ATI RN
ATI Leadership Proctored Exam 2023
1. When communicating with a client who has a complaint, what principle is important to keep in mind?
- A. Supervisors should always be involved.
- B. The client's physician is often the cause of the problem.
- C. Avoid discussion of complaints.
- D. Clients and families should be treated with respect; communication should be open and honest.
Correct answer: D
Rationale: When addressing complaints from clients, it is crucial to prioritize treating clients and families with respect. Open and honest communication fosters trust and transparency in resolving issues effectively. This client-centered approach emphasizes the importance of maintaining positive relationships within the healthcare setting. Choices A, B, and C are incorrect. Involving supervisors in every communication with a client who has a complaint may not always be necessary or practical. Blaming the client's physician for the issue is unprofessional and does not address the client's concerns. Avoiding discussion of complaints can lead to unresolved issues and dissatisfaction among clients.
2. When teaching a parent of a 2-month-old infant with acute gastroenteritis who is bottle feeding, which of the following statements should the nurse include?
- A. Offer Pedialyte between formula feedings.
- B. Feed the infant every 6 hours.
- C. Give diluted apple juice if the infant becomes dehydrated.
- D. Switch to soy-based formula permanently.
Correct answer: A
Rationale: In the case of acute gastroenteritis in a 2-month-old infant who is bottle feeding, the nurse should recommend offering Pedialyte between formula feedings. This helps prevent dehydration and ensures that the infant receives essential electrolytes and fluids to aid in recovery. Pedialyte is specifically formulated to help replace lost fluids and electrolytes due to vomiting and diarrhea, making it a suitable choice for infants with gastroenteritis. Choice B is incorrect because infants with acute gastroenteritis should be fed more frequently to prevent dehydration. Choice C is incorrect as apple juice is not recommended for infants with gastroenteritis; Pedialyte or oral rehydration solutions are preferred. Choice D is incorrect because switching to soy-based formula permanently is not necessary for managing acute gastroenteritis; Pedialyte and continuing with the current formula are more appropriate.
3. Which sign or reflex is used to diagnose meningitis?
- A. Homan’s sign
- B. Brudzinski
- C. Startle
- D. Anterior drawer
Correct answer: Brudzinski
Rationale: Brudzinski sign is a physical exam finding used to diagnose meningitis. It is elicited by flexing the patient's neck, resulting in involuntary flexion of the hips and knees. This maneuver indicates meningeal irritation, a common feature in meningitis. Homan’s sign is used to assess for deep vein thrombosis, Startle is a reflex response to sudden stimuli, and the Anterior drawer test is used to diagnose ligamentous instability in the knee.
4. When using Nitroglycerine (transdermal), how many hours should you be nitrate-free each day?
- A. 1-2 hours
- B. 5-10 hours
- C. 3-4 hours
- D. 10-12 hours
Correct answer: D
Rationale: When using Nitroglycerine (transdermal), it should be applied for 10-12 hours per day to ensure its effectiveness. A nitrate-free period within the day is essential to prevent the development of tolerance to the medication.
5. A client presents with shortness of breath, pain in the lung area, and a recent history of starting birth control pills and smoking. Vital signs include a heart rate of 110/min, respiratory rate of 40/min, and blood pressure of 140/80 mm Hg. Arterial blood gases reveal pH 7.50, PaCO2 29 mm Hg, PaO2 60 mm Hg, HCO3 20 mEq/L, and SaO2 86%. What is the priority nursing intervention?
- A. Prepare for mechanical ventilation.
- B. Administer oxygen via face mask.
- C. Prepare to administer a sedative.
- D. Assess for indications of pulmonary embolism.
Correct answer: Administer oxygen via face mask.
Rationale: In a client with a high respiratory rate, low PaO2, and low SaO2, the priority intervention is to improve oxygenation. Administering oxygen via a face mask will help increase the oxygen supply to the client's lungs and tissues, addressing the hypoxemia. While mechanical ventilation may be necessary in severe cases, administering oxygen is the initial and most appropriate intervention to address the client's respiratory distress. Sedatives should not be given without ensuring adequate oxygenation. Assessing for pulmonary embolism is important but not the priority at this moment when the client is experiencing respiratory distress and hypoxemia.
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