ATI RN
ATI RN Comprehensive Exit Exam 2023
1. A nurse is planning care for a client who has a new prescription for total parenteral nutrition (TPN). Which of the following interventions should the nurse include?
- A. Weigh the client weekly to monitor for fluid retention.
- B. Monitor the client's blood glucose level every 6 hours.
- C. Change the TPN tubing every 72 hours.
- D. Flush the TPN line with sterile water before and after administration.
Correct answer: B
Rationale: The correct answer is B: Monitor the client's blood glucose level every 6 hours. When a client is on TPN, it is crucial to monitor their blood glucose levels frequently to prevent complications such as hyperglycemia or hypoglycemia. Weighing the client weekly to monitor for fluid retention (choice A) is important but not as critical as monitoring blood glucose levels. Changing the TPN tubing every 72 hours (choice C) is important for infection control but does not directly relate to the client's metabolic status. Flushing the TPN line with sterile water before and after administration (choice D) is not a standard practice and may introduce contaminants into the TPN solution.
2. A healthcare professional is reviewing admission prescriptions for a group of clients. Which of the following prescriptions should the healthcare professional identify as complete?
- A. Furosemide 20 mg BID.
- B. Aspirin 1 tablet daily.
- C. Nitroglycerin transdermal patch.
- D. Metoprolol 5 mg IV now.
Correct answer: D
Rationale: The correct answer is D because it provides the medication (Metoprolol), dosage (5 mg), route of administration (IV), and timing (now), making it a complete prescription. Choices A, B, and C lack either the route of administration or timing, making them incomplete prescriptions. For choice A, it lacks the route of administration, and for choices B and C, they lack the timing of administration.
3. A nurse is planning care for a client who is receiving hemodialysis. Which of the following actions should the nurse include in the plan of care?
- A. Withhold all medications until after dialysis.
- B. Rehydrate with dextrose 5% in water for orthostatic hypotension.
- C. Check the vascular access site for bleeding after dialysis.
- D. Give an antibiotic 30 minutes before dialysis.
Correct answer: C
Rationale: The correct action the nurse should include in the plan of care for a client receiving hemodialysis is to check the vascular access site for bleeding after dialysis. This is crucial to detect any bleeding complications and ensure prompt intervention if necessary. Withholding all medications until after dialysis (Choice A) is not appropriate as some medications may need to be administered during dialysis. Rehydrating with dextrose 5% in water for orthostatic hypotension (Choice B) is not directly related to the immediate post-dialysis care. Giving an antibiotic 30 minutes before dialysis (Choice D) is not recommended as timing of medication administration should be based on the specific antibiotic and its pharmacokinetics.
4. When collecting a sputum specimen from a client with tuberculosis, what action should the nurse take?
- A. Obtain the specimen immediately upon the client waking up.
- B. Wait one day to collect the specimen if the client cannot provide sputum.
- C. Ask the client to provide 15 to 20 ml of sputum.
- D. Wear sterile gloves when collecting the specimen.
Correct answer: A
Rationale: The correct answer is to obtain the specimen immediately upon the client waking up. Collecting sputum early in the morning provides the best sample for tuberculosis testing. Option B is incorrect because waiting a day can decrease the accuracy of the specimen. Option C is incorrect as it does not specify the optimal timing for specimen collection. Option D is incorrect as sterile gloves should be worn for infection control but do not specifically relate to the timing of specimen collection.
5. A nurse is reviewing laboratory data for a client who has chronic kidney disease. Which of the following findings should the nurse expect?
- A. Increased creatinine
- B. Increased hemoglobin
- C. Increased bicarbonate
- D. Increased calcium
Correct answer: A
Rationale: The correct answer is A: Increased creatinine. In chronic kidney disease, the kidneys are unable to filter waste effectively, leading to a buildup of creatinine in the blood. This results in increased creatinine levels in laboratory tests. Choice B, increased hemoglobin, is not typically associated with chronic kidney disease. Choice C, increased bicarbonate, is also not a common finding in chronic kidney disease; in fact, metabolic acidosis with decreased bicarbonate levels is more common. Choice D, increased calcium, is not expected in chronic kidney disease; instead, calcium levels may be low due to impaired kidney function.
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