ATI RN
ATI Comprehensive 2023 With NGN 180 Questions And Answers Questions
Extract:
A nurse is preparing to administer three medications to a client who is receiving continuous enteral feeding through an NG tube.
Question 1 of 5
Which of the following actions is appropriate for the nurse to take?
Correct Answer: D
Rationale: The correct answer is D: Flush the NG tube with 5 ml water. This is appropriate to ensure the medication is fully administered and prevent clogging in the tube. Flushing helps clear any residue and ensures proper delivery.
A: Adding medication directly to enteral feeding can cause blockages and affect medication absorption.
B: Dissolving medications together can lead to chemical interactions and reduce effectiveness.
C: Using a syringe for gravity flow may not be suitable for all medications and can lead to improper dosing.
Extract:
A nurse is providing teaching about home safety to an adult child of an older adult client who is postoperative following knee replacement surgery.
Question 2 of 5
Which of the following instructions should the nurse include?
Correct Answer: B
Rationale: The correct answer is B: Remove loose rugs from the home to prevent falls. This instruction is essential for promoting safety and preventing accidents, especially for individuals at risk of falls. Loose rugs can be tripping hazards, so removing them reduces the risk of falls. Marking the doorway with tape (choice
A) or placing soft cushions on chairs (choice
C) do not directly address fall prevention. Installing bright overhead lighting only in the bedroom (choice
D) may not address fall hazards in other areas of the home. Overall, removing loose rugs is the most effective and direct way to prevent falls and promote safety at home.
Extract:
The nurse is continuing to care for the client 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.
Day 1, 0930:
Client reports a constant and throbbing headache and rates it as a 6 on a scale of 0 to 10. Denies
visual disturbances. +3 pitting edema in bilateral lower extremities. Patellar reflex 4+ without
the presence of clonus. Client reports occasional nighttime leg cramps. Reports three fetal
movements within the last 30 min, External fetal monitor applied with a baseline FHR 140/min
with occasional accelerations and moderate variability. No uterine contractions noted.
Question 3 of 5
The nurse is reviewing the assessment findings. For each assessment finding, click to specify if the finding is consistent with preeclampsia or HELLP syndrome. Each finding may support more than one disease process.
| Assessment Findings | Preeclampsia | HELLP syndrome |
|---|---|---|
| Hemoglobin | ||
| Alanine aminotransferase (ALT) | ||
| Blood pressure | ||
| Platelet count |
Correct Answer: C,D
Rationale: [
Rationale:
- Blood pressure is a key assessment finding for both preeclampsia and HELLP syndrome. In preeclampsia, hypertension is a hallmark feature, while in HELLP syndrome, it can also be elevated.
- Platelet count is another shared finding. Thrombocytopenia is a common feature of HELLP syndrome, while it can also be decreased in severe cases of preeclampsia.
- Hemoglobin and ALT levels are not specific to either condition, so they do not provide a clear indication of preeclampsia or HELLP syndrome.]
Extract:
A nurse is caring for a 75-year-old client who is admitted to the medical-surgical unit
Nurses' Notes
Today
0700:
Received change of shift report. Client is 2 days postoperative following a hysterectomy and
they have not yet ambulated with physical therapy due to significant postoperative pain. Per
change of shift report, pain medications have been adjusted and pain has improved. Client
currently reports pain level as 2 on a scale of 0 to 10.
0900:
Ambulating in hallway with the assistance of physical therapy.
1000:
Return to bed with siderails up x 2, but not wearing sequential compression devices because they
"hurt too much." Applied antiembolism stockings.
1400:
Client notified nurse that right leg is warm and painful. Assessment reveals unilateral right lower
extremity swelling and warmth below the knee. Provider notified.
Laboratory Results
Today
1430:
WBC count 10,500/mm³ (5,000 to 10,000/mm³)
Hgb 11.1 g/dL (12 to 16 g/dL)
Hct 34% (37% to 47%6)
Platelet count 250,000/mm³ (150,000 to 400,000/mm³)
Coagulation studies:
PT 11.5 seconds (11 to 12.5 seconds)
INR 0.9 (0.8 to 1.1)
History and Physical
3 days ago:
Past medical history: Type 2 diabetes mellitus, hypertension
Surgical history: Cesarean birth x 2 as a young adult
Social history: Has smoked 1 pack of cigarettes per day for 4 years, drinks socially, does not
exercise.
Weight: 121,3 kg (267.4 lb)
Vital Signs
Today
0800
Temperature 37° C (98.6" F)
Heart rate 97/min
Respiratory rate 18/min
BP 138/78 mm Hg
Question 4 of 5
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing.
Correct Answer: C
Rationale: Unilateral swelling and warmth suggest deep vein thrombosis (DVT), requiring assessment for ischemia.
Extract:
A nurse is assessing a client following an esophagogastroduodenoscopy.
Question 5 of 5
Which of the following findings should the nurse report to the provider?
Correct Answer: A
Rationale: The correct answer is A: Abdominal pain. Abdominal pain is a significant finding that could indicate underlying health issues. The nurse should report it to the provider for further evaluation and management. Belching, flatulence, and sore throat are common symptoms that may not require immediate attention. Reporting abdominal pain is crucial for timely intervention.