ATI RN
ATI Exit Exam 180 Questions Quizlet
1. A nurse is assessing a client who is receiving packed RBCs. Which of the following findings indicate fluid overload?
- A. Low back pain
- B. Dyspnea
- C. Hypotension
- D. Thready pulse
Correct answer: B
Rationale: The correct answer is B: Dyspnea. Dyspnea, or difficulty breathing, is a common sign of fluid overload in a client receiving packed RBCs. When fluid accumulates in the lungs due to overload, it can lead to respiratory distress. This finding requires prompt intervention to prevent further complications. Choices A, C, and D are incorrect: A) Low back pain is not typically associated with fluid overload; C) Hypotension refers to low blood pressure and is not a typical finding in fluid overload; D) Thready pulse may indicate poor perfusion but is not a direct indicator of fluid overload.
2. A client is prescribed furosemide and needs to consume potassium-rich foods. Which of the following foods should the client be advised to include in the diet?
- A. Grapes.
- B. Apples.
- C. Bananas.
- D. Rice.
Correct answer: C
Rationale: The correct answer is C: Bananas. Bananas are rich in potassium and should be included in the diet of clients taking furosemide, a potassium-wasting diuretic. Grapes, apples, and rice are not as high in potassium as bananas and would not be as effective in replenishing potassium levels in clients taking furosemide.
3. A nurse is caring for a client who has a prescription for a high-protein diet. Which of the following foods should the nurse recommend?
- A. Almonds
- B. Cheddar cheese
- C. Chicken breast
- D. Pasta
Correct answer: C
Rationale: Chicken breast is an excellent choice for a high-protein diet as it is a lean source of protein. Almonds, while a good source of protein, also contain high amounts of fat. Cheddar cheese is high in protein but also high in saturated fat. Pasta is not a significant source of protein compared to chicken breast.
4. A client who had a colon resection and a new ascending colostomy is receiving discharge teaching from a nurse. Which of the following statements by the client indicates an understanding of the teaching?
- A. My stool will become fully formed within 3 weeks.
- B. My skin should be cleaned with alcohol before applying a new pouch.
- C. I should avoid eating popcorn and fresh pineapple.
- D. I should expect bruising around the stoma.
Correct answer: C
Rationale: The correct answer is C because avoiding popcorn and fresh pineapple helps prevent complications with an ascending colostomy. Statements A, B, and D are incorrect. Statement A is inaccurate as it takes time for bowel function to normalize after surgery. Statement B is incorrect as alcohol can be irritating to the skin; gentle soap and water are recommended for cleaning. Statement D is incorrect as bruising around the stoma is not an expected outcome of colostomy creation.
5. While caring for a newborn with jaundice receiving phototherapy, what action should the nurse take?
- A. Feed the infant 30 ml (1 oz) of glucose water every 2 hours.
- B. Keep the infant's head covered with a cap.
- C. Ensure that the newborn wears a diaper.
- D. Apply lotion to the newborn every 4 hours.
Correct answer: C
Rationale: The correct action for the nurse to take while caring for a newborn with jaundice receiving phototherapy is to ensure that the newborn wears a diaper. This is essential to prevent skin irritation during phototherapy. Feeding the infant glucose water or applying lotion are not pertinent to managing jaundice or phototherapy. Keeping the infant's head covered with a cap is also not necessary for this specific situation.
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