ATI RN
ATI RN Exit Exam
1. What is the best method to assess for fluid overload in patients with heart failure?
- A. Monitor daily weight
- B. Check for jugular vein distention
- C. Check for pitting edema
- D. Check for fluid retention
Correct answer: A
Rationale: The correct answer is A: Monitor daily weight. Daily weight monitoring is the most accurate method to assess fluid overload in patients with heart failure. Changes in weight can indicate fluid retention before visible signs like jugular vein distention or pitting edema appear. Checking for jugular vein distention (choice B) is helpful but may not be as sensitive as daily weight monitoring. Pitting edema (choice C) and fluid retention (choice D) are signs of fluid overload, but daily weight monitoring is a more proactive approach to detect changes early.
2. Which individual is most likely to experience the greatest percentage of REM sleep?
- A. Sammy, a preschool child
- B. Jake, a full-term newborn
- C. Sarah, a teenager
- D. Cheryl, a preterm newborn Answer: D Page Ref: 104 Copyright © 2018 Laura E. Berk. All Rights Reserved. 32 Test Bank for Berk, Development Through the Lifespan, 7e Skill Level: Apply Topic: The Newborn Baby’s Capacities Difficulty Level: Moderate
Correct answer: D
Rationale: Preterm newborns, like Cheryl, experience a higher percentage of REM sleep compared to full-term newborns. This is because REM sleep plays a critical role in brain development, and preterm infants have an increased need for brain development due to their early arrival. Therefore, Cheryl, as a preterm newborn, is most likely to experience the greatest percentage of REM sleep among the individuals listed.
3. When caring for a client who speaks a language different from their own, what action should the nurse take?
- A. Request an interpreter of a different sex from the client.
- B. Request a family member or friend to interpret information for the client.
- C. Direct attention toward the interpreter when speaking to the client.
- D. Review the facility policy about the use of an interpreter.
Correct answer: Review the facility policy about the use of an interpreter.
Rationale: When caring for a client who speaks a different language, it is essential for the nurse to review the facility policy about the use of an interpreter. Using a professional interpreter ensures accurate communication and protects the client's confidentiality. Requesting an interpreter of a specific sex or relying on family members or friends can lead to miscommunication or breaches of confidentiality. Directing attention towards the interpreter helps facilitate communication but does not address the need for a professional interpreter as per facility policy.
4. After teaching a client to increase dietary potassium intake, a nurse assesses the client's understanding. Which dietary meal selection indicates the client correctly understands the teaching?
- A. Toasted English muffin with butter and blueberry jam, and tea with sugar
- B. Two scrambled eggs, a slice of white toast, and a half cup of strawberries
- C. Sausage, one slice of whole wheat toast, half cup of raisins, and a glass of milk
- D. Bowl of oatmeal with brown sugar, a half cup of sliced peaches, and coffee
Correct answer: Sausage, one slice of whole wheat toast, half cup of raisins, and a glass of milk
Rationale: Choice C is the correct answer as it includes foods high in potassium, such as raisins, whole wheat toast, and milk. Potassium is essential for various bodily functions, including maintaining proper heart and muscle function. Choices A, B, and D do not contain significant sources of potassium. Choice A consists mainly of carbohydrates and sugar, choice B focuses on protein and carbohydrates, and choice D provides carbohydrates and some fruit but lacks high-potassium options like in choice C.
5. A nurse is reviewing the laboratory report of a client who has been receiving lithium carbonate for the past 12 months. The nurse notes a lithium level of 0.8 mEq/L. Which of the following orders from the provider should the nurse expect?
- A. Withhold the next dose.
- B. Increase the dosage.
- C. Discontinue the medication.
- D. Administer the medication.
Correct answer: D
Rationale: Administering the medication is appropriate for a stable lithium level of 0.8 mEq/L. A level of 0.8 mEq/L falls within the therapeutic range for lithium, indicating that the client is receiving an adequate dose to maintain therapeutic effects. Withholding the next dose, increasing the dosage, or discontinuing the medication would not be indicated at this lithium level as it is within the desired range for therapeutic benefit. Therefore, the correct action would be to continue administering the medication to ensure the client maintains the therapeutic level of lithium.
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