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 reviewing the laboratory results of a client who has hypokalemia. Which of the following findings should the nurse expect?
- A. Serum potassium 5.4 mEq/L
- B. Flat T waves
- C. Elevated ST segments
- D. Bradycardia
Correct answer: B
Rationale: Flat T waves are a characteristic ECG finding in hypokalemia. Hypokalemia causes a decrease in serum potassium levels, leading to altered cardiac conduction. Flat T waves are associated with hypokalemia-induced cardiac dysrhythmias. Elevated ST segments are typically seen in conditions like myocardial infarction, not in hypokalemia. Bradycardia is not a typical manifestation of hypokalemia; instead, tachycardia may occur due to potassium imbalances affecting the heart's electrical activity.
3. A nurse is caring for a client who is at risk for pressure ulcers. Which of the following interventions should the nurse implement?
- A. Turn the client every 2 hours
- B. Use a donut-shaped cushion when sitting
- C. Elevate the head of the bed to 45 degrees
- D. Massage reddened areas to increase circulation
Correct answer: A
Rationale: The correct intervention for preventing pressure ulcers in a client at risk is to turn the client every 2 hours. This helps relieve pressure on bony prominences, improving circulation and preventing tissue damage. Using a donut-shaped cushion can actually increase pressure on the skin and worsen the risk of pressure ulcers. Elevating the head of the bed to 45 degrees is beneficial for preventing aspiration in some cases but does not directly address pressure ulcer prevention. Massaging reddened areas can further damage the skin and increase the risk of pressure ulcer development by causing friction and shearing forces.
4. A healthcare provider is reviewing the medical records of a client with a prescription for combination oral contraceptives. Which of the following conditions is a contraindication?
- A. Hyperthyroidism
- B. Thrombophlebitis
- C. Diverticulosis
- D. Hypocalcemia
Correct answer: B
Rationale: Thrombophlebitis is a contraindication to combination oral contraceptives due to the increased risk of thromboembolic events. Hyperthyroidism, diverticulosis, and hypocalcemia are not contraindications to combination oral contraceptives. Hyperthyroidism may affect thyroid hormone levels but does not directly contraindicate oral contraceptives. Diverticulosis is a condition related to the digestive system and does not impact the use of oral contraceptives. Hypocalcemia, a low calcium level in the blood, is not a contraindication for oral contraceptives.
5. Nurses caring for four clients. Which of the following client data should the nurse report to the provider?
- A. A client who has pleurisy and reports pain of 6 on a scale of 0 to 10 when coughing
- B. Client drained a total of 110 mL of serosanguineous fluid from the Jackson Pratt drain within the first 24 hours following surgery
- C. Client who is 4 hours postoperative and has a heart rate of 98 per minute
- D. The client has a prescription for chemotherapy and an absolute neutrophil count of 75/mm3
Correct answer: D
Rationale: The correct answer is D. The client with chemotherapy and a low neutrophil count is at risk for infection and requires prompt intervention. Reporting this information to the provider is crucial to ensure appropriate monitoring and management to prevent potential complications. Choices A, B, and C do not indicate an immediate risk that requires immediate provider notification. A client reporting pain with pleurisy, a client draining fluid post-surgery, or a client with a heart rate of 98 per minute postoperative are not urgent enough to warrant immediate reporting compared to the client at risk for infection.
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