ATI RN
ATI Comprehensive Exit Exam 2023
1. A healthcare provider is assessing a client who has acute pancreatitis. Which of the following laboratory results should the healthcare provider expect to be elevated?
- A. Serum sodium.
- B. Serum calcium.
- C. Serum glucose.
- D. Serum amylase.
Correct answer: D
Rationale: Serum amylase levels are typically elevated in clients with acute pancreatitis as it is an enzyme released by the pancreas. Elevated serum sodium, calcium, or glucose levels are not typically associated with acute pancreatitis. Therefore, choices A, B, and C are incorrect.
2. A client is 24 hr postoperative following an abdominal aortic aneurysm resection. Which of the following findings is a priority to report?
- A. Serosanguineous drainage on dressing
- B. Abdominal distention
- C. Absent bowel sounds
- D. Urine output of 20 mL/hr
Correct answer: D
Rationale: Urine output less than 30 mL/hr is indicative of decreased kidney function, potentially due to inadequate perfusion or other complications post-aneurysm resection. This finding requires immediate reporting to prevent further complications such as acute kidney injury. Serosanguineous drainage on the dressing, abdominal distention, and absent bowel sounds are also important postoperative assessments but are not as critical as impaired kidney function in this scenario.
3. A nurse is preparing to administer an intermittent enteral feeding to a client who has a gastrostomy tube. Which of the following actions should the nurse take?
- A. Flush the tube with 30 mL of water after feeding
- B. Flush the tube with 10 mL of sterile water before feeding
- C. Place the client in a left lateral position
- D. Place the feeding bag 61 cm (24 in) above the client's abdomen
Correct answer: B
Rationale: Administering an intermittent enteral feeding through a gastrostomy tube requires flushing the tube with 10 mL of sterile water before feeding. This action helps ensure patency and prevents clogging. Choice A is incorrect because flushing after feeding does not address the need for pre-feeding tube flushing. Choice C is unrelated to tube feeding administration. Choice D is incorrect as the height of the feeding bag above the abdomen is typically regulated by healthcare facility policies and is not a universal standard.
4. A nurse is providing discharge teaching to a client who has a new prescription for lithium. Which of the following instructions should the nurse include?
- A. Take this medication on an empty stomach.
- B. Avoid eating foods that contain tyramine.
- C. Drink at least 2 liters of water each day.
- D. Take this medication in the evening before bedtime.
Correct answer: C
Rationale: The correct instruction for a client prescribed lithium is to drink at least 2 liters of water each day. This is important to prevent dehydration and reduce the risk of lithium toxicity. Option A is incorrect because lithium is usually taken with food to minimize gastrointestinal side effects. Option B is unrelated to lithium and is more applicable to clients taking MAOIs. Option D is incorrect as lithium is typically taken in divided doses throughout the day to maintain therapeutic levels.
5. 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.
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