ATI RN
ATI Comprehensive Exit Exam 2023
1. A nurse is assessing a client who is in active labor, and the FHR baseline has been 100/min for 15 minutes. What should the nurse suspect?
- A. Maternal fever.
- B. Fetal anemia.
- C. Maternal hypoglycemia.
- D. Chorioamnionitis.
Correct answer: C
Rationale: The correct answer is C: Maternal hypoglycemia. Maternal hypoglycemia can lead to fetal bradycardia, which is indicated by a baseline FHR of 100/min. In this scenario, the sustained low baseline FHR suggests a possible link to maternal hypoglycemia. Maternal fever (Choice A) typically presents with tachycardia rather than bradycardia in the fetus. Fetal anemia (Choice B) usually causes fetal tachycardia as a compensatory mechanism to deliver more oxygen to tissues. Chorioamnionitis (Choice D) is associated with maternal fever and an elevated fetal heart rate, not a sustained low baseline FHR.
2. A nurse is caring for a client who has a pulmonary embolism. The nurse should identify the effectiveness of the treatment by observing which of the following?
- A. A chest x-ray reveals increased density in all fields
- B. The client reports feeling less anxious
- C. Diminished breath sounds are auscultated bilaterally
- D. ABG results include pH 7.48, PaO2 77 mm Hg, and PaCO2 47 mm Hg
Correct answer: B
Rationale: The correct answer is B because when a client reports feeling less anxious, it suggests that the treatment for a pulmonary embolism is effective. This is a good indicator of the client's overall well-being and response to treatment. Choices A, C, and D are incorrect because a chest x-ray revealing increased density in all fields, diminished breath sounds auscultated bilaterally, and ABG results showing specific values do not directly correlate with the effectiveness of treatment for a pulmonary embolism. While these assessments are important for monitoring the client's condition, the client's subjective report of feeling less anxious provides a more direct insight into the impact of the treatment.
3. A client has a new prescription for furosemide. Which of the following statements should the nurse include in the teaching?
- A. This medication will increase your potassium levels.
- B. You should take this medication with food to prevent gastrointestinal upset.
- C. This medication will decrease your blood glucose levels.
- D. You should increase your intake of potassium-rich foods.
Correct answer: B
Rationale: The correct statement the nurse should include in the teaching for a client with a new prescription for furosemide is that the client should take the medication with food to prevent gastrointestinal upset. Furosemide is a loop diuretic that can cause gastrointestinal upset, so taking it with food can help reduce this side effect and improve medication tolerance. Choices A, C, and D are incorrect because furosemide does not increase potassium levels, decrease blood glucose levels, or require an increase in the intake of potassium-rich foods. Therefore, the most important teaching point for the client is to take furosemide with food.
4. A nurse is caring for a client who is 1 day postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?
- A. Serosanguineous drainage on the surgical dressing.
- B. Heart rate of 88/min.
- C. Blood pressure of 118/76 mm Hg.
- D. Temperature of 38.8°C (101.8°F).
Correct answer: D
Rationale: A temperature of 38.8°C (101.8°F) is above the normal range and may indicate infection, which should be reported. Elevated temperature postoperatively can be a sign of infection, especially in the early postoperative period. Serosanguineous drainage on the surgical dressing is expected in the early postoperative period. A heart rate of 88/min and a blood pressure of 118/76 mm Hg are within normal ranges and do not necessarily indicate a complication postoperatively.
5. During an emergency response following a disaster, which client should be recommended for early discharge?
- A. A client with COPD and a respiratory rate of 44/min.
- B. A client with cancer and a sealed implant for radiation therapy.
- C. A client receiving heparin for deep-vein thrombosis.
- D. A client who is 1 day postoperative following a vertebroplasty.
Correct answer: D
Rationale: The client who is 1 day postoperative following a vertebroplasty is stable and can be discharged early. In an emergency response situation, it is crucial to prioritize clients who are medically stable and do not require immediate hospital care. The client with COPD and a respiratory rate of 44/min needs close monitoring and intervention. The client with cancer and a sealed implant for radiation therapy requires specialized care and follow-up. The client receiving heparin for deep-vein thrombosis needs ongoing anticoagulant therapy and monitoring, making early discharge not appropriate.
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