ATI RN
Nutrition ATI Proctored Exam 2023
1. In taking the client’s blood pressure, the nurse should position the client’s arm:
- A. At the level of the heart
- B. Slightly above the level of the heart
- C. At the 5th intercostals space midclavicular line
- D. Below the level of the heart
Correct answer: A
Rationale: Proper patient positioning is essential for maximizing lung expansion and promoting the drainage of secretions. Postural drainage techniques rely on gravity to help clear different lung segments, which is critical in preventing complications such as atelectasis or pneumonia in immobilized patients.
2. When teaching a client with a new prescription for Lisinopril, which instruction should the nurse include?
- A. Take the medication with food.
- B. Expect a persistent, dry cough.
- C. Increase your intake of potassium-rich foods.
- D. Take the medication at bedtime.
Correct answer: B
Rationale: The correct answer is B: 'Expect a persistent, dry cough.' Lisinopril, an ACE inhibitor, commonly causes a persistent, dry cough as a side effect. This should be reported to the healthcare provider if it becomes bothersome. It is essential for the nurse to educate the client about this potential side effect so the client is aware and can seek appropriate guidance if needed. Choices A, C, and D are incorrect. Taking Lisinopril with food is not required. Increasing potassium-rich foods is not a specific instruction for Lisinopril, and taking the medication at bedtime is not a typical recommendation associated with this medication.
3. A male patient calls to tell the nurse that his monthly lithium level is 1.7 mEq/L. Which nursing intervention will the nurse implement initially?
- A. Reinforce that the level is above the therapeutic range.
- B. Instruct the patient to hold the next dose of medication and contact the prescriber.
- C. Advise the patient to go to the hospital emergency room immediately.
- D. Inform the patient about the possibility of seizures and appropriate precautions.
Correct answer: B
Rationale: A lithium level of 1.7 mEq/L is above the therapeutic range, indicating a potential risk of toxicity. The initial nursing intervention should be to instruct the patient to hold the next dose of medication and promptly contact the prescriber for further guidance and management. This action aims to prevent adverse effects and ensure the patient's safety by addressing the elevated lithium level appropriately.
4. A nurse is providing discharge teaching to a client following a cholecystectomy. Which of the following instructions should the nurse include?
- A. I should avoid lifting objects heavier than 5 pounds for 1 week.
- B. I can resume my usual activities after 2 weeks.
- C. I should expect to have pain in my right shoulder.
- D. I should follow a low-protein diet for 1 week.
Correct answer: C
Rationale: The correct answer is C. Pain in the right shoulder after a cholecystectomy is common due to residual gas from the procedure. Choices A, B, and D are incorrect. It is important to avoid heavy lifting for a longer period than just 1 week to prevent complications. Resuming usual activities after 2 weeks may not be appropriate depending on the individual's recovery. Following a low-protein diet is not a standard recommendation post-cholecystectomy.
5. Newborn Mariana, who reacts strongly to unpleasant stimuli, is __________.
- A. probably easy to console
- B. susceptible to colic
- C. likely to spend less time in REM sleep
- D. unlikely to respond to swaddling
Correct answer: B
Rationale: Newborn Mariana, who reacts strongly to unpleasant stimuli, is described as susceptible to colic. Colic is often characterized by excessive crying and fussiness in newborn babies, which can be challenging to console. This description suggests that Mariana's strong reactions to unpleasant stimuli may make her more prone to colic. Choices A, C, and D are incorrect because the strong reactions to unpleasant stimuli do not imply being easy to console, affect REM sleep, or responsiveness to swaddling.