ATI RN
ATI Clinical Exam Questions
Extract:
History & Physical (0700hrs)
Date: 06/28/0X
• Client presented to the clinic reporting pelvic pain, dysmenorrhea, dyspareunia, and pain with defecation.
• Vaginal examination reveals fixed, palpable nodules with a retroverted uterus.
• Imaging reveals endometrial lesions on the ovaries, uterosacral ligaments, and round ligaments.
• Endometriosis diagnosed.
Provider's Prescriptions (0700hrs)
• Nafarelin 200 mcg: 1 spray intranasally every morning and 1 spray in the opposite nostril every evening.
Nurse's Notes (0700hrs)
• Client reports adherence to nafarelin regimen without missing doses.
• Client verbalizes irritation in the nasal mucosa.
• Reports feeling better overall with decreased dyspareunia.
• Notes decreased pain during bowel movements.
• Reports decreased pelvic pain and the absence of menstruation last month.
• Mentions experiencing headaches, increased acne, and reduced sex drive since starting treatment.
• Client observes a decrease in breast size.
Scenario:
A nurse is caring for a 32-year-old female client who was recently diagnosed with endometriosis. The client is in the clinic for a follow-up visit after beginning nafarelin treatment.
Setting: Clinic
Question 1 of 5
Which of the following manifestations reported by the client should the nurse identify as a therapeutic effect of the nafarelin? (Select all that apply.)
Correct Answer: B,E
Rationale: The correct answers are B and E. Nafarelin is a gonadotropin-releasing hormone (GnRH) agonist used to treat endometriosis by suppressing estrogen production, thereby reducing symptoms like pain during intercourse (choice
B) and causing missed menstrual cycles (choice E). These are therapeutic effects.
Choices A, C, D, and F are incorrect because CNS manifestations, nasal mucosa changes, breast changes, and dermatological manifestations are not commonly reported therapeutic effects of nafarelin. Thus, options A, C, D, and F can be ruled out.
Extract:
Medical History (0700 hrs)
• Gestational age: 42 weeks
• Delivery: Spontaneous vaginal birth
• Amniotic fluid: Dark brown-greenish color noted
• Apgar scores: 8 at 1 minute, 9 at 5 minutes
Vital Signs (0700 hrs)
• Axillary temperature: 36.9°C (98.4°F)
• Heart rate: 170/min
• Respiratory rate: 72/min
• Birth weight: 4025 gm (8 lb 14 oz) (Appropriate for Gestational Age)
Nurses' Notes (0700 hrs)
The newborn was placed on the birth parent's abdomen immediately following delivery. The mouth and nose were suctioned with a bulb syringe to clear secretions. The newborn was dried and stimulated, resulting in a strong cry. The newborn was moving all extremities with a flexed tone noted. Acrocyanosis was present. The newborn was alert and active. Respirations were rapid and shallow with occasional expiratory grunting. Fine crackles were auscultated throughout the lung fields. A small amount of green- stained vernix was present in skin folds. The newborn had fingernails stained green. Molding of the skull and generalized soft occipital swelling were noted.
Question 2 of 5
A nurse is caring for a newborn who is 30 minutes old following a spontaneous vaginal birth. The birth parent noted dark brown- greenish amniotic fluid during labor. The newborn was delivered at 42 weeks gestation. Apgar scores were 8 at 1 minute and 9 at 5 minutes. Exhibits After reviewing the information in the newborn's medical record, which of the following complications should the nurse identify as posing the greatest risk? Drag one condition and one client finding to fill in each blank in the following sentence.The condition that poses the greatest risk to the newborn is ---------------- due to -------------------
Correct Answer: A,B
Rationale: Action to Take: A, B; Potential Condition: A; Parameter to Monitor: C, E.
Rationale:
- Meconium aspiration syndrome (MAS) is the correct answer as newborns exposed to meconium in amniotic fluid are at risk for respiratory distress.
- The color of amniotic fluid (brown-green) indicates presence of meconium, which can lead to MAS.
- Monitoring jaundice (
C) is important as newborns with MAS may develop complications affecting liver function.
- Monitoring birth weight (E) is crucial as MAS can impact the newborn's overall health and growth.
Summary of Incorrect
Choices:
- Jaundice (
C): Although important to monitor, it is not the greatest risk in this scenario.
- Cold stress (
D): Not relevant to the information provided about the newborn.
- Birth weight (E): While important to monitor, it is not the greatest risk posed by the scenario.
Extract:
Medication Administration Record
• 1700: Dextrose 5% in 0.45% sodium chloride (D5/0.45% NaCl) at 100 mL/hr
• 1700: Promethazine 25 mg IV bolus every 4 hours PRN for nausea/vomiting
• 1715: Morphine 4 mg IV bolus every 6 hours PRN for pain
• 2115: Acetaminophen 625 mg PO every 6 hours PRN if temperature > 38.6°C (101.5°F)
• Discontinue Morphine (Note: The morphine has not yet been administered as the order is due in the future.)
Nurses' Notes
The client was received from the Post Anesthesia Care Unit (PACU) with initial vital signs recorded. The client is drowsy but arouses to verbal stimuli and is oriented to person, place, and time. The client is able to move all extremities and follow simple commands.
The heart rhythm is normal sinus, bilateral radial and pedal pulses are +2, and capillary refill is less than 2 seconds. Respiratory rate is 18/min with clear lung sounds and oxygen saturation of 96% on 2 L via nasal cannula. Bowel sounds are hypoactive in all four quadrants. The indwelling urinary catheter is draining clear yellow urine. The dressing on the right knee is dry and intact, with no drainage noted.
At 1830, the client was repositioned for comfort with side rails up x2 and the call light within reach. The client remains somewhat lethargic but arouses easily and reports nausea and pain, rating the pain as 6 on a scale from 0 to 10. Metoclopramide 10 mg IV was administered at 1830 for nausea. The client is positioned comfortably with the side rails up and call light within reach.
Physical Examination
• Heart Rate: 88/min
• Respiratory Rate: 18/min
• Blood Pressure: 115/55 mm Hg
• Temperature: 36.4°C (97.5°F)
• Oxygen Saturation: 96% on 2 L via nasal cannula
• General Behavior: Drowsy but arouses easily, somewhat lethargic
• Pain Level: Rated as 6 on a scale from 0 to 10
• Bowel Sounds: Hypoactive in all four quadrants
• Urinary Output: Clear yellow urine from indwelling catheter
• Knee Dressing: Dry and intact with no drainage
Question 3 of 5
A nurse is caring for a client who is 6 hours postoperative following a right knee arthroplasty. The client has been receiving medications and fluids as outlined below.Exhibits Complete the following sentence by selecting the most appropriate action from the choices below: The nurse should first:---------------------,followed by--------------------------------------
Correct Answer: A,B
Rationale: Action to Take: A, B; Potential Condition: Postoperative pain; Parameter to Monitor: Pain level, Client comfort.
Rationale: After a knee arthroplasty, pain management is crucial for the client's comfort and recovery. Administering additional morphine (
A) addresses postoperative pain. Repositioning the client (
B) is important to prevent complications such as pressure ulcers. Assessing the area for the restraint (
C) and padding the client's wrists (
D) are not immediate priorities. Ensuring the call light is within reach (E) is important but not the first action to take.
Extract:
Question 4 of 5
A nurse is educating a parent of a 6-month-old infant about car seat safety. Which statement from the parent indicates a correct understanding of the teaching?,Which statement indicates correct understanding of car seat safety?
Correct Answer: A
Rationale: The correct answer is A because anchoring the infant car seat in the car is crucial for safety. This ensures the seat is securely installed and minimizes the risk of injury during a collision.
Choice B is incorrect as rear-facing car seats should never be placed in the front passenger seat due to the presence of airbags, which can be dangerous for infants.
Choice C is incorrect because the harness should be snug against the infant's body without any slack, and being able to fit a hand between the harness and the baby indicates it is too loose.
Choice D is incorrect as infants should be in rear-facing seats until at least 2 years old for optimal safety.
Question 5 of 5
A nurse is conducting a class on medication reconciliation. What information should the nurse include in the teaching?,What information should be included in medication reconciliation teaching?
Correct Answer: D
Rationale: The correct answer is D: Provide a list of the client's current medications during admission to a health care facility. This is essential in medication reconciliation to ensure that the healthcare team has accurate information about the client's current medications to prevent medication errors. During admission, it is crucial to compare the client's current medication list with the medications prescribed by the healthcare facility to identify any discrepancies. This information is vital for safe and effective care delivery.
Incorrect choices:
A: Providing a list of the client's current medications during the change of shift report is important but not specific to medication reconciliation during admission.
B: Over-the-counter medications should be included in the medication reconciliation report as they can interact with prescription medications.
C: Medication reconciliation should be performed at discharge to ensure a smooth transition of care and prevent medication discrepancies at home.