ATI RN
ATI Medical Surgical Proctored Exam
1. A newly graduated nurse in the hospital states that, since she is so new, she cannot participate in quality improvement (QI) projects. What response by the precepting nurse is best?
- A. All staff nurses are required to participate in quality improvement projects.
- B. Even as a new nurse, you can implement activities designed to improve care.
- C. It's easy to identify which indicators should be used to measure quality improvement.
- D. You should ask to be assigned to the research and quality committee.
Correct answer: B
Rationale: The best response is to encourage the newly graduated nurse to actively participate in quality improvement initiatives. Being new does not preclude one from contributing to improving care processes and outcomes. By engaging in small activities focused on quality improvement, the new nurse can start making a positive impact and learn valuable skills early in their career.
2. During a home visit to an older client living alone post-coronary artery bypass graft, what finding prompts the nurse to consider additional referrals?
- A. Dirty carpets requiring vacuuming
- B. Expired food found in the refrigerator
- C. Outdated medications stored in the kitchen
- D. Presence of multiple cats in the home
Correct answer: B
Rationale: The presence of expired food in the refrigerator is concerning as it raises safety issues for the client and indicates potential financial constraints preventing them from buying fresh food. The nurse should consider referring the client to services like Meals on Wheels or other home-based food programs to address this issue and ensure the client's nutritional needs are met.
3. A client is 12 hours postoperative following colon resection. Which of the following interventions should the nurse include in the plan to reduce respiratory complications?
- A. Use incentive spirometer every 4 hours while awake.
- B. Initiate ambulation after discontinuing the NG tube.
- C. Maintain a supine position with an abdominal binder.
- D. Splint the incision to support coughing every 2 hours.
Correct answer: D
Rationale: Following a colon resection surgery, it is essential to support the incision site to reduce the risk of respiratory complications. Splinting the incision helps to minimize pain during coughing, aiding in effective clearing of secretions and preventing respiratory problems. This intervention supports the client's respiratory function postoperatively, promoting optimal recovery.
4. A client is caring for a postoperative client on the surgical unit. The client's blood pressure was 142/76 mm Hg 30 minutes ago and is now 88/50 mm Hg. What action by the nurse is best?
- A. Call the Rapid Response Team.
- B. Document and continue to monitor.
- C. Notify the primary care provider.
- D. Repeat blood pressure measurement in 15 minutes.
Correct answer: A
Rationale: In this scenario, the significant drop in blood pressure indicates a potential emergency situation. The correct action is to call the Rapid Response Team (RRT) to ensure prompt intervention and prevent further deterioration that could lead to respiratory or cardiac arrest. It is crucial to act swiftly in response to such a critical change in vital signs to provide the client with the necessary care and support.
5. A client with acute respiratory failure (ARF) is being cared for by a nurse. The nurse should monitor the client for which of the following manifestations of this condition?
- A. Severe dyspnea
- B. Nausea
- C. Decreased level of consciousness
- D. Headache
Correct answer: B
Rationale: In acute respiratory failure, the body is not getting enough oxygen, leading to hypoxia. Symptoms of hypoxia include severe dyspnea (A), decreased level of consciousness (C), and headache (D) due to inadequate oxygen supply to the brain. Nausea (B) is not a typical manifestation of acute respiratory failure and is not directly related to the lack of oxygen in the body. Therefore, the nurse should not monitor the client for nausea as a direct consequence of ARF.
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