ATI RN
ATI RN Exit Exam
1. A client is at risk for developing deep vein thrombosis (DVT). Which of the following actions should the nurse take?
- A. Encourage the client to remain on bed rest.
- B. Massage the client's legs every 4 hours.
- C. Apply sequential compression devices to the client's legs.
- D. Administer anticoagulants as prescribed.
Correct answer: C
Rationale: The correct action the nurse should take for a client at risk for developing DVT is to apply sequential compression devices to the client's legs. This intervention helps prevent venous stasis by promoting circulation and reducing the risk of DVT. Encouraging the client to remain on bed rest (Choice A) can actually increase the risk of DVT due to immobility. Massaging the client's legs every 4 hours (Choice B) can dislodge blood clots and is contraindicated in DVT prevention. While administering anticoagulants as prescribed (Choice D) is a treatment for DVT, it is not a preventive measure for a client at risk.
2. Which of the following actions is appropriate when administering a blood transfusion?
- A. Verify patient identity
- B. Administer medication
- C. Monitor vital signs
- D. Start blood transfusion without verification
Correct answer: A
Rationale: Verifying the patient's identity is a critical step when administering a blood transfusion to ensure that the correct blood product is given to the right patient. This process helps prevent errors and enhances patient safety. Choice B, 'Administer medication,' is incorrect because the focus during a blood transfusion should be on ensuring the correct blood product is administered. Choice C, 'Monitor vital signs,' is also important but comes after verifying the patient's identity. Choice D, 'Start blood transfusion without verification,' is incorrect and unsafe as patient identification verification is essential prior to starting any medical procedure, especially one as important as a blood transfusion.
3. The removal of wastes produced by metabolic reactions is
- A. metabolism.
- B. absorption.
- C. assimilation.
- D. excretion.
Correct answer: excretion.
Rationale: The correct answer is 'excretion.' Excretion is the process of eliminating waste products produced by metabolic reactions from the body. Metabolism (Choice A) refers to the chemical processes that occur within a living organism to maintain life. Absorption (Choice B) is the process of taking in nutrients and fluids into the body. Assimilation (Choice C) is the process of absorbing and incorporating nutrients into the body after digestion. Therefore, excretion is the most appropriate term for the removal of metabolic wastes.
4. A student is feeling inside her backpack to find her mobile phone. There are a number of other items in the bag other than the phone. The nurse knows that which term best describes one's ability to sense the shape and size of an object in the absence of visualization?
- A. Stereognosis
- B. Graphesthesia
- C. Proprioception
- D. Kinesthesia
Correct answer: A
Rationale: Stereognosis is the correct answer. It refers to the ability to recognize objects by touch, specifically determining their shape and size without relying on visual cues. Graphesthesia, on the other hand, is the ability to recognize symbols or numbers traced on the skin. Proprioception involves the awareness of body position and movement. Kinesthesia relates to the perception of body movement.
5. During a change-of-shift report, a nurse is receiving information about an adult female client who is postoperative. Which of the following client information should the nurse report?
- A. The client's oxygen saturation is 95%
- B. The client's blood pressure is 110/70 mm Hg
- C. The client has a temperature of 36.8°C (98.2°F)
- D. The client's heart rate is 88/min
Correct answer: B
Rationale: The correct answer is B because a blood pressure of 110/70 mm Hg is within the normal range and stable. Reporting this information is crucial to monitor the client's condition postoperatively. Oxygen saturation of 95% is acceptable, a temperature of 36.8°C (98.2°F) is normal, and a heart rate of 88/min is within the expected range for an adult female client, so these values do not raise concerns that require immediate reporting.
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