ATI RN
ATI Comprehensive Exit Exam 2023
1. A nurse is preparing a sterile field for a client with a surgical wound. Which of the following actions should the nurse take to maintain the sterile field?
- A. Open sterile packages using the flap closest to your body first.
- B. Don sterile gloves before opening the sterile package.
- C. Avoid reaching over the sterile field.
- D. Place sterile items at least 2.5 cm (1 in) from the edge of the sterile field.
Correct answer: C
Rationale: The correct action to maintain a sterile field is to avoid reaching over it. This prevents contamination of the sterile environment by reducing the risk of unintentionally dropping microorganisms from non-sterile areas onto the sterile field. Opening sterile packages using the flap closest to your body first (choice A) is a good practice but not directly related to maintaining the sterile field. Donning sterile gloves before opening the sterile package (choice B) is crucial for maintaining sterility but not specific to maintaining the sterile field. Placing sterile items at least 2.5 cm (1 in) from the edge of the sterile field (choice D) is important to prevent accidental contamination, but it is not the primary action to maintain the sterile field.
2. A client is diagnosed with obsessive-compulsive disorder (OCD), and a nurse is planning care. Which of the following interventions should the nurse exclude from the care plan?
- A. Allowing the client to perform rituals initially
- B. Discouraging the client from washing their hands
- C. Monitoring for suicidal ideation
- D. Providing a structured schedule of activities
Correct answer: C
Rationale: The correct answer is monitoring for suicidal ideation. When caring for a client with OCD, interventions should include allowing the client to perform rituals initially, setting limits on the time allowed for rituals, encouraging the client to verbalize feelings, and providing a structured schedule of activities. Monitoring for suicidal ideation is crucial in assessing the client's safety and mental health status, but it is not a direct intervention specific to managing OCD symptoms.
3. A parent of an infant with gastroesophageal reflux is being taught by a nurse. Which of the following instructions should the nurse include in the teaching?
- A. Offer the infant feedings every 2 hours.
- B. Position the infant upright after feedings.
- C. Feed the infant thickened formula.
- D. Place the infant in a prone position after feedings.
Correct answer: B
Rationale: Correct posture after feedings is crucial for an infant with gastroesophageal reflux to reduce the risk of regurgitation. Placing the infant upright helps prevent the backflow of stomach contents into the esophagus, minimizing symptoms of reflux.
4. A patient reports feeling dizzy when standing up. What is the most appropriate nursing intervention?
- A. Encourage the patient to take deep breaths.
- B. Assist the patient to sit down slowly.
- C. Instruct the patient to use a walker for support.
- D. Teach the patient how to change positions safely.
Correct answer: B
Rationale: The correct answer is to assist the patient to sit down slowly. This intervention is appropriate for a patient experiencing dizziness when standing up, as it helps prevent falls due to orthostatic hypotension. Encouraging deep breaths (Choice A) may not address the underlying cause of dizziness, which is related to postural changes. Instructing the patient to use a walker for support (Choice C) or teaching the patient how to change positions safely (Choice D) are not the most immediate and direct interventions to address the immediate risk of falling when feeling dizzy upon standing.
5. A nurse that is always ready to answer for all his actions and decision is said to be:
- A. Accountable C. Critical thinker
- B. Responsible D. Assertive
- C.
- D.
Correct answer: A
Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.
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