A nurse in the emergency department is caring for a client who is actively bleeding from a stab wound to the thigh.
Question 4 of 5
Which action should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Apply direct pressure to the wound with thick dressing material. This action helps control bleeding by applying pressure to the wound site, promoting clot formation. Direct pressure is the first step in managing bleeding. Elevating the leg (
B) above the heart level is not effective for controlling bleeding in this case. Applying a tourniquet (
C) should only be considered as a last resort for life-threatening bleeding. Applying ice packs (
D) can vasoconstrict blood vessels, potentially worsening the bleeding.
Extract:
A nurse in an outpatient clinic is caring for a client.
Assessment
0840:
Client is calm and cooperative. Skin warm and dry. No rash noted. Lung sounds clear. Abdomen
soft to palpation with fundal height at 20 cm. Fetal heart rate 150/min. Bowel sounds active in all
four quadrants. No edema to lower extremities. Client denies visual changes or severe headaches.
Weight gain of 1.8 kg (4 lb) since last visit. Small amount of mucoid discharge noted on perineal
pad
Laboratory Results
0900:
Urine dipstick:
pH 6.0 mg/d (4.6 to 8 mg/dL)
Specific Gravity 1.022 (1.010 to 1.025)
Leukocyte esterase negative (Negative)
Nitrite negative (Negative)
Protein trace negative (Negative)
Glucose negative (Negative)
Ketones none (None)
Bilirubin none (None)
Blood none (None)
Nurses' Notes
0830:
Client reports to clinic for monthly prenatal visit. Client is at 20 weeks of gestation. Since last
visit, client reports concerns about the occurrence of intermittent mild backaches, increased
heartburn, generalized itching, and vaginal discharge.
Vital Signs
0830:
BP 124/68 mm Hg
Heart rate 80/min
Temperature 37° C (98.6° F)
Respiratory rate 16/min
Weight 67.1 kg (148 lb)
Question 5 of 5
Which of the following statements should the nurse include in the client's teaching?
Correct Answer: B,D,F
Rationale: Wearing flat shoes, wearing loose-fitting clothes, and avoiding fried foods are beneficial practices during pregnancy.