ATI RN
ATI Exit Exam 2024
1. A nurse is providing discharge teaching to a client following a cholecystectomy. Which of the following instructions should the nurse include?
- A. I should avoid lifting objects heavier than 5 pounds for 1 week.
- B. I can resume my usual activities after 2 weeks.
- C. I should expect to have pain in my right shoulder.
- D. I should follow a low-protein diet for 1 week.
Correct answer: C
Rationale: The correct answer is C. Pain in the right shoulder after a cholecystectomy is common due to residual gas from the procedure. Choices A, B, and D are incorrect. It is important to avoid heavy lifting for a longer period than just 1 week to prevent complications. Resuming usual activities after 2 weeks may not be appropriate depending on the individual's recovery. Following a low-protein diet is not a standard recommendation post-cholecystectomy.
2. A client who is 48 hours postoperative following abdominal surgery is being assessed by a nurse. Which of the following findings should the nurse report to the provider?
- A. Heart rate of 80/min
- B. Sanguineous drainage on the surgical dressing
- C. Temperature of 37.5°C (99.5°F)
- D. Serous drainage on the surgical dressing
Correct answer: B
Rationale: Sanguineous drainage from the surgical site 48 hours after surgery could indicate a complication such as hemorrhage or infection and should be reported. Sanguineous drainage is typically seen in the early postoperative period due to the presence of blood. Serous drainage, on the other hand, is normal in the later stages of wound healing. A heart rate of 80/min is within the normal range for an adult. A temperature of 37.5°C (99.5°F) is slightly elevated but not a concerning finding in the absence of other symptoms.
3. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?
- A. Take a tablet every 5 minutes for pain relief, up to three doses.
- B. Take this medication with a glass of water.
- C. Chew the tablet for faster absorption.
- D. Store the tablets in a refrigerator.
Correct answer: A
Rationale: The correct answer is A: 'Take a tablet every 5 minutes for pain relief, up to three doses.' Nitroglycerin sublingual tablets are used to relieve chest pain or to prevent chest pain before activities known to cause angina. The tablets should be taken every 5 minutes for pain relief, up to three doses, as prescribed. Choice B is incorrect because nitroglycerin sublingual tablets should be placed under the tongue until they dissolve, not taken with water. Choice C is incorrect because nitroglycerin sublingual tablets should not be chewed but placed under the tongue for absorption. Choice D is incorrect because nitroglycerin tablets should be stored in their original container at room temperature away from light and moisture.
4. A nurse is preparing to mix NPH and regular insulin in the same syringe. Which of the following actions should the nurse take?
- A. Inject air into the NPH insulin vial.
- B. Withdraw the prescribed dose of regular insulin.
- C. Withdraw the prescribed dose of NPH insulin.
- D. Mix the two insulins in separate syringes.
Correct answer: A
Rationale: When mixing NPH and regular insulin in the same syringe, the nurse should first inject air into the NPH insulin vial. This action prevents contamination by allowing an easier withdrawal of the correct dose of NPH insulin after withdrawing the regular insulin. Withdrawing the prescribed dose of regular insulin (Choice B) is incorrect as it does not address the initial step of injecting air into the NPH vial. Similarly, withdrawing the prescribed dose of NPH insulin (Choice C) is incorrect as it skips the crucial first step. Mixing the two insulins in separate syringes (Choice D) is not ideal since combining them in one syringe is a common practice to reduce the number of injections for the patient.
5. A nurse is caring for a client who is in labor and is receiving oxytocin. Which of the following findings indicates that the nurse should increase the rate of infusion?
- A. Urine output of 20 ml/hr
- B. Montevideo units consistently at 300 mm Hg
- C. FHR pattern with absent variability
- D. Contractions every 5 minutes that last 30 seconds
Correct answer: D
Rationale: The correct answer is D because contractions every 5 minutes that last 30 seconds indicate that the rate of infusion should be increased. This pattern suggests weak contractions or intervals that are too far apart, requiring an adjustment to improve labor progress. Option A is incorrect as a low urine output is not directly related to the need for an increase in the oxytocin infusion rate. Option B, Montevideo units consistently at 300 mm Hg, is incorrect because it is a measure of intrauterine pressure and does not determine the need for an increase in oxytocin infusion. Option C, FHR pattern with absent variability, is incorrect as it may indicate fetal distress but does not specifically relate to the need for adjusting the oxytocin infusion rate.
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