ATI RN
ATI Comprehensive Exit Exam 2023 With NGN
1. During a change-of-shift report, a nurse is receiving information about an adult female client who is postoperative. Which of the following client information should the nurse report?
- A. The client's oxygen saturation is 95%
- B. The client's blood pressure is 110/70 mm Hg
- C. The client has a temperature of 36.8°C (98.2°F)
- D. The client's heart rate is 88/min
Correct answer: B
Rationale: The correct answer is B because a blood pressure of 110/70 mm Hg is within the normal range and stable. Reporting this information is crucial to monitor the client's condition postoperatively. Oxygen saturation of 95% is acceptable, a temperature of 36.8°C (98.2°F) is normal, and a heart rate of 88/min is within the expected range for an adult female client, so these values do not raise concerns that require immediate reporting.
2. A nurse is preparing to administer blood to a client. Which of the following actions should the nurse take first?
- A. Check the client's identification bracelet.
- B. Obtain the client's vital signs.
- C. Initiate the transfusion slowly over the first 15 minutes.
- D. Verify the client's blood type and Rh factor.
Correct answer: D
Rationale: The correct answer is to verify the client's blood type and Rh factor first before administering blood. This is crucial to ensure compatibility and prevent transfusion reactions. Checking the client's identification bracelet (Choice A) is important but should come after verifying blood type. Obtaining vital signs (Choice B) and initiating the transfusion slowly (Choice C) are important steps but verifying blood type is the priority to ensure safe blood administration.
3. A client is receiving total parenteral nutrition (TPN). Which of the following actions should the nurse take?
- A. Measure the client's blood glucose level every 6 hours
- B. Change the TPN tubing every 24 hours
- C. Weigh the client weekly
- D. Administer the TPN through a peripheral IV line
Correct answer: B
Rationale: The correct action for the nurse to take when caring for a client receiving total parenteral nutrition (TPN) is to change the TPN tubing every 24 hours. This practice helps reduce the risk of infection in clients receiving parenteral nutrition. Measuring the client's blood glucose level every 6 hours is important for clients on insulin therapy or with diabetes, but it is not directly related to TPN administration. Weighing the client weekly is essential for monitoring fluid status and nutritional progress, but it is not specific to TPN care. Administering TPN through a peripheral IV line is incorrect because TPN solutions are hypertonic and can cause phlebitis or thrombosis if administered through a peripheral line; a central venous access is typically used for TPN administration.
4. A client is receiving intermittent enteral tube feedings and is experiencing dumping syndrome. Which of the following actions should the nurse take?
- A. Administer a refrigerated feeding.
- B. Increase the amount of water used to flush the tubing.
- C. Decrease the rate of the client's feedings.
- D. Instruct the client to move onto their right side.
Correct answer: C
Rationale: Dumping syndrome is a condition that occurs when food moves too quickly from the stomach into the small intestine. Symptoms can include abdominal cramping, diarrhea, and sweating. To manage dumping syndrome in a client receiving enteral tube feedings, the nurse should decrease the rate of the feedings. This intervention helps slow down the movement of food through the gastrointestinal tract, reducing the symptoms. Administering a refrigerated feeding (choice A) or increasing the amount of water used to flush the tubing (choice B) are not appropriate actions for addressing dumping syndrome. Instructing the client to move onto their right side (choice D) is not a relevant intervention for managing dumping syndrome in this scenario.
5. A healthcare provider is reviewing the medical record of a client who is requesting combination oral contraceptives. Which of the following conditions in the client's history is a contraindication to the use of oral contraceptives?
- A. Hyperthyroidism.
- B. Thrombophlebitis.
- C. Diverticulosis.
- D. Hypocalcemia.
Correct answer: B
Rationale: Thrombophlebitis is a contraindication for the use of oral contraceptives due to the increased risk of complications such as thromboembolism. Hyperthyroidism, diverticulosis, and hypocalcemia are not contraindications for oral contraceptives. Hyperthyroidism may affect the metabolism of contraceptives but does not contraindicate their use. Diverticulosis and hypocalcemia do not directly impact the safety or effectiveness of oral contraceptives.
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