ATI RN
ATI Comprehensive Exit Exam 2023 With NGN Quizlet
1. A client is 4 hours postpartum. Which of the following interventions should be implemented to prevent postpartum hemorrhage?
- A. Monitor for signs of infection.
- B. Massage the uterus every 4 hours.
- C. Apply ice packs to the perineum.
- D. Administer methylergonovine IM.
Correct answer: D
Rationale: Administering methylergonovine intramuscularly helps contract the uterus, reducing the risk of postpartum hemorrhage. Monitoring for signs of infection (Choice A) is important but not directly related to preventing postpartum hemorrhage. Uterine massage (Choice B) is beneficial to prevent uterine atony, but methylergonovine is a more specific intervention to prevent hemorrhage. Applying ice packs to the perineum (Choice C) is helpful for perineal pain and swelling, not for preventing postpartum hemorrhage.
2. A nurse is providing teaching about gastrostomy tube feedings to the parents of a school-age child. Which of the following instructions should the nurse give?
- A. Administer the feeding over 30 minutes
- B. Place the child in a supine position after the feeding
- C. Change the feeding bag and tubing every 3 days
- D. Warm the formula in the microwave prior to administration
Correct answer: A
Rationale: The correct answer is to administer the feeding over 30 minutes. This slow administration helps prevent complications like nausea. Placing the child in a supine position after the feeding can increase the risk of aspiration, making choice B incorrect. Changing the feeding bag and tubing every 3 days is important for infection control and hygiene but is not directly related to the administration process, making choice C incorrect. Warming the formula in the microwave is not recommended as it can create hot spots that may burn the child's mouth or esophagus, so choice D is incorrect.
3. A nurse is caring for a client who is in a seclusion room following violent behavior. The client continues to display aggressive behavior. Which of the following actions should the nurse take?
- A. Confront the client about this behavior
- B. Express sympathy for the client's situation
- C. Speak assertively to the client
- D. Stand within 30 cm (1 ft) of the client when speaking with them
Correct answer: C
Rationale: In this situation, speaking assertively is the most appropriate action for the nurse to take. Confronting the client may escalate the situation further. Expressing sympathy, although important in other contexts, may not be effective in managing aggressive behavior. Standing within close proximity to an aggressive client can compromise the nurse's safety. Therefore, speaking assertively helps to set clear boundaries and manage the situation while ensuring safety in a seclusion room.
4. A nurse is assessing a client who has increased intracranial pressure (ICP). Which of the following findings should the nurse expect?
- A. Bradycardia.
- B. Increased level of consciousness.
- C. Tachycardia.
- D. Hyperactive bowel sounds.
Correct answer: C
Rationale: The correct answer is C: Tachycardia. In a client with increased intracranial pressure (ICP), tachycardia is a common finding. This is due to the body's compensatory mechanisms in response to the increased pressure. Bradycardia (choice A) is not typically associated with increased ICP and may indicate a different issue. Increased level of consciousness (choice B) is unlikely with increased ICP, as it often leads to altered mental status. Hyperactive bowel sounds (choice D) are not directly related to increased ICP and are more indicative of gastrointestinal issues.
5. A nurse is planning care for a group of clients. Which of the following clients should the nurse plan to assess first?
- A. A client who has a fractured femur and reports feeling short of breath.
- B. A client who is postoperative and has abdominal distention.
- C. A client who is receiving IV fluids and has a temperature of 38.5°C (101.3°F).
- D. A client who has cancer and has been receiving radiation therapy.
Correct answer: A
Rationale: The correct answer is A. A client with a fractured femur and reports feeling short of breath is at risk for a fat embolism, which is a medical emergency. The nurse should assess this client first to rule out this serious complication. Choice B may indicate paralytic ileus, which is important but not immediately life-threatening compared to a fat embolism. Choice C has a fever, which indicates infection but is not as urgent as a potential fat embolism. Choice D, a client receiving radiation therapy, is not experiencing an acute, life-threatening complication that requires immediate assessment compared to a fat embolism.
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