ATI RN
ATI Exit Exam 2023
1. A nurse is teaching a client who has diabetes mellitus about foot care. Which of the following instructions should the nurse include?
- A. Soak your feet in warm water every day to prevent dryness.
- B. Wear cotton socks to keep your feet dry.
- C. Apply lotion between your toes after bathing.
- D. Cut your toenails in a rounded shape.
Correct answer: B
Rationale: The correct instruction the nurse should include is to 'Wear cotton socks to keep your feet dry.' This is essential in diabetes mellitus as moisture can lead to infections. Choice A is incorrect as soaking feet in warm water can actually cause dryness and skin breakdown, which is harmful in diabetes. Choice C is incorrect as applying lotion between the toes can create excess moisture, increasing the risk of fungal infections. Choice D is incorrect as cutting toenails in a rounded shape can lead to ingrown toenails; clients with diabetes should cut their nails straight across to prevent complications.
2. A nurse is assessing a client who is postoperative following a transurethral resection of the prostate (TURP). Which of the following findings should the nurse report to the provider?
- A. Passing small clots in the urine.
- B. Continuous bladder irrigation.
- C. Red-tinged urine with numerous clots.
- D. Urine output of 50 mL/hr.
Correct answer: C
Rationale: The correct answer is C: Red-tinged urine with numerous clots. This finding should be reported because it indicates excessive bleeding following a TURP procedure. Passing small clots in the urine (choice A) is expected post-TURP. Continuous bladder irrigation (choice B) is a standard procedure after TURP to prevent clot retention. Urine output of 50 mL/hr (choice D) is within the expected range postoperatively and does not indicate a complication.
3. A nurse is preparing to administer dopamine hydrochloride at 4 mcg/kg/min for a client weighing 80 kg. How many mL/hr should the nurse set the IV infusion to deliver?
- A. 6 mL/hr
- B. 8 mL/hr
- C. 12 mL/hr
- D. 16 mL/hr
Correct answer: A
Rationale: To calculate the correct rate, you first need to convert the weight to micrograms: 4 mcg/kg/min * 80 kg = 320 mcg/min. Then, convert micrograms to milligrams: 320 mcg/min / 1000 = 0.32 mg/min. Next, calculate how many milligrams per hour: 0.32 mg/min * 60 min/hr = 19.2 mg/hr. Finally, determine the mL/hr rate by using the concentration provided: 19.2 mg/hr / 800 mg in 250 mL = 6 mL/hr. Therefore, the correct answer is 6 mL/hr. Choice B, 8 mL/hr, is incorrect as it does not reflect the accurate calculation based on the weight and drug concentration. Choices C and D, 12 mL/hr and 16 mL/hr, are also incorrect as they do not align with the correct calculation of the infusion rate for dopamine hydrochloride based on the client's weight and the medication concentration.
4. A nurse is caring for a client who has a new prescription for warfarin. Which of the following laboratory values should the nurse monitor to determine the effectiveness of the medication?
- A. Hemoglobin
- B. Platelet count
- C. Prothrombin time (PT)
- D. International normalized ratio (INR)
Correct answer: D
Rationale: The correct answer is D, International normalized ratio (INR). INR is used to monitor the therapeutic effect of warfarin, an anticoagulant medication. Warfarin works by inhibiting the synthesis of vitamin K-dependent clotting factors. Monitoring the INR helps assess how well the medication is working to prevent blood clots. Choices A, B, and C are not specific indicators for monitoring the effectiveness of warfarin. Hemoglobin levels primarily assess the oxygen-carrying capacity of red blood cells, platelet count evaluates the clotting ability of blood, and PT measures the time it takes for blood to clot. While these values are important for overall health assessment, they do not directly reflect the anticoagulant effects of warfarin.
5. A nurse is caring for a client who has an indwelling urinary catheter. Which of the following interventions should the nurse implement to prevent catheter-associated infections?
- A. Change the catheter every 24 hours
- B. Ensure the drainage bag is positioned above the bladder
- C. Perform routine irrigation of the catheter
- D. Empty the drainage bag every 4 hours
Correct answer: B
Rationale: The correct answer is to ensure the drainage bag is positioned above the bladder. This positioning prevents urine reflux into the bladder, reducing the risk of catheter-associated infections. Changing the catheter too frequently (Choice A) can actually increase the risk of infection by introducing pathogens. Performing routine catheter irrigation (Choice C) is no longer recommended as it can increase the risk of infection by introducing bacteria. Emptying the drainage bag every 4 hours (Choice D) is a standard practice to prevent urinary stasis but is not directly related to preventing catheter-associated infections.
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