ATI Exit

Free preview · Original latest version

Sample questions from ATI Exit

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 72-year-old client on a medical unit develops sudden dyspnea 2 days after hip surgery. Respirations are 30/min, heart rate is 124/min, blood pressure is 94/58 mm Hg, and oxygen saturation is 85% on room air. The client reports sharp chest pain with inspiration. Which action should the nurse take first?

   • A.Assist the client to walk to improve ventilation.
   • B.Apply oxygen and activate the rapid response team.
   • C.Obtain a sputum specimen for culture.
   • D.Administer the prescribed oral analgesic.

   Rationale: Sudden hypoxemia, pleuritic pain, and hypotension after orthopedic surgery suggest a pulmonary embolism requiring immediate oxygenation and emergency escalation. Ambulation increases oxygen demand and is unsafe in an unstable client. Sputum collection addresses infection rather than the immediate threat, and oral analgesia delays stabilization. Prioritize breathing and circulation before diagnostic or comfort measures.

2. 2.A 64-year-old client is admitted to the intensive care unit with pneumonia. After prescribed IV fluid resuscitation, blood pressure is 80/44 mm Hg, mean arterial pressure is 56 mm Hg, lactate is 4.8 mmol/L, and urine output is 15 mL/hr. Which prescription should the nurse anticipate next?

   • A.IV furosemide to increase urine output.
   • B.Oral metoprolol to decrease myocardial workload.
   • C.IV norepinephrine titrated to a prescribed pressure goal.
   • D.Restriction of all fluids for the next 8 hours.

   Rationale: Persistent hypotension and hypoperfusion after initial fluid resuscitation indicate septic shock, for which norepinephrine is the first-line vasopressor. Furosemide can worsen intravascular depletion and does not correct shock-related oliguria. Metoprolol can further reduce perfusion, and blanket fluid restriction does not address the client's immediate circulatory failure. Recognize persistent shock and anticipate support of a mean arterial pressure generally >= 65 mm Hg.

3. 3.A 23-year-old client in the emergency department has type 1 diabetes, vomiting, and deep respirations. Glucose is 486 mg/dL, pH is 7.18, potassium is 2.9 mEq/L, and blood pressure is 98/60 mm Hg. Isotonic IV fluid is infusing. Which action is most appropriate before starting the prescribed insulin infusion?

   • A.Initiate prescribed potassium replacement.
   • B.Administer IV sodium bicarbonate.
   • C.Add dextrose to the initial fluid immediately.
   • D.Restrict fluids until the glucose decreases.

   Rationale: Insulin shifts potassium into cells and can cause life-threatening dysrhythmias when significant hypokalemia is present, so potassium must be replaced before insulin begins. Bicarbonate is not routinely indicated at this pH. Dextrose is generally added later as glucose falls, and fluid restriction worsens dehydration and perfusion. In diabetic ketoacidosis, evaluate potassium before initiating insulin.

4. 4.A 58-year-old client in a dialysis clinic missed the previous treatment and reports weakness. Potassium is 6.8 mEq/L, and the cardiac monitor shows widened QRS complexes. Which prescribed medication should the nurse administer first?

   • A.Oral sodium zirconium cyclosilicate.
   • B.IV regular insulin with dextrose.
   • C.Nebulized albuterol.
   • D.IV calcium gluconate.

   Answer and rationale are in the full material.

5. 5.A 69-year-old client arrives at a stroke center 55 minutes after sudden right-sided weakness and difficulty speaking. Blood pressure is 178/96 mm Hg, glucose is 108 mg/dL, and oxygen saturation is 96% on room air. Which action has priority?

   • A.Give aspirin before further testing.
   • B.Arrange immediate noncontrast head CT.
   • C.Provide oral fluids to assess swallowing.
   • D.Lower the systolic blood pressure to 120 mm Hg.

   Answer and rationale are in the full material.