ATI RN
ATI RN Comprehensive Exit Exam
1. A nurse is completing a dietary assessment for a client who is Jewish and observes kosher dietary practices. Which of the following behaviors should the nurse expect to find?
- A. Leavened bread may be eaten during Passover.
- B. Shellfish is commonly consumed in the diet.
- C. Meat and dairy products are eaten separately.
- D. Fasting from meat occurs during Hanukkah.
Correct answer: C
Rationale: The correct answer is C. Kosher dietary laws require the separation of meat and dairy products. Choice A is incorrect because leavened bread is not eaten during Passover in Jewish dietary practices. Choice B is incorrect as shellfish is not considered kosher and is not consumed in Jewish dietary practices. Choice D is incorrect as fasting from meat does not occur during Hanukkah.
2. A nurse is caring for a client who is postoperative following a bowel resection. Which of the following findings should the nurse report to the provider?
- A. Bowel sounds present in all four quadrants
- B. Temperature of 37.5°C (99.5°F)
- C. Scant urine output
- D. Serosanguineous wound drainage
Correct answer: D
Rationale: The correct answer is D: 'Serosanguineous wound drainage.' Serosanguineous drainage should be reported in postoperative clients as it may indicate complications such as infection or impaired wound healing. Options A, B, and C are expected findings in a postoperative client. Bowel sounds present in all four quadrants indicate normal gastrointestinal function, a temperature of 37.5°C (99.5°F) is within the normal range, and scant urine output may be expected initially due to factors like anesthesia and fluid shifts postoperatively.
3. A client with a new colostomy requires care planning by a nurse. Which of the following interventions should the nurse include in the plan of care?
- A. Change the ostomy pouch every 4 to 7 days.
- B. Empty the ostomy pouch when it is half full.
- C. Apply a skin barrier around the stoma.
- D. Cleanse the peristomal skin with alcohol.
Correct answer: A
Rationale: The correct answer is to change the ostomy pouch every 4 to 7 days. This practice helps prevent skin irritation and leakage by maintaining a clean and secure seal around the stoma. Option B is incorrect because it is more important to change the pouch regularly rather than emptying it when half full. Option C is incorrect as applying a skin barrier is typically done during the initial application of the pouch, not during regular changes. Option D is incorrect because alcohol can be too harsh for the peristomal skin and can cause irritation.
4. A nurse is performing a gastric lavage for a client who has upper gastrointestinal bleeding. Which of the following actions should the nurse take?
- A. Instill 500 ml of solution through the NG tube
- B. Insert a large-bore NG tube
- C. Use a cold irrigation solution
- D. Instruct the client to lie on his right side
Correct answer: B
Rationale: The correct answer is B: 'Insert a large-bore NG tube.' When performing a gastric lavage for a client with upper gastrointestinal bleeding, a large-bore NG tube is used to effectively remove gastric contents and blood. Option A is incorrect because the amount of solution to instill depends on the specific situation and should be guided by the healthcare provider's order. Option C is incorrect because using a cold irrigation solution can lead to hypothermia and is not recommended. Option D is incorrect as there is no need to instruct the client to lie on his right side specifically for gastric lavage.
5. A client is being taught how to perform self-catheterization. Which of the following instructions should the nurse include?
- A. Clean the catheter with alcohol after each use.
- B. Perform self-catheterization while sitting on the toilet.
- C. Use a new catheter each time you perform self-catheterization.
- D. Lubricate the catheter tip with petroleum jelly before insertion.
Correct answer: C
Rationale: The correct answer is C: 'Use a new catheter each time you perform self-catheterization.' It is essential to use a new, sterile catheter each time to prevent infection during the procedure. Choice A is incorrect because cleaning the catheter with alcohol may not be sufficient to prevent infection. Choice B is incorrect because self-catheterization is typically done in a clean, private area, not necessarily on the toilet. Choice D is incorrect because lubricating the catheter tip with petroleum jelly is a common practice but not as crucial as using a new catheter each time to prevent infection.
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