Ati Comprehensive Exit Exam– Questions And Answers | Verified And
Well Detailed Answers Plus Rationales | Guaranteed Pass | Latest
Exam Update | Exam Prep | Study Guide | Practice Test| Download
Instant Pdf
1. A nurse is caring for a client who is 4 hours postoperative following a total hip
arthroplasty. Which of the following findings requires immediate intervention by the
nurse?
A. Temperature of 37.6 C (99.7 F)
B. Serosanguineous drainage of 45 mL on the surgical dressing
C. Acute confusion and sudden onset of dyspnea
D. Mild discomfort reported at the surgical site when repositioning
Rationale: Acute confusion and sudden onset of dyspnea strongly indicate a pulmonary
embolism, which is a life-threatening postoperative complication requiring immediate
intervention. Options A, B, and D represent expected postoperative findings that require
ongoing monitoring rather than emergency action.
2. A nurse is performing an assessment on a client with chronic heart failure. Which of the
following findings is the most reliable indicator of fluid volume excess?
A. Daily weight gain of 1 kg (2.2 lbs)
B. Bounding peripheral pulses
C. 1+ pitting edema in the lower extremities
D. Blood pressure reading of 138/86 mmHg
Rationale: Daily weight is the most sensitive and reliable indicator of fluid balance changes in
a client with heart failure. Pitting edema, bounding pulses, and mild blood pressure elevations
can be influenced by other factors and are less precise indicators of total body fluid status.
3. A client is prescribed lithium carbonate for bipolar disorder. Which of the following
laboratory values should the nurse review prior to administering the initial dose?
A. Serum potassium level
B. Serum creatinine and blood urea nitrogen
C. Complete blood count with differential
,D. Fasting blood glucose level
Rationale: Lithium is excreted almost exclusively by the kidneys; therefore, baseline renal
function tests including serum creatinine and blood urea nitrogen must be evaluated to
prevent toxicity. Potassium, glucose, and complete blood counts are not the primary screening
parameters for lithium therapy.
4. A public health nurse is planning care for a community experiencing an outbreak of a
communicable disease. Which of the following actions represents primary prevention?
A. Administering antibiotics to individuals exposed to the disease
B. Conducting screening clinics in local community centers
C. Providing immunization campaigns for the local population
D. Referring diagnosed individuals to specialized rehabilitation programs
Rationale: Immunization campaigns are a primary prevention strategy aimed at preventing the
initial occurrence of a disease. Antibiotic administration is secondary prevention or treatment,
screening is secondary prevention, and rehabilitation is tertiary prevention.
5. A nurse is admitting a client who has anorexia nervosa. Which of the following
interventions should the nurse include in the plan of care?
A. Allow the client to select meal times to promote autonomy
B. Weigh the client weekly in the morning after voiding
C. Monitor the client for at least 1 hour following meals
D. Permit the client to exercise freely to reduce anxiety
Rationale: Clients with anorexia nervosa require direct supervision during and after meals to
prevent purging behaviors such as self-induced vomiting or hiding food. Weighing should
occur daily rather than weekly, meal times should be structured, and strenuous exercise
should be restricted.
6. A nurse is caring for a client receiving mechanical ventilation via an endotracheal tube.
Which of the following complications should the nurse monitor for during high pressure
ventilator alarms?
A. Disconnection of the ventilator tubing
B. Kinked endotracheal tube or client biting the tube
C. Cuff leak in the endotracheal tube
, D. Accidental extubation
Rationale: High pressure alarms are triggered when there is an obstruction to airflow, such as
secretions, kinking, or biting of the tube, or if the client is coughing. Low pressure alarms are
triggered by disconnections, leaks, or extubation.
7. A charge nurse is evaluating a newly licensed nurse's understanding of standard
precautions. Which of the following statements by the newly licensed nurse indicates a need
for further teaching?
A. "I will wear gloves when touching any client's nonintact skin."
B. "I should wear a mask and face shield if splashing of body fluids is anticipated."
C. "I must wear sterile gloves when emptying a urinary drainage bag."
D. "I will perform hand hygiene immediately after removing gloves."
Rationale: Clean, non-sterile gloves are appropriate when emptying a urinary drainage bag, as
this is a clean procedure, not a sterile one. All other statements correctly reflect standard
precautions guidelines regarding PPE and hand hygiene.
8. A nurse is reviewing the laboratory results of a client receiving heparin therapy via
continuous intravenous infusion. Which of the following findings indicates the infusion rate
should be adjusted?
A. Platelet count of 180,000/mm3
B. Activated partial thromboplastin time (aPTT) of 85 seconds
C. International Normalized Ratio (INR) of 1.1
D. Hemoglobin of 14 g/dL
Rationale: An aPTT of 85 seconds is elevated above the therapeutic range of 1.5 to 2 times the
normal control value, indicating a risk for bleeding and the need to decrease the heparin
infusion rate. The other values are within normal limits or appropriate.
9. A nurse is assessing an older adult client for signs of delirium versus dementia. Which of
the following findings is characteristic of delirium?
A. Slow, insidious onset over several years
B. Stable mood and intact attention span
C. Fluctuating level of consciousness and acute onset
D. Permanent and irreversible cognitive decline
Well Detailed Answers Plus Rationales | Guaranteed Pass | Latest
Exam Update | Exam Prep | Study Guide | Practice Test| Download
Instant Pdf
1. A nurse is caring for a client who is 4 hours postoperative following a total hip
arthroplasty. Which of the following findings requires immediate intervention by the
nurse?
A. Temperature of 37.6 C (99.7 F)
B. Serosanguineous drainage of 45 mL on the surgical dressing
C. Acute confusion and sudden onset of dyspnea
D. Mild discomfort reported at the surgical site when repositioning
Rationale: Acute confusion and sudden onset of dyspnea strongly indicate a pulmonary
embolism, which is a life-threatening postoperative complication requiring immediate
intervention. Options A, B, and D represent expected postoperative findings that require
ongoing monitoring rather than emergency action.
2. A nurse is performing an assessment on a client with chronic heart failure. Which of the
following findings is the most reliable indicator of fluid volume excess?
A. Daily weight gain of 1 kg (2.2 lbs)
B. Bounding peripheral pulses
C. 1+ pitting edema in the lower extremities
D. Blood pressure reading of 138/86 mmHg
Rationale: Daily weight is the most sensitive and reliable indicator of fluid balance changes in
a client with heart failure. Pitting edema, bounding pulses, and mild blood pressure elevations
can be influenced by other factors and are less precise indicators of total body fluid status.
3. A client is prescribed lithium carbonate for bipolar disorder. Which of the following
laboratory values should the nurse review prior to administering the initial dose?
A. Serum potassium level
B. Serum creatinine and blood urea nitrogen
C. Complete blood count with differential
,D. Fasting blood glucose level
Rationale: Lithium is excreted almost exclusively by the kidneys; therefore, baseline renal
function tests including serum creatinine and blood urea nitrogen must be evaluated to
prevent toxicity. Potassium, glucose, and complete blood counts are not the primary screening
parameters for lithium therapy.
4. A public health nurse is planning care for a community experiencing an outbreak of a
communicable disease. Which of the following actions represents primary prevention?
A. Administering antibiotics to individuals exposed to the disease
B. Conducting screening clinics in local community centers
C. Providing immunization campaigns for the local population
D. Referring diagnosed individuals to specialized rehabilitation programs
Rationale: Immunization campaigns are a primary prevention strategy aimed at preventing the
initial occurrence of a disease. Antibiotic administration is secondary prevention or treatment,
screening is secondary prevention, and rehabilitation is tertiary prevention.
5. A nurse is admitting a client who has anorexia nervosa. Which of the following
interventions should the nurse include in the plan of care?
A. Allow the client to select meal times to promote autonomy
B. Weigh the client weekly in the morning after voiding
C. Monitor the client for at least 1 hour following meals
D. Permit the client to exercise freely to reduce anxiety
Rationale: Clients with anorexia nervosa require direct supervision during and after meals to
prevent purging behaviors such as self-induced vomiting or hiding food. Weighing should
occur daily rather than weekly, meal times should be structured, and strenuous exercise
should be restricted.
6. A nurse is caring for a client receiving mechanical ventilation via an endotracheal tube.
Which of the following complications should the nurse monitor for during high pressure
ventilator alarms?
A. Disconnection of the ventilator tubing
B. Kinked endotracheal tube or client biting the tube
C. Cuff leak in the endotracheal tube
, D. Accidental extubation
Rationale: High pressure alarms are triggered when there is an obstruction to airflow, such as
secretions, kinking, or biting of the tube, or if the client is coughing. Low pressure alarms are
triggered by disconnections, leaks, or extubation.
7. A charge nurse is evaluating a newly licensed nurse's understanding of standard
precautions. Which of the following statements by the newly licensed nurse indicates a need
for further teaching?
A. "I will wear gloves when touching any client's nonintact skin."
B. "I should wear a mask and face shield if splashing of body fluids is anticipated."
C. "I must wear sterile gloves when emptying a urinary drainage bag."
D. "I will perform hand hygiene immediately after removing gloves."
Rationale: Clean, non-sterile gloves are appropriate when emptying a urinary drainage bag, as
this is a clean procedure, not a sterile one. All other statements correctly reflect standard
precautions guidelines regarding PPE and hand hygiene.
8. A nurse is reviewing the laboratory results of a client receiving heparin therapy via
continuous intravenous infusion. Which of the following findings indicates the infusion rate
should be adjusted?
A. Platelet count of 180,000/mm3
B. Activated partial thromboplastin time (aPTT) of 85 seconds
C. International Normalized Ratio (INR) of 1.1
D. Hemoglobin of 14 g/dL
Rationale: An aPTT of 85 seconds is elevated above the therapeutic range of 1.5 to 2 times the
normal control value, indicating a risk for bleeding and the need to decrease the heparin
infusion rate. The other values are within normal limits or appropriate.
9. A nurse is assessing an older adult client for signs of delirium versus dementia. Which of
the following findings is characteristic of delirium?
A. Slow, insidious onset over several years
B. Stable mood and intact attention span
C. Fluctuating level of consciousness and acute onset
D. Permanent and irreversible cognitive decline
