ATI RN
ATI Comprehensive Exit Exam 2023 With NGN
1. A nurse is preparing to administer medications to a client who has a nasogastric (NG) tube. Which of the following actions should the nurse take first?
- A. Check for tube placement.
- B. Flush the NG tube with 0.9% sodium chloride.
- C. Administer the medications as a bolus.
- D. Dissolve the medications in 30 mL of sterile water.
Correct answer: A
Rationale: The correct first action for the nurse to take when preparing to administer medications to a client with a nasogastric (NG) tube is to check for tube placement. This step is crucial to ensure that the NG tube is correctly positioned in the stomach and not in the respiratory tract, reducing the risk of aspiration. Flushing the NG tube with 0.9% sodium chloride, administering the medications as a bolus, or dissolving the medications in sterile water should only be done after confirming the proper placement of the NG tube. Therefore, options B, C, and D are incorrect as they precede the essential step of verifying tube placement.
2. A client with a new diagnosis of Graves' disease and a prescription for propylthiouracil (PTU) is receiving teaching from a nurse. Which of the following client statements indicates an understanding of the teaching?
- A. I should report a sore throat to my provider.
- B. I will need to take this medication for the rest of my life.
- C. This medication increases my risk for infection.
- D. This medication decreases my appetite.
Correct answer: C
Rationale: The correct answer is C because propylthiouracil (PTU) can increase the risk of infection. Therefore, the client should be aware that this medication may compromise their immune system, making them more susceptible to infections. Reporting any signs of infection promptly to the provider is crucial for timely intervention and management. Choices A, B, and D are incorrect because reporting a sore throat, assuming lifelong medication intake, or experiencing decreased appetite are not directly related to the medication's side effects or risks.
3. A nurse is planning care for a client who is receiving hemodialysis. Which action should the nurse include in the care plan?
- A. Withhold all medications until after dialysis.
- B. Rehydrate with dextrose 5% in water for orthostatic hypotension.
- C. Check the vascular access site for bleeding after dialysis.
- D. Give an antibiotic 30 minutes before dialysis.
Correct answer: C
Rationale: The correct action the nurse should include in the care plan for a client receiving hemodialysis is to check the vascular access site for bleeding after dialysis. This is crucial as it helps in detecting and addressing any bleeding complications that may arise from the dialysis procedure. Choice A is incorrect because medications should not be withheld unless specified by the healthcare provider. Choice B is incorrect as dextrose 5% in water is not typically used for orthostatic hypotension. Choice D is incorrect as giving an antibiotic before dialysis is not a routine practice unless specifically prescribed for a particular reason.
4. A nurse is caring for a client who is receiving enteral nutrition via a nasogastric tube. Which of the following actions should the nurse take to reduce the risk of aspiration?
- A. Position the client supine during feedings.
- B. Administer the feedings over 10 minutes.
- C. Elevate the head of the bed during feedings.
- D. Place the client in a lateral position after feedings.
Correct answer: C
Rationale: The correct action to reduce the risk of aspiration in clients receiving enteral feedings is to elevate the head of the bed during feedings. This position helps prevent regurgitation and aspiration of the feeding. Positioning the client supine (Choice A) increases the risk of aspiration as it promotes reflux. Administering feedings over 10 minutes (Choice B) does not directly reduce the risk of aspiration. Placing the client in a lateral position after feedings (Choice D) does not address the risk of aspiration during the feeding process.
5. A nurse is caring for a client who is 1 hr postoperative following a transurethral resection of the prostate (TURP). The nurse notes that the client's indwelling urinary catheter has not drained in the past hour. Which of the following actions should the nurse take?
- A. Irrigate the catheter with 0.9% sodium chloride.
- B. Reposition the catheter.
- C. Notify the provider.
- D. Increase the rate of the continuous bladder irrigation.
Correct answer: A
Rationale: In this situation, the nurse should irrigate the catheter with 0.9% sodium chloride to help relieve any obstruction and ensure proper urinary drainage following a TURP. Repositioning the catheter may not address the underlying issue of obstruction. Notifying the provider should be done after attempting to resolve the drainage issue. Increasing the rate of continuous bladder irrigation is not the initial intervention for a catheter that is not draining.
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