ATI RN
ATI RN Comprehensive Exit Exam
1. What is the primary action when caring for a patient with a stage 3 pressure ulcer?
- A. Apply a hydrocolloid dressing
- B. Provide wound debridement
- C. Change the dressing daily
- D. Apply moist gauze to the ulcer
Correct answer: A
Rationale: The correct answer is to apply a hydrocolloid dressing. This type of dressing helps maintain a moist environment that is conducive to healing in stage 3 pressure ulcers. Providing wound debridement (choice B) is more suitable for higher stages of pressure ulcers where there is necrotic tissue. Changing the dressing daily (choice C) may be necessary but is not the primary action for a stage 3 pressure ulcer. Applying moist gauze (choice D) is not the recommended approach as it does not provide the same benefits as a hydrocolloid dressing.
2. What is the best intervention for a patient experiencing respiratory distress?
- A. Administer oxygen
- B. Administer bronchodilators
- C. Administer IV fluids
- D. Provide humidified air
Correct answer: A
Rationale: Administering oxygen is the best intervention for a patient experiencing respiratory distress because it helps improve oxygenation and alleviate respiratory distress. Oxygen therapy is a critical and priority intervention in such cases as it aims to increase oxygen levels in the blood. Administering bronchodilators may be beneficial for specific respiratory conditions like asthma or COPD, but oxygen should be the initial priority. Administering IV fluids and providing humidified air, while important in certain situations, are not the primary interventions for respiratory distress.
3. A nurse is preparing to perform postmortem care for a client. Which of the following actions should the nurse take?
- A. Place the client's dentures in a labeled container
- B. Remove the client's IV lines
- C. Place the client's body in a semi-fowler's position
- D. Lower the client's head of the bed
Correct answer: B
Rationale: The correct action for the nurse to take when preparing to perform postmortem care is to remove the client's IV lines. This step is essential to help maintain the dignity and appearance of the body. Placing the client's dentures in a labeled container (Choice A) is not a priority during postmortem care as the focus is on the body's preparation. While positioning the body in a semi-fowler's position (Choice C) or lowering the client's head of the bed (Choice D) are common practices for living clients to prevent aspiration, they are not necessary after death. Therefore, the immediate action of removing IV lines is most appropriate in this situation.
4. A client with chronic kidney disease is being taught about dietary modifications by a nurse. Which of the following foods should the nurse instruct the client to avoid?
- A. Grilled chicken.
- B. Fresh fruit.
- C. White bread.
- D. Cheddar cheese.
Correct answer: D
Rationale: Cheddar cheese is high in phosphorus, which should be avoided by clients with chronic kidney disease. Fresh fruit is generally a healthy choice unless the client needs to limit potassium intake. Grilled chicken is a good protein source for clients with chronic kidney disease. White bread is low in phosphorus and can be included in the diet of clients with kidney disease unless they need to watch their carbohydrate intake.
5. A nurse is reviewing the medical record of a client who has a new prescription for insulin glargine. Which of the following should the nurse include in the teaching?
- A. This insulin has a peak effect of 2 to 4 hours.
- B. This insulin has a duration of action of 24 hours.
- C. This insulin is given before meals to control your blood sugar.
- D. You should avoid eating 30 minutes before or after taking this insulin.
Correct answer: B
Rationale: The correct answer is B. Insulin glargine has a 24-hour duration of action, making it suitable for once-daily dosing for long-term blood sugar control. Choice A is incorrect as insulin glargine is a long-acting insulin with no pronounced peak effect in its action profile. Choice C is incorrect as insulin glargine is usually given at the same time each day regardless of meals. Choice D is incorrect as there is no specific requirement to avoid eating before or after taking insulin glargine.
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