ATI Exit Test

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Sample questions from ATI Exit Test

This material has 180 questions with answers and rationales. Here are the first 5.

1. 1.In the emergency department, a client with chronic kidney disease reports new muscle weakness. The cardiac monitor shows peaked T waves, and the potassium level is 6.4 mEq/L. Which prescribed intervention should the nurse implement first?

   • A.Restrict dietary potassium and recheck the level in 4 hours.
   • B.Administer IV calcium gluconate.
   • C.Prepare to administer IV regular insulin with dextrose.
   • D.Give sodium polystyrene sulfonate orally.

   Rationale: IV calcium gluconate stabilizes the myocardium immediately when severe hyperkalemia is accompanied by ECG changes. Insulin with dextrose can shift potassium into cells, but it does not provide the same immediate cardiac membrane protection. Oral potassium removal and dietary restriction do not address the immediate risk of a lethal dysrhythmia.

2. 2.Refer to the client's chart. Which actions should the nurse take now in response to the client's worsening respiratory status? Select all that apply.

   • A.Place the client in high-Fowler position and coach pursed-lip breathing.
   • B.Titrate oxygen to maintain the prescribed target saturation of 88% to 92%.
   • C.Request an immediate prescription for a sedative to reduce respiratory effort.
   • D.Prepare to administer the prescribed short-acting bronchodilator.
   • E.Notify the rapid response team about the increasing somnolence and rising PaCO2.

   Rationale: Titrating oxygen to the prescribed 88% to 92% target and positioning the client upright support oxygenation while limiting excessive oxygen administration in this client with COPD. Increasing somnolence with a rising PaCO2 indicates worsening ventilatory failure and warrants urgent escalation; the prescribed bronchodilator should also be prepared. A sedative can further depress ventilation and is not an appropriate response to this deterioration.

3. 3.After thyroidectomy, a client reports tingling around the mouth and develops inspiratory stridor. Which action should the nurse take first?

   • A.Place the client supine and reassess the surgical dressing.
   • B.Administer the prescribed oral levothyroxine.
   • C.Prepare to administer IV calcium gluconate and activate the rapid response team.
   • D.Encourage the client to cough forcefully to clear secretions.

   Rationale: Stridor signals possible airway compromise, and perioral tingling after thyroid surgery suggests acute hypocalcemia from parathyroid injury. The nurse should urgently summon assistance and prepare IV calcium gluconate while prioritizing airway support. Checking the dressing or encouraging coughing does not treat the likely cause, and levothyroxine is not an immediate intervention.

4. 4.At change of shift on a medical unit, which task is appropriate for the RN to delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.Obtain and record the daily weight of a stable client with heart failure.
   • B.Evaluate whether a prescribed analgesic relieved a client's pain.
   • C.Assess a client who reports new shortness of breath after walking.
   • D.Teach a client with a new ostomy how to empty the pouch.

   Answer and rationale are in the full material.

5. 5.A client taking warfarin for a mechanical heart valve asks how to reduce the risk of complications at home. Which instructions should the nurse include? Select all that apply.

   • A.Take an extra dose if a dose is missed the previous evening.
   • B.Use a soft-bristled toothbrush and an electric razor.
   • C.Check with the anticoagulation clinic before starting an over-the-counter medication.
   • D.Keep the intake of foods containing vitamin K consistent from week to week.
   • E.Report black, tarry stools or unusual bleeding promptly.

   Answer and rationale are in the full material.