ATI RN
ATI Comprehensive Exit Exam 2023 With NGN
1. A client is postoperative following a thyroidectomy. Which of the following findings should the nurse identify as an indication of hypocalcemia?
- A. Constipation
- B. Numbness and tingling of the fingers
- C. Increased thirst
- D. Frequent urination
Correct answer: B
Rationale: Numbness and tingling of the fingers are classic signs of hypocalcemia, a condition that may result from inadvertent damage to the parathyroid glands during a thyroidectomy. These symptoms occur due to decreased levels of calcium in the bloodstream affecting nerve function. Choices A, C, and D are not typical manifestations of hypocalcemia. Constipation is more associated with hypercalcemia, increased thirst can be seen in diabetes or dehydration, and frequent urination is a symptom more commonly linked to conditions like diabetes or urinary tract issues.
2. While caring for a client receiving total parenteral nutrition (TPN), which of the following actions should the nurse take?
- A. Monitor the client's urine output every 8 hours.
- B. Administer a bolus of 0.9% sodium chloride.
- C. Check the client's blood glucose level every 4 hours.
- D. Flush the TPN line with sterile water before and after administration.
Correct answer: C
Rationale: Checking the client's blood glucose level every 4 hours is essential when managing a client on TPN to monitor for hyperglycemia, a common complication. Monitoring urine output (Choice A) is important but not a priority in this scenario. Administering a bolus of 0.9% sodium chloride (Choice B) is not indicated as it is unrelated to managing TPN. Flushing the TPN line with sterile water (Choice D) is necessary, but it should be done with 0.9% sodium chloride, not water.
3. A nurse is reviewing laboratory results for a client who has rheumatoid arthritis and is prescribed methotrexate. Which of the following results should the nurse report to the provider?
- A. White blood cell count 8,000/mm³
- B. Platelet count 150,000/mm³
- C. Hemoglobin 14 g/dL
- D. Aspartate aminotransferase (AST) 60 units/L
Correct answer: D
Rationale: The correct answer is D: Aspartate aminotransferase (AST) 60 units/L. An elevated AST level indicates liver damage, which can be a side effect of methotrexate and should be reported. Elevated white blood cell count (choice A), platelet count (choice B), or normal hemoglobin level (choice C) are not directly related to methotrexate therapy for rheumatoid arthritis.
4. A nurse is caring for a client who is postoperative following an abdominal surgery. Which of the following assessments should the nurse prioritize?
- A. Assess the client's pain level.
- B. Monitor the client's respiratory rate.
- C. Measure the client's blood pressure.
- D. Check the client's bowel sounds.
Correct answer: B
Rationale: The correct answer is to monitor the client's respiratory rate. This assessment is crucial in the postoperative period to detect any respiratory complications such as hypoxia or respiratory distress. Assessing pain level (Choice A) is important but may not be the top priority as respiratory status takes precedence. Measuring blood pressure (Choice C) is also important but not as critical immediately postoperatively as monitoring respiratory function. Checking bowel sounds (Choice D) is relevant for assessing gastrointestinal function but is typically not the top priority in the immediate postoperative phase.
5. A nurse is caring for a client who is receiving continuous cardiac monitoring. The client's heart rate is 69/min, and the PR interval is 0.24 seconds. What cardiac rhythm should the nurse interpret this finding as?
- A. First-degree AV block.
- B. Premature ventricular contraction.
- C. Sinus bradycardia.
- D. Atrial fibrillation.
Correct answer: A
Rationale: The correct answer is A: First-degree AV block. A PR interval of 0.24 seconds indicates a prolonged PR interval, which is characteristic of first-degree AV block. This rhythm is considered benign and often does not require treatment. Choice B, premature ventricular contraction, is characterized by early, abnormal ventricular contractions and would not be indicated by the findings provided. Choice C, sinus bradycardia, would present with a normal PR interval but a heart rate less than 60 beats per minute. Choice D, atrial fibrillation, is characterized by an irregularly irregular rhythm with no identifiable P waves, which does not align with the findings of a prolonged PR interval in this scenario.
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