ATI RN
ATI Comprehensive Exit Exam 2023
1. A healthcare provider is planning care for a client who is receiving total parenteral nutrition (TPN). Which of the following actions should the healthcare provider include?
- A. Administer 0.9% sodium chloride with the TPN.
- B. Change the TPN tubing every 24 hours.
- C. Weigh the client every 72 hours.
- D. Flush the TPN line with heparin.
Correct answer: B
Rationale: The correct action the healthcare provider should include is changing the TPN tubing every 24 hours to decrease the risk of infection. Administering 0.9% sodium chloride with TPN is not typically recommended as it can cause chemical instability. Weighing the client every 72 hours is important but not directly related to TPN administration. Flushing the TPN line with heparin is not a standard practice and not recommended as it can increase the risk of complications.
2. A nurse is caring for a client who has chronic kidney disease and is experiencing fluid volume overload. Which of the following findings should the nurse expect?
- A. Decreased blood pressure
- B. Increased urine output
- C. Decreased heart rate
- D. Increased heart rate
Correct answer: A
Rationale: In a client with chronic kidney disease experiencing fluid volume overload, the nurse should expect a decreased blood pressure. Fluid volume overload can lead to poor cardiac output, which in turn can cause a decrease in blood pressure. Choices B, C, and D are incorrect. Increased urine output is not expected in fluid volume overload; decreased heart rate is not typically associated with fluid volume overload; and an increased heart rate is more commonly seen in response to fluid overload to compensate for the decreased cardiac output.
3. A healthcare provider is reviewing the laboratory report of a client with a prescription for digoxin. Which result requires withholding the medication?
- A. Digoxin 0.8 ng/mL
- B. Sodium 145 mEq/L
- C. BUN 20 mg/dL
- D. Potassium 3.1 mEq/L
Correct answer: D
Rationale: The correct answer is D. A low potassium level (3.1 mEq/L) can increase the risk of digoxin toxicity. Hypokalemia can potentiate the effects of digoxin on the heart, leading to serious dysrhythmias. Choices A, B, and C are within normal ranges and do not indicate a need to withhold digoxin.
4. A nurse is assessing a newborn who was delivered at 32 weeks of gestation. Which of the following findings should the nurse expect?
- A. Dry, cracked skin.
- B. Lanugo covering the skin.
- C. Vernix caseosa covering the skin.
- D. Creases covering the soles of the feet.
Correct answer: B
Rationale: The correct answer is B: Lanugo covering the skin. Lanugo, a fine downy hair, is a common finding in newborns delivered prematurely at 32 weeks gestation. Choice A (Dry, cracked skin) is incorrect as premature infants often have translucent and delicate skin. Choice C (Vernix caseosa covering the skin) is incorrect as vernix, a waxy substance, is more commonly seen in full-term newborns. Choice D (Creases covering the soles of the feet) is incorrect as creases on the soles of the feet are a normal finding in term newborns, not specifically related to prematurity.
5. A client has a new prescription for ferrous sulfate. Which of the following instructions should the nurse include in the teaching?
- A. Take this medication on an empty stomach.
- B. Take this medication with milk if it causes stomach upset.
- C. Take this medication with orange juice to increase absorption.
- D. Take an antacid 1 hour after this medication.
Correct answer: C
Rationale: The correct instruction is to take ferrous sulfate with orange juice to increase absorption because the vitamin C content in orange juice enhances iron absorption. Choice A is incorrect because ferrous sulfate should be taken with food to reduce gastrointestinal side effects. Choice B is incorrect because milk can decrease iron absorption. Choice D is incorrect because antacids can reduce the absorption of ferrous sulfate.
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