ATI RN
ATI RN Exit Exam Quizlet
1. A nurse is assessing a client who is postoperative following a gastric bypass. Which of the following findings should the nurse report to the provider?
- A. Heart rate of 78/min
- B. Oxygen saturation of 95%
- C. Urine output of 30 mL/hr
- D. Serosanguineous wound drainage
Correct answer: C
Rationale: In a postoperative client, a urine output of 30 mL/hr is a concerning finding as it indicates oliguria, which may suggest dehydration or kidney impairment. Adequate urine output is essential for monitoring renal function and overall fluid status. A heart rate of 78/min is within the normal range for an adult. An oxygen saturation of 95% is acceptable and indicates adequate oxygenation. Serosanguineous wound drainage is expected in the early postoperative period and is not a cause for immediate concern unless it becomes excessive or changes character.
2. A nurse is providing care for a client who is in the advanced stage of amyotrophic lateral sclerosis (ALS). Which of the following referrals is the nurse's priority?
- A. Psychologist
- B. Social worker
- C. Occupational therapist
- D. Speech-language pathologist
Correct answer: D
Rationale: In the advanced stage of ALS, clients often experience swallowing difficulties, known as dysphagia. A speech-language pathologist specializes in assessing and managing these swallowing problems, making them the nurse's priority referral in this case. A psychologist primarily focuses on mental health and emotional well-being, which may not be the most critical issue at this stage. Social workers assist with social support and resources, while occupational therapists help with activities of daily living and mobility, which are important but not the priority when dysphagia is a concern.
3. The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of clinical reasoning?
- A. Purposeful and goal-directed
- B. A simple developmental process
- C. Based on deliberate and irrational thought
- D. Assists individuals in guessing what is most appropriate
Correct answer: A
Rationale: Clinical reasoning is purposeful and goal-directed, involving the use of critical thinking and decision-making skills to provide effective patient care.
4. Chemicals, agents, or factors that cause physical defects in the developing embryo and are most harmful during organogenesis are:
- A. Teratogens
- B. Heterozygous
- C. Inborn errors
- D. Multifactorial
Correct answer: A
Rationale: Teratogens are substances that can cause congenital abnormalities, especially during the first trimester when organogenesis occurs. Choice A, Teratogens, is the correct answer as it specifically refers to substances that cause physical defects in the developing embryo. Choices B, Heterozygous, C, Inborn errors, and D, Multifactorial, are incorrect as they do not directly relate to substances that cause physical defects in embryos during organogenesis.
5. Mrs. Jordan is an elderly client diagnosed with Alzheimer’s disease. She becomes agitated and combative when a nurse approaches to help with morning care. The most appropriate nursing intervention in this situation would be to:
- A. tell the client firmly that it is time to get dressed.
- B. obtain assistance to restrain the client for safety.
- C. remain calm and talk quietly to the client.
- D. call the doctor and request an order for sedation.
Correct answer: C
Rationale: When dealing with an elderly client with Alzheimer’s disease who is agitated and combative, the most appropriate nursing intervention is to remain calm and talk quietly to the client. This approach can help soothe the client and prevent escalating the situation. Choice A is incorrect as being firm may further agitate the client. Choice B is inappropriate as restraining should only be used as a last resort for safety reasons and after other de-escalation techniques have been attempted. Choice D is not the best initial intervention and should only be considered after other non-pharmacological interventions have failed.
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