ATI RN
ATI Exit Exam 2023
1. A client receiving intermittent enteral feedings is being cared for by a nurse. Which action should the nurse take to reduce the risk of aspiration?
- A. Administer the feeding over 60 minutes.
- B. Position the client in a supine position during feedings.
- C. Elevate the head of the bed to 45 degrees during feedings.
- D. Flush the feeding tube with 60 mL of water before each feeding.
Correct answer: C
Rationale: The correct action to reduce the risk of aspiration during enteral feedings is to elevate the head of the bed to 45 degrees. This position helps prevent the reflux of feeding into the lungs. Administering the feeding over 60 minutes (Choice A) does not directly reduce the risk of aspiration. Positioning the client in a supine position (Choice B) increases the risk of aspiration as it promotes reflux. Flushing the feeding tube with water (Choice D) is important for tube patency but does not directly reduce the risk of aspiration.
2. A major factor associated with a child's rejection by peers is ________.
- A. Overly aggressive behavior.
- B. Being too intelligent.
- C. Socioeconomic background.
- D. A lack of empathy.
Correct answer: A
Rationale: Overly aggressive behavior is often a major factor in a child's rejection by peers. Children who display overly aggressive behavior may intimidate or harm their peers, leading to social rejection. Being too intelligent or having a different socioeconomic background are not typically primary reasons for peer rejection. While empathy is important for healthy social interactions, a lack of empathy, on its own, is less likely to be a primary factor in peer rejection compared to overly aggressive behavior.
3. A nurse is teaching a newly licensed nurse about the stages of wound healing. The nurse should include in the teaching that collagen is added to the wound during which of the following stages?
- A. Hemostasis phase.
- B. Inflammatory phase.
- C. Proliferative phase.
- D. Maturation phase.
Correct answer: C
Rationale: The correct answer is C: Proliferative phase. During the proliferative phase of wound healing, collagen is added to the wound to promote tissue regeneration. In the hemostasis phase (choice A), the primary goal is to stop bleeding by forming a blood clot. The inflammatory phase (choice B) involves cleaning the wound and preparing it for healing. The maturation phase (choice D) is when the wound undergoes remodeling and gains strength, but collagen addition primarily occurs during the proliferative phase.
4. The nurse is caring for a patient with an incision. Which actions will best indicate an understanding of medical and surgical asepsis for a sterile dressing change?
- A. Donning sterile gown and gloves to remove the wound dressing
- B. Utilizing clean gloves to remove the dressing and clean supplies for the new dressing
- C. Utilizing clean gloves to remove the dressing and sterile supplies for the new dressing
- D. Donning clean goggles, gown, and gloves to dress the wound
Correct answer: C
Rationale: Choice C is the correct answer. When performing a sterile dressing change, it is essential to use clean gloves to remove soiled dressings and sterile gloves and supplies for applying the new dressing. This helps maintain aseptic technique and reduce the risk of introducing pathogens to the wound. Choices A, B, and D involve incorrect use of sterile and clean supplies, which can compromise the sterility of the procedure and increase the risk of infection.
5. Why does a nurse on an oncology unit verify a client's current cumulative lifetime dose of doxorubicin before administering it to a client with breast cancer?
- A. Excessive doxorubicin can result in myelosuppression.
- B. Exceeding the lifetime cumulative dose limit of doxorubicin may lead to extravasation.
- C. An excess amount of doxorubicin can lead to cardiomyopathy.
- D. Exceeding the lifetime cumulative dose limit of doxorubicin may cause red-tinged urine and sweat.
Correct answer: C
Rationale: Verifying the client's current cumulative lifetime dose of doxorubicin is necessary because excessive amounts of the medication can lead to cardiomyopathy, a serious and potentially life-threatening side effect. By monitoring the cumulative dose, healthcare providers can help prevent cardiotoxicity and ensure patient safety during treatment.
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