ATI RN
ATI RN Custom Exams Set 4
1. Which outcome should the nurse identify for the client diagnosed with fluid volume excess?
- A. The client will void a minimum of 30 mL per hour
- B. The client will have elastic skin turgor
- C. The client will have no adventitious breath sounds
- D. The client will have a serum creatinine of 1.4 mg/dL
Correct answer: C
Rationale: The correct outcome for a client diagnosed with fluid volume excess is the absence of adventitious breath sounds. This indicates that fluid is not accumulating in the lungs, a crucial sign in managing fluid volume excess. Choices A, B, and D are incorrect because voiding a specific amount of urine, having elastic skin turgor, and a serum creatinine level do not directly relate to managing fluid volume excess.
2. The nurse cares for a client receiving furosemide (Lasix). The nurse determines that teaching is effective if the client selects which of the following foods?
- A. One medium baked potato
- B. One slice of white bread
- C. One medium apple
- D. One scrambled egg
Correct answer: A
Rationale: The correct answer is A: One medium baked potato. Potatoes are high in potassium, which is crucial for clients on furosemide (Lasix) to prevent hypokalemia, as furosemide can cause potassium loss. White bread (choice B) and scrambled egg (choice D) are not high-potassium foods and do not address the specific need related to furosemide therapy. While apples (choice C) contain some potassium, they are not as rich in potassium as a baked potato, making them a less optimal choice for a client on furosemide.
3. At the end of the Practical Nurse Course, the student receives a structured review to prepare the student for which of the following?
- A. The Army Nurse Course
- B. Out-processing
- C. The next duty assignment
- D. The practical nurse licensure examination
Correct answer: D
Rationale: The structured review at the end of the Practical Nurse Course is specifically designed to prepare students for the practical nurse licensure examination. This examination is crucial for students to obtain their practical nurse license and start their career as a licensed practical nurse. Choices A, B, and C are incorrect because the focus at the end of the course is on preparing students for the licensure examination, not for Army Nurse Course, out-processing, or the next duty assignment.
4. The nurse supervises care of a client in Buck’s traction. The nurse determines that care is appropriate if which of the following is observed? (Select all that apply)
- A. The nurse removes the foam boot three times per day to inspect the skin
- B. The staff turn the client to the unaffected side
- C. The staff turn the client to the unaffected side and the nurse asks the client to dorsiflex the foot on the affected leg
- D. The nurse asks the client to dorsiflex the foot on the affected leg
Correct answer: C
Rationale: The correct answer is C. Turning the client to the unaffected side helps prevent complications such as pressure ulcers. Dorsiflexion of the foot on the affected leg helps maintain proper alignment and prevent foot drop. The incorrect choices are A and D. Removing the foam boot multiple times per day can disrupt traction, and asking the client to dorsiflex the foot may not be appropriate without ensuring proper alignment and direction from the healthcare provider.
5. Enteral feedings may be appropriate for patients with:
- A. Acute cholecystitis
- B. Hepatic encephalopathy
- C. Ulcerative colitis in remission
- D. Acute exacerbation of Crohn’s disease
Correct answer: D
Rationale: Enteral feedings are commonly used in patients with Crohn’s disease during acute exacerbations to provide adequate nutrition while resting the bowel. Acute cholecystitis, hepatic encephalopathy, and ulcerative colitis in remission wouldn't typically require enteral feedings as the primary nutritional support. Acute cholecystitis may necessitate fasting and intravenous fluids, hepatic encephalopathy may require dietary modifications but not enteral feedings, and patients with ulcerative colitis in remission usually have their nutritional needs met through a regular diet.
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