ATI RN
ATI Fundamentals Proctored Exam
1. When providing discharge teaching for a group of clients, a nurse should recommend a referral to a dietitian for which client?
- A. A client who has a prescription for warfarin and states, 'I will need to limit how much spinach I eat.'
- B. A client who has gout and states, 'I can continue to eat anchovies on my pizza.'
- C. A client who has a prescription for spironolactone and states, 'I will reduce my intake of foods that contain potassium.'
- D. A client who has osteoporosis and states, 'I'll plan to take my calcium carbonate with a full glass of water.'
Correct answer: B
Rationale: The correct answer is the client who has gout and states, 'I can continue to eat anchovies on my pizza.' Gout is a condition that requires dietary modifications to manage symptoms. Anchovies are high in purines, which can exacerbate gout symptoms. Therefore, a referral to a dietitian is essential to provide appropriate dietary guidance for a client with gout. Clients on warfarin may need to monitor their vitamin K intake, particularly from foods like spinach. Clients taking spironolactone should be cautious about potassium-rich foods. Clients with osteoporosis should be educated on the proper administration of calcium supplements but do not necessarily need a dietitian referral for this specific statement.
2. A client who is intubated and has an intra-aortic balloon pump is restless and agitated. What action should the nurse perform first for comfort?
- A. Allow family members to remain at the bedside.
- B. Ask the family if the client would like a fan in the room.
- C. Keep the television tuned to the client's favorite channel.
- D. Speak loudly to the client in case of hearing problems.
Correct answer: A
Rationale: Allowing the family to remain at the bedside can help calm the client with familiar voices and presence, potentially reducing restlessness and agitation. Introducing a fan may not be the priority as it can spread germs through air movement. Keeping the television on all the time may not promote rest and recovery. Speaking loudly is not advisable as it may further agitate the client. Therefore, the initial action of allowing family members to stay is most likely to provide comfort and reassurance to the client.
3. If a pair of monozygotic twins raised in the same environment end up being different from one another (e.g., interests, hobbies, etc.), it is highly likely due to:
- A. Cephalocaudal pattern
- B. Proximodistal pattern
- C. Cephamodistal pattern
- D. Gene-environment correlation
Correct answer: B
Rationale: The correct answer is B: Proximodistal pattern. Differences between monozygotic twins raised in the same environment are likely due to non-shared environmental influences, which lead to differences in interests, hobbies, and other individual characteristics. Choices A, C, and D are incorrect. Cephalocaudal pattern refers to the principle of development from head to toe, not relevant in explaining differences between twins. Cephamodistal pattern is not a recognized developmental term. Gene-environment correlation does not directly explain the differences between identical twins raised in the same environment.
4. Which neurotransmitter is reduced in both the manic and depressive phases of bipolar disorder?
- A. Acetylcholine
- B. Dopamine
- C. Norepinephrine
- D. Serotonin
Correct answer: D
Rationale: The correct answer is D, Serotonin. Serotonin levels are reduced during both the manic and depressive phases of bipolar disorder. Acetylcholine (choice A) is not typically linked to bipolar disorder. Dopamine (choice B) and norepinephrine (choice C) are more commonly associated with conditions like schizophrenia and depression, respectively, rather than bipolar disorder. Therefore, they are not the neurotransmitters reduced in both manic and depressive phases of bipolar disorder.
5. The nurse is doing preoperative teaching with the client who is about to undergo creation of a Kock pouch. The nurse interprets that the client has the best understanding of the nature of the surgery if the client makes which of the following statements?
- A. I will need to drain the pouch regularly with a catheter.
- B. I will need to wear a drainage bag for the rest of my life.
- C. The drainage from this type of ostomy will be formed.
- D. I will be able to pass stool from the rectum eventually.
Correct answer: A
Rationale: A Kock pouch is a continent ileostomy. As the ileostomy begins to function, the client drains it every 3 to 4 hours and then decreases the draining about 3 times a day or as needed when full. The client does not need to wear a drainage bag but should wear an absorbent dressing to absorb mucous drainage from the stoma. Ileostomy drainage is liquid. The client would be able to pass stool only from the rectum if an ileal-anal pouch or anastomosis were created. This type of operation is a two-stage procedure.
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