ATI RN
ATI RN Custom Exams Set 1
1. Which of the following is a specialized medical treatment and teaching facility that provides general and specialized medical and dental care and treatment?
- A. CONUS
- B. MEDCEN
- C. MEDCOM
- D. MEDDAC
Correct answer: B
Rationale: The correct answer is B, MEDCEN, which stands for Medical Center. A MEDCEN is a specialized medical treatment and teaching facility that provides general and specialized medical and dental care and treatment. Choices A, C, and D are incorrect. CONUS refers to the continental United States and is not a medical facility. MEDCOM stands for Medical Command, which is an organization rather than a specific facility for medical treatment. MEDDAC stands for Medical Department Activity and is also an organization responsible for medical care delivery, not a specific treatment facility.
2. The nurse on the medical/surgical unit cares for a client with a diagnosis of cerebrovascular accident (CVA). The nursing assessment of the client’s neurological status should include which of the following? (Select all that apply)
- A. Obtain the pulses in all four extremities
- B. Ask the client to grasp and squeeze two fingers on each of the nurse’s hands
- C. Determine the client’s orientation to person, place, and time
- D. B, C
Correct answer: D
Rationale: The correct answer is 'D' because assessing grasp strength (choice B) and orientation to person, place, and time (choice C) are crucial components of a neurological assessment following a cerebrovascular accident (CVA). Pulse assessment in all four extremities (choice A) is not directly related to a neurological assessment and is more pertinent to vascular status. Therefore, choices A and D are incorrect in this context.
3. Which outcome should the nurse identify for the client diagnosed with fluid volume excess?
- A. The client will void a minimum of 30 mL per hour
- B. The client will have elastic skin turgor
- C. The client will have no adventitious breath sounds
- D. The client will have a serum creatinine of 1.4 mg/dL
Correct answer: C
Rationale: The correct outcome for a client diagnosed with fluid volume excess is the absence of adventitious breath sounds. This indicates that fluid is not accumulating in the lungs, a crucial sign in managing fluid volume excess. Choices A, B, and D are incorrect because voiding a specific amount of urine, having elastic skin turgor, and a serum creatinine level do not directly relate to managing fluid volume excess.
4. Which potential complication should the nurse assess for in the client with infective endocarditis who has embolization of vegetative lesions from the mitral valve?
- A. Pulmonary embolism
- B. Decreased urine output
- C. Hemoptysis
- D. Deep vein thrombosis
Correct answer: B
Rationale: The correct answer is 'Decreased urine output.' Embolization of vegetative lesions from the mitral valve can cause renal infarction, leading to a decrease in urine output. This complication is due to the obstruction of blood flow to the kidneys. Choices A, C, and D are incorrect because embolization from the mitral valve typically does not directly cause pulmonary embolism, hemoptysis, or deep vein thrombosis.
5. After a pericardiocentesis, what interventions should the nurse implement?
- A. Monitor vital signs every 15 minutes for the first hour
- B. Evaluate the client’s cardiac rhythm
- C. Record the amount of fluid removed as output
- D. All of the above
Correct answer: D
Rationale: After a pericardiocentesis, the nurse should implement multiple interventions to monitor the client's condition closely. Monitoring vital signs every 15 minutes for the first hour is crucial to detect any immediate changes that may indicate complications. Evaluating the client's cardiac rhythm is important to identify any arrhythmias that may occur due to the procedure. Recording the amount of fluid removed is essential to calculate fluid balance and ensure accurate monitoring of the client's status. Therefore, all the interventions mentioned are necessary to detect and manage any potential issues post-pericardiocentesis. Choices A, B, and C are all essential components of post-procedural care and should be implemented to ensure the client's safety and well-being.
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