ATI RN
ATI Comprehensive Exit Exam 2023
1. A nurse is caring for a client who has a Clostridium difficile infection. Which of the following precautions should the nurse implement?
- A. Place the client in a negative pressure room
- B. Wear an N95 respirator mask when entering the room
- C. Wear a gown and gloves when providing care to the client
- D. Place a face mask on the client
Correct answer: C
Rationale: The correct precaution to implement when caring for a client with Clostridium difficile infection is to wear a gown and gloves when providing care. Clostridium difficile is primarily spread through contact with feces, so wearing personal protective equipment like gowns and gloves is crucial in preventing the spread of the infection. Placing the client in a negative pressure room (Choice A) is not necessary for Clostridium difficile. While wearing an N95 respirator mask (Choice B) is important for airborne precautions, it is not required for Clostridium difficile. Placing a face mask on the client (Choice D) is not a standard precaution for preventing the spread of Clostridium difficile.
2. A nurse is caring for a client who has pneumonia and is receiving oxygen therapy. Which of the following findings indicates the need for suctioning?
- A. Increased respiratory rate.
- B. Oxygen saturation 96%.
- C. Clear lung sounds.
- D. Productive cough.
Correct answer: A
Rationale: The correct answer is A: Increased respiratory rate. An increased respiratory rate suggests the client is having difficulty clearing secretions and may require suctioning. Oxygen saturation of 96% is within the normal range and indicates adequate oxygenation. Clear lung sounds suggest good air entry without the need for suctioning. A productive cough, although a symptom of pneumonia, does not directly indicate the need for suctioning.
3. A nurse is assessing a client who is experiencing acute pain. Which of the following manifestations should the nurse expect?
- A. Hypertension
- B. Bradycardia
- C. Diaphoresis
- D. Piloerection
Correct answer: C
Rationale: The correct answer is C: Diaphoresis. Diaphoresis, which is excessive sweating, is a common manifestation of acute pain caused by increased sympathetic nervous system activity. This response is the body's way of trying to regulate body temperature during the stress response. Choices A, B, and D are incorrect. Hypertension (Choice A) and tachycardia (not bradycardia as in Choice B) are more likely responses to acute pain due to sympathetic nervous system activation. Piloerection (Choice D), also known as goosebumps, is not a typical manifestation of acute pain.
4. A nurse is assessing a newborn who was delivered at 32 weeks of gestation. Which of the following findings should the nurse expect?
- A. Dry, cracked skin.
- B. Lanugo covering the skin.
- C. Vernix caseosa covering the skin.
- D. Creases covering the soles of the feet.
Correct answer: B
Rationale: The correct answer is B: Lanugo covering the skin. Lanugo, a fine downy hair, is a common finding in newborns delivered prematurely at 32 weeks gestation. Choice A (Dry, cracked skin) is incorrect as premature infants often have translucent and delicate skin. Choice C (Vernix caseosa covering the skin) is incorrect as vernix, a waxy substance, is more commonly seen in full-term newborns. Choice D (Creases covering the soles of the feet) is incorrect as creases on the soles of the feet are a normal finding in term newborns, not specifically related to prematurity.
5. A nurse is providing teaching to an older adult client about methods to promote nighttime sleep. Which of the following instructions should the nurse include?
- A. Stay in bed for at least 1 hour if unable to fall asleep.
- B. Take a 1-hour nap during the day.
- C. Perform exercise before bed.
- D. Eat a light snack before bedtime.
Correct answer: D
Rationale: The correct answer is to eat a light snack before bedtime. Consuming a light snack can help promote sleep by preventing discomfort from hunger. Choice A is incorrect because staying in bed for too long when unable to fall asleep can lead to frustration and worsen insomnia. Choice B is incorrect as taking a nap during the day can interfere with nighttime sleep. Choice C is incorrect as exercising before bed can increase alertness and make falling asleep more difficult.
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