ATI RN
ATI Comprehensive Exit Exam 2023 With NGN
1. A nurse is caring for a client who has chronic kidney disease and reports nausea. The nurse should identify that this client is at risk for which of the following imbalances?
- A. Metabolic alkalosis
- B. Metabolic acidosis
- C. Respiratory alkalosis
- D. Respiratory acidosis
Correct answer: B
Rationale: The correct answer is B: Metabolic acidosis. Clients with chronic kidney disease are at risk for metabolic acidosis because the kidneys are unable to effectively excrete acids, leading to an accumulation of acid in the body. This metabolic imbalance can result in symptoms like nausea. Choices A, C, and D are incorrect. Metabolic alkalosis is not typically associated with chronic kidney disease. Respiratory alkalosis is more commonly seen in conditions such as hyperventilation. Respiratory acidosis, on the other hand, is often linked to conditions affecting the lungs or respiratory system, not primarily kidney disease.
2. What is the most appropriate nursing intervention for a patient with suspected deep vein thrombosis (DVT)?
- A. Administer anticoagulants
- B. Apply compression stockings
- C. Encourage ambulation
- D. Monitor oxygen saturation
Correct answer: A
Rationale: The correct answer is A: Administer anticoagulants. Administering anticoagulants is the most appropriate nursing intervention for a patient with suspected DVT because it helps prevent further clot formation and complications. Applying compression stockings (choice B) can be a preventive measure but is not the primary intervention for treating DVT. Encouraging ambulation (choice C) is beneficial for preventing DVT but is not the immediate intervention for a suspected case. Monitoring oxygen saturation (choice D) is important for assessing respiratory function but is not the primary intervention for DVT treatment.
3. How should a healthcare provider manage a patient with chronic kidney disease?
- A. Limit fluid intake
- B. Increase potassium intake
- C. Provide a high-protein diet
- D. Administer IV antibiotics
Correct answer: A
Rationale: Limiting fluid intake is essential in managing patients with chronic kidney disease to prevent fluid overload, which can worsen kidney function. Increasing potassium intake is not recommended as patients with kidney disease often need to limit potassium. Providing a high-protein diet may put extra strain on the kidneys, so it is not ideal. Administering IV antibiotics is not a standard treatment for chronic kidney disease.
4. Which lab value is most critical to monitor in a patient receiving insulin therapy?
- A. Monitor blood glucose
- B. Monitor potassium levels
- C. Monitor calcium levels
- D. Monitor sodium levels
Correct answer: A
Rationale: The correct answer is to monitor blood glucose levels. When a patient is receiving insulin therapy, it is crucial to monitor blood glucose levels regularly to prevent hypoglycemia, a potential side effect of insulin therapy. Monitoring potassium, calcium, or sodium levels is important for different medical conditions or treatments and is not directly related to insulin therapy.
5. A nurse is preparing to administer medications to a client who has a nasogastric (NG) tube. Which of the following actions should the nurse take first?
- A. Check for tube placement.
- B. Flush the NG tube with 0.9% sodium chloride.
- C. Administer the medications as a bolus.
- D. Dissolve the medications in 30 mL of sterile water.
Correct answer: A
Rationale: The correct first action for the nurse to take when preparing to administer medications to a client with a nasogastric (NG) tube is to check for tube placement. This step is crucial to ensure that the NG tube is correctly positioned in the stomach and not in the respiratory tract, reducing the risk of aspiration. Flushing the NG tube with 0.9% sodium chloride, administering the medications as a bolus, or dissolving the medications in sterile water should only be done after confirming the proper placement of the NG tube. Therefore, options B, C, and D are incorrect as they precede the essential step of verifying tube placement.
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