ATI RN
ATI Comprehensive Exit Exam 2023 With NGN
1. A nurse is caring for a client who has chronic kidney disease and reports nausea. The nurse should identify that this client is at risk for which of the following imbalances?
- A. Metabolic alkalosis
- B. Metabolic acidosis
- C. Respiratory alkalosis
- D. Respiratory acidosis
Correct answer: B
Rationale: The correct answer is B: Metabolic acidosis. Clients with chronic kidney disease are at risk for metabolic acidosis because the kidneys are unable to effectively excrete acids, leading to an accumulation of acid in the body. This metabolic imbalance can result in symptoms like nausea. Choices A, C, and D are incorrect. Metabolic alkalosis is not typically associated with chronic kidney disease. Respiratory alkalosis is more commonly seen in conditions such as hyperventilation. Respiratory acidosis, on the other hand, is often linked to conditions affecting the lungs or respiratory system, not primarily kidney disease.
2. A healthcare provider is assessing a client who has heart failure and is taking digoxin. Which of the following findings should the healthcare provider identify as an indication of digoxin toxicity?
- A. Bradycardia.
- B. Yellow-tinged vision.
- C. Constipation.
- D. Hypertension.
Correct answer: B
Rationale: Yellow-tinged vision is a classic sign of digoxin toxicity due to its effect on the eyes. It can cause a yellow or green visual halo around objects. Bradycardia, constipation, and hypertension are not typical signs of digoxin toxicity. Bradycardia may be a sign of digoxin's therapeutic effect in heart failure, while constipation and hypertension are not commonly associated with digoxin toxicity.
3. A nurse is caring for a client who is 2 hr postoperative following an inguinal hernia repair. Which of the following findings should the nurse report to the provider?
- A. Heart rate of 88/min
- B. Pain rating of 4 on a scale of 0 to 10
- C. Blood pressure 110/70 mm Hg
- D. Urine output of 20 mL/hr
Correct answer: D
Rationale: A low urine output of 20 mL/hr, less than the expected 30 mL/hr or more, could indicate renal impairment or inadequate fluid status postoperatively. In this scenario, early detection and intervention are crucial to prevent further complications. The other findings - heart rate of 88/min, pain rating of 4, and blood pressure of 110/70 mm Hg - are within normal limits for a client 2 hr postoperative following an inguinal hernia repair and do not raise immediate concerns.
4. What should the healthcare provider monitor for a patient receiving furosemide?
- A. Monitor urine output
- B. Monitor blood pressure
- C. Monitor potassium levels
- D. Monitor serum creatinine
Correct answer: C
Rationale: The correct answer is to monitor potassium levels when a patient is receiving furosemide because furosemide can cause potassium depletion. It is essential to monitor potassium levels to prevent complications such as hypokalemia. While monitoring urine output is important in assessing kidney function, and monitoring blood pressure and serum creatinine are relevant in certain situations, the priority when administering furosemide is to monitor potassium levels due to the medication's potential to deplete potassium.
5. What is the best intervention for a patient experiencing respiratory distress?
- A. Administer oxygen
- B. Administer bronchodilators
- C. Administer IV fluids
- D. Provide humidified air
Correct answer: A
Rationale: Administering oxygen is the best intervention for a patient experiencing respiratory distress because it helps improve oxygenation and alleviate respiratory distress. Oxygen therapy is a critical and priority intervention in such cases as it aims to increase oxygen levels in the blood. Administering bronchodilators may be beneficial for specific respiratory conditions like asthma or COPD, but oxygen should be the initial priority. Administering IV fluids and providing humidified air, while important in certain situations, are not the primary interventions for respiratory distress.
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