ATI RN
ATI Nutrition Proctored
1. Which set of guidelines is intended to assess nutrient adequacy or plan intake of a population group, not individuals?
- A. RDA
- B. EAR
- C. DRA
- D. UL
Correct answer: B
Rationale: The Estimated Average Requirement (EAR) is the correct choice because it is specifically designed to assess the nutrient adequacy of population groups, not individuals. The Recommended Dietary Allowance (RDA) (choice A) is the average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%-98%) healthy individuals in a particular life stage and gender group. The Dietary Reference Intake (DRI) (choice C) includes the EAR, RDA, Adequate Intake (AI), and UL, making it a broader set of nutrient reference values. The Tolerable Upper Intake Level (UL) (choice D) is the highest average daily nutrient intake level that is likely to pose no risk of adverse health effects to almost all individuals in the general population.
2. A nurse orientee is preparing to insert a nasogastric tube, and a nurse educator is observing the procedure. Which of the following supplies if obtained by the nurse orientee would indicate a need for further education regarding this procedure?
- A. Half-inch or one-inch tape
- B. Oil-soluble lubricant
- C. A glass of tap water with a straw
- D. A 50-mL catheter tip syringe
Correct answer: B
Rationale: Water-soluble lubricant is used to lubricate 3 to 4 inches of the tube at the insertion end. An oil lubricant is not used because if the tube accidentally goes into the bronchus, pneumonia can develop. Half-inch tape is used to secure the tube after the correct placement is verified. A 50-mL catheter tip syringe is used to aspirate gastric contents to confirm placement. The client will be asked to take a sip of water through a straw to help with the passage of the tube.
3. An emergency department nurse is triaging a 77-year-old man who presents with uncharacteristic fatigue as well as back and rib pain. The patient denies any recent injuries. The nurse should recognize the need for this patient to be assessed for what health problem?
- A. Hodgkin disease
- B. Non-Hodgkin lymphoma
- C. Multiple myeloma
- D. Acute thrombocythemia
Correct answer: C
Rationale: The correct answer is multiple myeloma (choice C). Back pain is a common presenting symptom in multiple myeloma, especially in older patients. This malignancy can lead to bone pain due to bone destruction and fractures. Hodgkin disease (choice A) and Non-Hodgkin lymphoma (choice B) typically present with symptoms like painless lymph node enlargement, fever, and weight loss. Acute thrombocythemia (choice D) is characterized by an increase in platelet count but is not typically associated with the symptoms described by the patient.
4. A hospital patient's complex medical history includes a recent diagnosis of kidney cancer. Which of the following medications is used to treat metastatic kidney cancer?
- A. Filgrastim (Neupogen)
- B. Aldesleukin (Proleukin)
- C. Interferon alfa-2b (Intron A)
- D. Darbepoetin alfa (Aranesp)
Correct answer: B
Rationale: The correct answer is B: Aldesleukin (Proleukin). Aldesleukin is a medication used in the treatment of metastatic kidney cancer. It is a recombinant interleukin-2 that works by stimulating the immune system to attack cancer cells. Choice A, Filgrastim, is a medication used to stimulate the production of white blood cells. Choice C, Interferon alfa-2b, is used in the treatment of certain cancers but not specifically metastatic kidney cancer. Choice D, Darbepoetin alfa, is used to treat anemia by stimulating red blood cell production and is not indicated for metastatic kidney cancer.
5. A client has a nasogastric tube for gastric decompression. Which of the following actions should the nurse take?
- A. Check for the presence of bowel sounds every 8 hours.
- B. Flush the NG tube every 24 hours.
- C. Provide the client with sips of water every 2 hours.
- D. Keep the client's head of the bed elevated to 45 degrees.
Correct answer: D
Rationale: The correct answer is to keep the client's head of the bed elevated to 45 degrees. This position helps prevent aspiration in clients with a nasogastric tube for gastric decompression by reducing the risk of reflux and promoting proper drainage. Choice A is incorrect because checking for bowel sounds is not directly related to the care of a nasogastric tube. Choice B is incorrect as flushing the NG tube every 24 hours is not a standard nursing practice and may lead to complications. Choice C is incorrect because providing sips of water may interfere with the purpose of gastric decompression, which is to keep the stomach empty.