ATI RN
ATI Nutrition Practice Test A 2019
1. Where should a nurse auscultate the apex beat?
- A. At the fifth intercostal space, along the midclavicular line
- B. At the mid-sternum
- C. 2 inches to the left of the lower end of the sternum
- D. 1 inch to the left of the xiphoid process
Correct answer: A
Rationale: The correct location to auscultate the apex beat is at the fifth intercostal space, along the midclavicular line. This is where the apical impulse, also known as the point of maximal impulse (PMI), can be best heard. Choices B, C, and D are incorrect anatomical locations for auscultating the apex beat, which makes them incorrect choices. Auscultating at the correct location allows healthcare providers to assess the heart's function and detect any abnormalities in heart sounds, which is crucial for comprehensive patient care.
2. What health instruction will enhance regulation of a colostomy (defecation) of clients?
- A. Irrigate after lunch everyday
- B. Eat fruits and vegetables in all three meals
- C. Eat balanced meals at regular intervals
- D. Restrict exercise to walking only
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.
3. What is a condition characterized by an abnormal buildup of fluid between the layers of tissue lining the lungs and chest cavity?
- A. Pleural effusion
- B. Pulmonary edema
- C. Atelectasis
- D. Sarcoidosis
Correct answer: A
Rationale: Pleural effusion is the correct answer as it refers to the accumulation of excess fluid between the layers of the pleura surrounding the lungs and chest cavity. This condition can be caused by various factors such as infections, heart failure, or cancer. Pulmonary edema (choice B) involves fluid accumulation in the lungs' air sacs and is not specific to the pleura. Atelectasis (choice C) is the collapse or closure of a lung leading to airless lung tissue and is not related to fluid buildup. Sarcoidosis (choice D) is a condition characterized by the growth of tiny collections of inflammatory cells in different parts of the body, not specifically involving fluid accumulation in the pleural space.
4. Which of the following describes the four-step method of assessment, planning, implementation, and evaluation?
- A. It is a problem-focused process of continued nursing care
- B. It is an open-ended process of continued nursing care
- C. It is a circular process of continued nursing care
- D. It is a trial-and-error process of continued nursing care
Correct answer: C
Rationale: The correct answer is C: 'It is a circular process of continued nursing care.' The four-step method of assessment, planning, implementation, and evaluation in nursing is a continuous and cyclical process. Choice A is incorrect because the method is not solely problem-focused; it involves a comprehensive approach. Choice B is incorrect as it does not capture the cyclical nature of the process. Choice D is incorrect as the method is systematic and not based on trial-and-error but rather evidence-based practice.
5. A nurse is preparing to administer potassium chloride IV to a client. Which of the following actions should the nurse take to prevent complications?
- A. Administer the medication by IV bolus over 2 minutes
- B. Infuse the medication slowly using an IV pump
- C. Add the medication to an IV solution of D5W
- D. Dilute the medication in 5 mL of sterile water
Correct answer: B
Rationale: The correct action to prevent complications when administering potassium chloride IV is to infuse the medication slowly using an IV pump. Rapid administration of potassium chloride can lead to complications such as hyperkalemia and cardiac arrest. Options A, C, and D are incorrect as they do not promote the safe administration of potassium chloride. Administering the medication by IV bolus over 2 minutes is too rapid and can cause adverse effects. Adding the medication to an IV solution of D5W or diluting it in sterile water may not control the rate of administration, increasing the risk of complications.