ATI RN
ATI RN Comprehensive Exit Exam
1. What is the most important nursing action for a patient post-surgery?
- A. Monitor vital signs
- B. Monitor the surgical site
- C. Check blood pressure
- D. Check oxygen saturation
Correct answer: A
Rationale: The most crucial nursing action for a patient post-surgery is to monitor vital signs. Monitoring vital signs helps in detecting early signs of complications such as hemorrhage, shock, or infection. While monitoring the surgical site is important for assessing wound healing and signs of infection, it is secondary to monitoring vital signs. Checking blood pressure and oxygen saturation are also important, but they are components of monitoring vital signs.
2. Which of the following is a central vasoconstrictor and peripheral vasodilator?
- A. Parasympathetic nervous system
- B. Sympathetic nervous system
- C. Dopamine
- D. Epinephrine
Correct answer: D
Rationale: The correct answer is D, Epinephrine. Epinephrine acts as a central vasoconstrictor and peripheral vasodilator. It increases heart rate and blood flow to muscles, helping to prepare the body for a 'fight or flight' response. Parasympathetic nervous system (choice A) does not cause vasoconstriction but rather vasodilation. The sympathetic nervous system (choice B) is primarily responsible for the fight or flight response, causing vasoconstriction. Dopamine (choice C) primarily acts as a neurotransmitter and hormone, not directly causing central vasoconstriction and peripheral vasodilation.
3. A client who experienced a femur fracture 8 hr ago now reports sudden onset dyspnea and severe chest pain. Which of the following actions should the nurse take first?
- A. Provide high-flow oxygen.
- B. Check the client for a positive Chvostek's sign.
- C. Administer an IV vasopressor medication.
- D. Monitor the client for headache.
Correct answer: Provide high-flow oxygen.
Rationale: In this situation, the priority action is to provide high-flow oxygen to the client. Sudden onset dyspnea and severe chest pain can be indicative of a pulmonary embolism, which is a life-threatening emergency. Oxygen therapy helps improve oxygenation and stabilizes the client's condition. Checking for Chvostek's sign, administering IV vasopressors, or monitoring for a headache are not the immediate priorities in this critical situation.
4. The presence of which pair of factors is a good predictor of a fluid deficit of at least 5% in an infant?
- A. Weight loss and decreased heart rate
- B. Capillary refill of less than 2 seconds and no tears
- C. Increased skin elasticity and sunken anterior fontanel
- D. Dry mucous membranes and generally ill appearance
Correct answer: D
Rationale: Dry mucous membranes and an ill appearance are good indicators of dehydration in infants, often correlating with a fluid deficit of at least 5%. Sunken fontanels and poor skin turgor are also indicative but were not options here.
5. Which nursing action will most likely increase a patient's risk for developing a health care-associated infection?
- A. Uses a sterile bottled solution more than once within a 24-hour period.
- B. Uses surgical aseptic technique to suction an airway.
- C. Uses a clean technique for inserting a urinary catheter.
- D. Uses a cleaning stroke from the urinary meatus toward the rectum.
Correct answer: C
Rationale: The correct answer is C. Using a clean technique for inserting a urinary catheter increases the risk for healthcare-associated infections. Invasive procedures like catheter insertion require a sterile technique to prevent introducing pathogens into the urinary tract. Choices A and B demonstrate appropriate infection control measures by emphasizing the use of sterile or aseptic techniques. Choice D represents an incorrect technique that can lead to the introduction of bacteria from the rectum into the urinary tract, potentially causing infections.
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