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ATI PN COMPREHENSIVE EXIT EXAM 2024 / PN
COMPREHENSIVE EXIT EXAM ACTUAL EXAM 180
QUESTIONS AND CORRECT DETAILED ANSWERS
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ATI PN Comprehensive Exit Exam Practice
2024: 180 Questions with Answers and
Rationales
Medical-Surgical Nursing (50 Questions)
- A nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is prescribed ipratropium. What is the nurse’s priority assessment? A. Blood pressure B. Respiratory rate C. Anticholinergic side effects D. Oxygen saturation Answer : C. Anticholinergic side effects Rationale : Ipratropium is an anticholinergic bronchodilator. The nurse should prioritize assessing for side effects such as dry mouth, blurred vision, or urinary retention, and ensure proper inhaler technique.
- A client with hypertension is prescribed enalapril. What should the nurse monitor for? A. Hyperkalemia B. Hypoglycemia C. Tachycardia D. Hypokalemia Answer : A. Hyperkalemia Rationale : Enalapril, an ACE inhibitor, can cause hyperkalemia due to potassium retention. The nurse should monitor serum potassium levels.
- A client with heart failure is prescribed furosemide. Which instruction should the nurse include? A. Take the medication at bedtime B. Monitor daily weight C. Increase sodium intake D. Avoid potassium-rich foods Answer : B. Monitor daily weight Rationale : Furosemide is a loop diuretic. Monitoring daily weight helps assess fluid status and the effectiveness of the medication.
- A nurse is caring for a client with a new colostomy. Which statement indicates the client understands colostomy care? A. "I will empty the pouch when it is full." B. "I will change the pouch every day." C. "I will avoid high-fiber foods permanently." D. "I will irrigate the colostomy daily." Answer : A. "I will empty the pouch when it is full." Rationale : The pouch should be emptied when it is one-third to one-half full to prevent leakage and skin irritation.
- A client with type 2 diabetes mellitus reports a blood glucose level of 300 mg/dL. What is the nurse’s priority action? A. Administer insulin as prescribed B. Encourage oral fluid intake C. Check the client’s HbA1c D. Provide a high-carbohydrate snack Answer : A. Administer insulin as prescribed
Rationale : Coolness and pallor suggest compromised circulation, requiring immediate intervention to prevent tissue damage.
- A nurse is caring for a client with a chest tube. Which action is appropriate if the chest tube becomes disconnected? A. Reconnect the tube immediately B. Place the end of the tube in sterile water C. Notify the provider immediately D. Tape the tube to the chest Answer : B. Place the end of the tube in sterile water Rationale : Placing the tube in sterile water maintains a water seal and prevents air entry into the pleural space.
- A client with chronic kidney disease is on a low-potassium diet. Which food should the nurse recommend? A. Bananas B. Apples C. Potatoes D. Oranges Answer : B. Apples Rationale : Apples are low in potassium, unlike bananas, potatoes, and oranges, which are high-potassium foods.
- A client with a history of atrial fibrillation is prescribed warfarin. What should the nurse teach the client? A. Avoid green leafy vegetables B. Take the medication in the morning C. Monitor for signs of bleeding D. Increase vitamin K intake Answer : C. Monitor for signs of bleeding Rationale : Warfarin increases bleeding risk, so clients should monitor for signs such as bruising or blood in urine.
- A client with a tracheostomy is at risk for which complication? A. Hyperglycemia B. Airway obstruction C. Hypotension D. Peripheral edema Answer : B. Airway obstruction Rationale : Tracheostomy tubes can become blocked by mucus, increasing the risk of airway obstruction.
- A nurse is caring for a client with a nasogastric tube. Which action ensures proper placement? A. Check the pH of aspirated fluid B. Measure the tube length daily C. Auscultate over the epigastrium D. Observe for respiratory distress Answer : A. Check the pH of aspirated fluid Rationale : A pH of 1–5 confirms gastric placement of the nasogastric tube.
- A client with rheumatoid arthritis is prescribed methotrexate. Which side effect should the nurse monitor for? A. Hypertension B. Hepatotoxicity C. Hypoglycemia D. Constipation Answer : B. Hepatotoxicity Rationale : Methotrexate can cause liver damage, requiring monitoring of liver function tests.
- A client with a history of stroke has dysphagia. Which intervention should the nurse implement? A. Offer thin liquids B. Position the client upright during meals C. Encourage rapid eating D. Provide large food portions Answer : B. Position the client upright during meals Rationale : An upright position reduces the risk of aspiration in clients with dysphagia.
- A client with a urinary tract infection is prescribed ciprofloxacin. Which instruction should the nurse include? A. Take with milk to reduce stomach upset B. Avoid exposure to sunlight C. Take with antacids for better absorption D. Discontinue if diarrhea occurs Answer : B. Avoid exposure to sunlight Rationale : Ciprofloxacin increases photosensitivity, requiring sun protection to prevent burns.
- A client with a pressure injury is at risk for which complication? A. Infection B. Hypokalemia C. Hyperglycemia D. Hypertension Answer : A. Infection Rationale : Pressure injuries disrupt skin integrity, increasing the risk of infection.
- A client with cirrhosis reports ascites. Which dietary modification should the nurse recommend? A. Low-sodium diet B. High-protein diet C. High-carbohydrate diet D. Low-fat diet Answer : A. Low-sodium diet Rationale : A low-sodium diet helps reduce fluid retention and ascites in cirrhosis.
- A client with a history of heart failure reports shortness of breath. What is the nurse’s priority action? A. Administer oxygen B. Elevate the head of the bed C. Check blood pressure
Answer : C. Fetal position Rationale : The fetal position reduces pressure on the pancreas, alleviating pain.
- A client with a history of Parkinson’s disease is prescribed levodopa-carbidopa. Which side effect should the nurse monitor for? A. Dyskinesia B. Hyperglycemia C. Constipation D. Bradycardia Answer : A. Dyskinesia Rationale : Levodopa-carbidopa can cause involuntary movements (dyskinesia) as a side effect.
- A client with a history of hypothyroidism is prescribed levothyroxine. When should the nurse instruct the client to take the medication? A. At bedtime B. With meals C. In the morning on an empty stomach D. After exercise Answer : C. In the morning on an empty stomach Rationale : Levothyroxine is best absorbed on an empty stomach to ensure efficacy.
- A client with a history of chronic pain is prescribed ibuprofen. Which instruction should the nurse include? A. Take with food B. Take on an empty stomach C. Avoid fluids D. Take at bedtime only Answer : A. Take with food Rationale : Ibuprofen can cause gastric irritation, so it should be taken with food.
- A client with a history of a stroke is at risk for which complication during feeding? A. Hypoglycemia B. Aspiration C. Hyperkalemia D. Hypertension Answer : B. Aspiration Rationale : Stroke patients with dysphagia are at high risk for aspiration during feeding.
- A client with a history of glaucoma is prescribed timolol eye drops. What should the nurse teach the client? A. Apply pressure to the inner canthus after administration B. Administer at bedtime only C. Avoid blinking after administration D. Store the drops in the refrigerator Answer : A. Apply pressure to the inner canthus after administration Rationale : Applying pressure prevents systemic absorption through the nasolacrimal duct.
- A client with a history of bipolar disorder is prescribed lithium. Which laboratory value should the nurse monitor? A. Serum sodium
B. Serum lithium levels C. Serum potassium D. Serum calcium Answer : B. Serum lithium levels Rationale : Lithium has a narrow therapeutic range, requiring regular monitoring to prevent toxicity.
- A client with a history of heart failure reports weight gain of 3 pounds in one day. What is the nurse’s priority action? A. Administer a diuretic B. Notify the provider C. Restrict fluids D. Encourage ambulation Answer : B. Notify the provider Rationale : Rapid weight gain indicates fluid retention, requiring medical evaluation.
- A client with a history of osteoporosis is prescribed alendronate. Which instruction should the nurse include? A. Take with a full glass of water and remain upright for 30 minutes B. Take with meals C. Take at bedtime D. Crush the tablet for easier swallowing Answer : A. Take with a full glass of water and remain upright for 30 minutes Rationale : Alendronate can cause esophageal irritation, requiring upright positioning after administration.
- A client with a history of a seizure disorder reports a recent seizure. What is the nurse’s priority action? A. Administer lorazepam as prescribed B. Place the client in a supine position C. Insert an oral airway D. Restrain the client’s limbs Answer : A. Administer lorazepam as prescribed Rationale : Lorazepam is used to stop active seizures, prioritizing airway safety and seizure control.
- A client with a history of chronic renal failure is prescribed erythropoietin. What should the nurse monitor? A. Blood pressure B. Hemoglobin levels C. Serum potassium D. Blood glucose Answer : B. Hemoglobin levels Rationale : Erythropoietin stimulates red blood cell production, requiring hemoglobin monitoring.
- A client with a history of tuberculosis is prescribed isoniazid. Which vitamin should the nurse recommend? A. Vitamin C B. Vitamin B C. Vitamin D
A. Supine B. Trendelenburg C. High Fowler’s D. Prone Answer : C. High Fowler’s Rationale : High Fowler’s position facilitates lung expansion and improves breathing.
- A client with a history of diabetes mellitus is prescribed insulin glargine. When should the nurse administer this medication? A. With meals B. At bedtime C. Every 4 hours D. Before exercise Answer : B. At bedtime Rationale : Insulin glargine is a long-acting insulin typically administered once daily at bedtime.
- A client with a history of a myocardial infarction is prescribed aspirin. What is the purpose of this medication? A. Reduce pain B. Prevent clot formation C. Lower blood pressure D. Reduce cholesterol Answer : B. Prevent clot formation Rationale : Aspirin has antiplatelet effects, reducing the risk of clot formation post-MI.
- A client with a history of liver disease is prescribed lactulose. What is the purpose of this medication? A. Reduce ammonia levels B. Increase blood glucose C. Prevent bleeding D. Reduce blood pressure Answer : A. Reduce ammonia levels Rationale : Lactulose is used to treat hepatic encephalopathy by reducing ammonia levels.
- A client with a history of a stroke has a new prescription for clopidogrel. What should the nurse monitor for? A. Signs of bleeding B. Blood glucose levels C. Respiratory rate D. Joint pain Answer : A. Signs of bleeding Rationale : Clopidogrel, an antiplatelet medication, increases bleeding risk.
- A client with a history of anemia is prescribed ferrous sulfate. Which instruction should the nurse include? A. Take with orange juice B. Take with milk C. Take at bedtime D. Take with antacids
Answer : A. Take with orange juice Rationale : Vitamin C in orange juice enhances iron absorption.
- A client with a history of heart failure is prescribed spironolactone. Which electrolyte imbalance should the nurse monitor for? A. Hypokalemia B. Hyperkalemia C. Hyponatremia D. Hypercalcemia Answer : B. Hyperkalemia Rationale : Spironolactone, a potassium-sparing diuretic, can cause hyperkalemia.
- A client with a history of a urinary tract infection reports burning on urination. What should the nurse recommend? A. Increase fluid intake B. Avoid fluids C. Take ibuprofen D. Restrict protein intake Answer : A. Increase fluid intake Rationale : Increased fluid intake flushes bacteria from the urinary tract.
Pharmacology (30 Questions)
- A nurse is administering morphine to a client with severe pain. Which assessment is the priority? A. Blood pressure B. Respiratory rate C. Heart rate D. Pain level Answer : B. Respiratory rate Rationale : Morphine, an opioid, can cause respiratory depression, making respiratory rate the priority assessment.
- A client is prescribed digoxin for heart failure. Which instruction should the nurse include? A. Take your pulse before taking this medication B. Increase sodium intake C. Stop the medication if nausea occurs D. Take with meals Answer : A. Take your pulse before taking this medication Rationale : Digoxin can cause bradycardia, requiring pulse monitoring before administration.
- A client is prescribed prednisone for rheumatoid arthritis. Which side effect should the nurse monitor for? A. Hypoglycemia B. Weight gain C. Hypotension
- A client is prescribed levothyroxine for hypothyroidism. Which symptom indicates the dose may be too high? A. Weight gain B. Palpitations C. Fatigue D. Cold intolerance Answer : B. Palpitations Rationale : Excessive levothyroxine can cause hyperthyroidism symptoms, such as palpitations.
- A client is prescribed heparin for deep vein thrombosis. Which antidote should the nurse have available? A. Vitamin K B. Protamine sulfate C. Naloxone D. Flumazenil Answer : B. Protamine sulfate Rationale : Protamine sulfate reverses heparin’s anticoagulant effects.
- A client is prescribed omeprazole for GERD. When should the nurse instruct the client to take the medication? A. With meals B. 30 minutes before breakfast C. At bedtime D. After exercise Answer : B. 30 minutes before breakfast Rationale : Omeprazole is most effective when taken before meals to reduce acid production.
- A client is prescribed lisinopril for hypertension. Which side effect should the nurse monitor for? A. Dry cough B. Weight loss C. Sedation D. Hypoglycemia Answer : A. Dry cough Rationale : Lisinopril, an ACE inhibitor, commonly causes a dry cough.
- A client is prescribed insulin lispro for diabetes. When should the nurse administer this medication? A. 30 minutes before meals B. At bedtime C. Every 4 hours D. With meals Answer : A. 30 minutes before meals Rationale : Insulin lispro is a rapid-acting insulin administered before meals to control postprandial glucose.
- A client is prescribed prednisone for an allergic reaction. Which instruction should the nurse include? A. Stop the medication abruptly
B. Taper the dose as prescribed C. Take with antacids D. Avoid fluids Answer : B. Taper the dose as prescribed Rationale : Abrupt cessation of prednisone can cause adrenal insufficiency; tapering is required.
- A client is prescribed phenytoin for seizures. Which instruction should the nurse include? A. Brush teeth regularly B. Avoid sunlight C. Take with meals D. Increase calcium intake Answer : A. Brush teeth regularly Rationale : Phenytoin can cause gingival hyperplasia, requiring good oral hygiene.
- A client is prescribed ciprofloxacin for a urinary tract infection. Which instruction should the nurse include? A. Take with milk B. Avoid sunlight C. Take with antacids D. Stop if diarrhea occurs Answer : B. Avoid sunlight Rationale : Ciprofloxacin increases photosensitivity, requiring sun protection.
- A client is prescribed spironolactone for heart failure. Which laboratory value should the nurse monitor? A. Serum potassium B. Serum calcium C. Serum sodium D. Serum magnesium Answer : A. Serum potassium Rationale : Spironolactone, a potassium-sparing diuretic, can cause hyperkalemia.
- A client is prescribed methotrexate for rheumatoid arthritis. Which instruction should the nurse include? A. Avoid alcohol B. Take with meals C. Increase sun exposure D. Take at bedtime Answer : A. Avoid alcohol Rationale : Methotrexate can cause hepatotoxicity, and alcohol increases this risk.
- A client is prescribed digoxin for heart failure. Which symptom indicates toxicity? A. Nausea and vomiting B. Increased appetite C. Clear lung sounds D. Improved energy levels Answer : A. Nausea and vomiting Rationale : Nausea and vomiting are early signs of digoxin toxicity.
B. Take with antacids C. Increase vitamin K intake D. Take at bedtime Answer : A. Monitor for signs of bleeding Rationale : Clopidogrel increases bleeding risk, requiring monitoring for signs like bruising.
- A client is prescribed omeprazole for peptic ulcer disease. Which side effect should the nurse monitor for? A. Diarrhea B. Hypertension C. Bradycardia D. Weight loss Answer : A. Diarrhea Rationale : Omeprazole can cause gastrointestinal side effects, including diarrhea.
- A client is prescribed heparin for a pulmonary embolism. Which assessment finding requires immediate action? A. Blood in the urine B. Mild headache C. Increased appetite D. Dry skin Answer : A. Blood in the urine Rationale : Hematuria indicates potential bleeding, a serious side effect of heparin.
- A client is prescribed prednisone for asthma. Which instruction should the nurse include? A. Taper the dose as prescribed B. Take with antacids C. Stop if nausea occurs D. Take at bedtime Answer : A. Taper the dose as prescribed Rationale : Tapering prevents adrenal insufficiency from abrupt corticosteroid cessation.
- A client is prescribed metformin for type 2 diabetes. Which side effect should the nurse monitor for? A. Diarrhea B. Hypertension C. Bradycardia D. Weight gain Answer : A. Diarrhea Rationale : Metformin commonly causes gastrointestinal side effects, such as diarrhea.
- A client is prescribed phenytoin for seizures. Which side effect should the nurse monitor for? A. Gingival hyperplasia B. Hypoglycemia C. Weight loss D. Hypertension Answer : A. Gingival hyperplasia Rationale : Phenytoin can cause gingival hyperplasia, requiring good oral hygiene.
Maternal-Newborn Nursing (30 Questions)
- A nurse is caring for a client in the third trimester of pregnancy. Which finding requires immediate action? A. Blood pressure of 140/90 mmHg B. Mild pedal edema C. Heartburn D. Frequent urination Answer : A. Blood pressure of 140/90 mmHg Rationale : A blood pressure of 140/90 mmHg may indicate preeclampsia, requiring immediate evaluation.
- A nurse is reinforcing teaching about home care with the parents of a newborn. Which instruction should the nurse include? A. Bathe the newborn daily B. Place the newborn on their stomach to sleep C. Keep the umbilical cord stump dry D. Feed the newborn every 6 hours Answer : C. Keep the umbilical cord stump dry Rationale : Keeping the cord stump dry prevents infection and promotes healing.
- A nurse is caring for a client who had a cesarean delivery 24 hours ago. Which assignment is appropriate for a float nurse? A. Monitoring for postpartum hemorrhage B. Administering oxytocin C. Assessing lochia D. Performing a fundal massage Answer : C. Assessing lochia Rationale : Assessing lochia is within the scope of a float nurse, while hemorrhage monitoring and fundal massage require specialized skills.
- A nurse is caring for a newborn with jaundice. Which intervention should the nurse implement? A. Increase formula feedings B. Place the newborn under phototherapy C. Administer vitamin K D. Restrict fluid intake Answer : B. Place the newborn under phototherapy Rationale : Phototherapy breaks down bilirubin to treat jaundice.
- A nurse is caring for a client in labor. Which finding indicates the need to notify the provider? A. Contractions every 5 minutes B. Fetal heart rate of 90 bpm C. Clear amniotic fluid D. Cervical dilation of 4 cm Answer : B. Fetal heart rate of 90 bpm
C. Increase formula feedings D. Bathe the newborn Answer : A. Place the newborn under a radiant warmer Rationale : Hypothermia in newborns requires warming to maintain body temperature.
- A nurse is caring for a client with gestational diabetes. Which complication should the nurse monitor for in the newborn? A. Hyperglycemia B. Hypoglycemia C. Hyperkalemia D. Hypocalcemia Answer : B. Hypoglycemia Rationale : Newborns of mothers with gestational diabetes are at risk for hypoglycemia due to high insulin levels.
- A nurse is caring for a client in the second stage of labor. Which position is most effective for pushing? A. Supine B. Lithotomy C. Squatting D. Prone Answer : C. Squatting Rationale : Squatting opens the pelvis and uses gravity to facilitate delivery.
- A nurse is caring for a newborn with respiratory distress. Which action is appropriate? A. Place the newborn prone B. Suction the airway C. Administer antibiotics D. Restrict fluids Answer : B. Suction the airway Rationale : Suctioning clears the airway to improve breathing in respiratory distress.
- A nurse is teaching a client about contraceptive options postpartum. Which method is safe during breastfeeding? A. Combined oral contraceptives B. Progestin-only pills C. Estrogen patches D. Intrauterine device with estrogen Answer : B. Progestin-only pills Rationale : Progestin-only pills do not affect milk production, unlike estrogen-containing contraceptives.
- A nurse is caring for a client with preeclampsia. Which medication should the nurse expect to administer? A. Magnesium sulfate B. Oxytocin C. Misoprostol D. Dinoprostone Answer : A. Magnesium sulfate Rationale : Magnesium sulfate is used to prevent seizures in preeclampsia.
- A nurse is caring for a newborn with a heart murmur. What is the priority action? A. Notify the provider B. Administer oxygen C. Restrict feedings D. Place in a warmer Answer : A. Notify the provider Rationale : A heart murmur may indicate a congenital heart defect, requiring medical evaluation.
- A nurse is caring for a client with a vaginal delivery. Which finding indicates a postpartum hemorrhage? A. Lochia serosa B. Saturating a pad in 1 hour C. Mild cramping D. Firm fundus Answer : B. Saturating a pad in 1 hour Rationale : Saturating a pad in 1 hour indicates excessive bleeding, suggestive of hemorrhage.
- A nurse is teaching a client about newborn safety. Which instruction should the nurse include? A. Place soft pillows in the crib B. Use a firm mattress C. Keep the crib near a heater D. Place the newborn on their stomach Answer : B. Use a firm mattress Rationale : A firm mattress reduces the risk of sudden infant death syndrome (SIDS).
- A nurse is caring for a client in labor. Which finding indicates umbilical cord prolapse? A. Variable decelerations in fetal heart rate B. Clear amniotic fluid C. Contractions every 3 minutes D. Cervical dilation of 6 cm Answer : A. Variable decelerations in fetal heart rate Rationale : Variable decelerations suggest cord compression, a sign of cord prolapse.
- A nurse is caring for a newborn with a low Apgar score. What is the priority action? A. Administer vitamin K B. Provide respiratory support C. Place in a warmer D. Administer antibiotics Answer : B. Provide respiratory support Rationale : A low Apgar score indicates poor respiratory effort or oxygenation, requiring immediate support.
- A nurse is teaching a client about postpartum nutrition. Which food should the nurse recommend? A. High-fiber foods B. High-sodium foods
