ATI RN
ATI RN Comprehensive Exit Exam 2023
1. A nurse is assessing a client who is postoperative following a thyroidectomy. Which of the following findings is the priority for the nurse to report to the provider?
- A. Increased hoarseness
- B. Serum calcium level of 8.0 mg/dL
- C. Respiratory rate of 18/min
- D. Urinary output of 60 mL in 2 hours
Correct answer: B
Rationale: The correct answer is B: 'Serum calcium level of 8.0 mg/dL.' A low serum calcium level indicates hypocalcemia, which is a potential complication of thyroidectomy that can lead to life-threatening consequences, such as tetany or laryngospasm. Therefore, it is crucial for the nurse to report this finding promptly to the provider for timely intervention. Choices A, C, and D are important assessments following a thyroidectomy but are not as critical as detecting and addressing hypocalcemia, which can have serious implications for the client's health.
2. The nurse is caring for a client on warfarin with an INR of 1.8. What is the most appropriate action?
- A. Increase the dose of warfarin.
- B. Administer vitamin K.
- C. Hold the warfarin and notify the healthcare provider.
- D. Monitor the client’s INR closely.
Correct answer: D
Rationale: An INR of 1.8 is below the therapeutic range for a client on warfarin, indicating the need for monitoring closely to ensure that the INR levels reach the desired therapeutic range. Increasing the dose of warfarin (Choice A) without proper monitoring may lead to an increased risk of bleeding. Administering vitamin K (Choice B) is not typically recommended unless the client is experiencing major bleeding or requires rapid reversal of warfarin's effects. Holding the warfarin and notifying the healthcare provider (Choice C) may be necessary in certain situations, but the immediate action in this case should be to monitor the client's INR closely to guide further management.
3. A gastrectomy is performed on a client with gastric cancer. In the immediate postoperative period, the nurse notes bloody drainage from the nasogastric tube. The nurse should take which most appropriate action?
- A. Measure abdominal girth.
- B. Irrigate the nasogastric tube.
- C. Continue to monitor the drainage.
- D. Notify the health care provider (HCP).
Correct answer: D
Rationale: In the immediate postoperative period following a gastrectomy, any bloody drainage from the nasogastric (NG) tube is concerning and requires prompt evaluation. This could indicate potential complications such as bleeding from the surgical site, erosion, or other postoperative issues. Notifying the healthcare provider immediately is crucial to ensure that the patient receives timely assessment and intervention. The presence of blood may necessitate further diagnostic procedures, interventions, or changes in management to prevent serious complications.
4. The Acceptable Macronutrient Distribution Ranges state that half of your calories should come from protein.
- A. TRUE
- B. FALSE
- C.
- D.
Correct answer: B
Rationale: The statement is FALSE. The Acceptable Macronutrient Distribution Ranges recommend that 10-35% of daily calories come from protein, not half. The remaining calories should be derived from a combination of carbohydrates and fats to ensure a balanced diet. Choosing option A is incorrect because it misinterprets the recommended percentage for protein intake. Options C and D are left blank as they are not applicable to the question.
5. It is difficult to isolate the precise damage caused by illegal drugs during pregnancy because __________.
- A. most drug-using mothers refuse to participate in teratology research
- B. the majority of babies born to drug-using mothers do not survive for more than a few days
- C. most drug-using mothers quit using illegal drugs during the first trimester of pregnancy
- D. drug users often take several drugs, display other high-risk behaviors, and suffer from other stresses
Correct answer: D
Rationale: The difficulty in isolating the precise damage caused by illegal drugs during pregnancy is due to the fact that drug users often take several drugs, display other high-risk behaviors, and suffer from other stresses. This makes it challenging to identify the specific impact of each individual factor on prenatal development. Choices A, B, and C are incorrect because they do not address the complexity of the situation involving drug users during pregnancy. Most drug-using mothers refusing to participate in teratology research, the majority of babies not surviving, or drug-using mothers quitting during the first trimester do not directly explain the difficulty in isolating the precise damage caused by illegal drugs during pregnancy.
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