ATI RN
ATI RN Exit Exam
1. When digitally evacuating stool from a client with a fecal impaction, what action should the nurse take?
- A. Insert a lubricated gloved finger and advance along the rectal wall
- B. Apply lubricant and stimulate peristalsis
- C. Apply pressure to the abdomen to assist with the removal
- D. Increase fluid intake before the procedure
Correct answer: A
Rationale: The correct action when digitally evacuating stool from a client with a fecal impaction is to insert a lubricated gloved finger and advance along the rectal wall. This technique helps prevent trauma and is the appropriate method for addressing fecal impaction. Choice B is incorrect as stimulating peristalsis will not directly assist in evacuating the impacted stool. Choice C is incorrect as applying pressure to the abdomen is not the recommended method for stool evacuation. Choice D is incorrect as increasing fluid intake does not directly aid in digitally evacuating the stool.
2. A nurse in an emergency department is assessing a client who reports ingesting thirty diazepam tablets. After securing the client's airway and initiating an IV, which of the following actions should the nurse take next?
- A. Monitor the client's IV site for thrombophlebitis
- B. Administer flumazenil to the client
- C. Evaluate the client for further suicidal behavior
- D. Initiate seizure precautions for the client
Correct answer: B
Rationale: In cases of benzodiazepine overdose, such as diazepam ingestion, flumazenil is the antidote. Therefore, the priority action for the nurse is to administer flumazenil to the client. Monitoring the IV site for thrombophlebitis (Choice A) is important but not the immediate priority. Evaluating the client for further suicidal behavior (Choice C) is important but not the next immediate action. Initiating seizure precautions (Choice D) is not the priority as the client's airway has already been secured.
3. What is the primary focus of a patient-centered care model?
- A. Cost reduction
- B. Healthcare provider satisfaction
- C. Patient satisfaction
- D. Quality assurance
Correct answer: C
Rationale: The primary focus of a patient-centered care model is on patient satisfaction. This approach emphasizes providing care that is personalized to meet the unique needs and preferences of each patient, fostering a collaborative and respectful partnership between healthcare providers and patients to achieve better health outcomes. While cost reduction (choice A) can be a byproduct of improved outcomes, it is not the primary focus. Healthcare provider satisfaction (choice B) is important but not the primary focus in patient-centered care. Quality assurance (choice D) is crucial but is secondary to patient satisfaction in a patient-centered care model.
4. Which surgical procedure involves opening or replacing a narrowed or blocked heart valve?
- A. Valve replacement
- B. Angioplasty
- C. Stent placement
- D. Coronary bypass surgery
Correct answer: A
Rationale: Valve replacement is the correct answer because it specifically involves surgically replacing a damaged or diseased heart valve with a prosthetic valve to address narrowing or blockage, thereby improving blood flow and heart function. Angioplasty (choice B) is a procedure to widen narrowed or obstructed arteries, typically using a balloon catheter. Stent placement (choice C) involves inserting a mesh tube to support a weakened artery. Coronary bypass surgery (choice D) is a procedure to create new routes for blood flow to the heart muscle by bypassing blocked arteries.
5. A client with asthma is assessed by a nurse and presents with bilateral wheezing, decreased pulse oxygen saturation, and suprasternal retraction on inhalation. Which actions should the nurse take? (Select all that apply)
- A. Administer prescribed albuterol (Ventolin) inhaler.
- B. Assess the client for tracheal deviation.
- C. Administer oxygen to maintain saturations greater than 94%.
- D. Perform peak expiratory flow measurements.
Correct answer: C
Rationale: Suprasternal retraction during inhalation indicates the use of accessory muscles and difficulty in moving air due to airway narrowing, supported by bilateral wheezing and decreased pulse oxygen saturation. This client needs immediate intervention as their asthma is not responding to the medication. Administering oxygen to maintain saturations above 94% is crucial to ensure adequate oxygenation. While administering a rescue inhaler could also be necessary, oxygen therapy takes priority in this situation.
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