ATI RN
ATI Comprehensive Exit Exam 2023
1. A nurse is preparing to perform tracheostomy care for a client. Which of the following actions should the nurse take first?
- A. Apply a sterile dressing.
- B. Suction the tracheostomy.
- C. Remove the inner cannula.
- D. Clean the stoma with sterile saline.
Correct answer: B
Rationale: Suctioning the tracheostomy should be performed first to clear the airway of secretions and ensure proper oxygenation before proceeding with other care. This helps maintain a patent airway and prevent complications such as aspiration. Applying a sterile dressing, removing the inner cannula, or cleaning the stoma can follow after ensuring adequate airway clearance through suctioning.
2. A client in end-stage osteoporosis is reporting severe pain, with a respiratory rate of 14 per minute. Which of the following medications should the nurse expect to be the highest priority to administer to the client?
- A. Promethazine
- B. Hydromorphone
- C. Ketorolac
- D. Amitriptyline
Correct answer: B
Rationale: In a client with severe pain like the one described, the priority medication to administer is a potent analgesic like hydromorphone. Hydromorphone is a strong opioid pain medication that can effectively manage severe pain. Promethazine (Choice A) is an antiemetic and antihistamine, not a pain medication. Ketorolac (Choice C) is a nonsteroidal anti-inflammatory drug (NSAID) that is contraindicated in end-stage renal disease due to its potential to cause kidney damage. Amitriptyline (Choice D) is a tricyclic antidepressant used for conditions like depression and neuropathic pain, but it is not the first-line treatment for severe acute pain.
3. A client at 32 weeks of gestation with preeclampsia is receiving teaching from a nurse. Which statement by the client indicates an understanding of the teaching?
- A. I will take a daily aspirin to prevent blood clots.
- B. I will call my provider if I experience swelling in my hands.
- C. I should increase my calcium intake to prevent seizures.
- D. I will restrict my protein intake to prevent further kidney damage.
Correct answer: B
Rationale: The correct answer is B because swelling in the hands is a potential sign of worsening preeclampsia, and the client should report this to their provider. Choice A is incorrect since aspirin is not recommended in preeclampsia. Choice C is incorrect as calcium intake is not directly related to preventing seizures in preeclampsia. Choice D is incorrect because protein restriction is not the standard management for preventing further kidney damage in preeclampsia.
4. A nurse in the emergency department is caring for a client who reports intimate partner violence. Which of the following interventions is the nurse's priority?
- A. Develop a safety plan with the client.
- B. Refer the client to a community support group.
- C. Determine if the client has any injuries.
- D. Contact the client's family about the incident.
Correct answer: A
Rationale: The correct answer is to develop a safety plan with the client. In cases of intimate partner violence, the priority is to ensure the client's immediate safety. While referring the client to a community support group (choice B) and determining if the client has any injuries (choice C) are important interventions, ensuring the client's safety through a safety plan takes precedence. Contacting the client's family about the incident (choice D) may not be appropriate as it can further endanger the client.
5. 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.
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