RN Comprehensive Online Practice 2023 B
Unabridged Formatted Document • Complete Practice Exam Edition
ATI RN Comprehensive Online Practice 2023 B
1. A nurse is caring for a 5-year-old child
Physical Examination:
1510:
Upon visual inspection, throat is inflamed, tonsils appear pink, reddened and
epiglottis is edematous and cherry red in appearance. Skin appears pale.
Stridor noted upon inspiration with diminished bilateral lung sounds.
Nurse's Notes:
1500
Child accompanied to emergency department by caregiver . Caregiver states
child has a sore throat and reports the child has "pain on swallowing" and
denies cough. Child is agitated and lean: Condition: Epiglottis
Actions: Initiate droplet precautions and request a prescription for IV antibiotics
Monitors: Breath sounds and temperature
The nurse should anticipate initiating droplet precautions and requesting a prescription for IV antibiotics. The child
is
most likely experiencing epiglottis because of the clinical manifestations of a high fever, inflammation and redness
of
the throat, pale skin, stridor with inspiration, painful swallowing, no cough, is sitting in tripod position, and drooling.
The nurse should monitor the child's temperature and breath sounds.
Davieacademia • RN Comprehensive Online Practice 2023 B Page 1 of 93
, 2. A nurse is caring for a client who is on the spinal cord injury (SCI) unit
Nurses' Notes
Day 3, 1700
Client admitted to SCI unit 3 days ago following C7 injury. Skin is cool, pale,
and dry to touch. Respirations easy and unlabored. Lung sounds diminished
in lower lobes. Abdomen soft and nondistended with active bowel sounds.
Client passed a small amount of hard formed stool this AM. Indwelling urinary
catheter draining clear yellow urine. Deep tendon reflexes (DTR) are biceps 1+,
triceps 1+, pa: The client is most likely experiencing manifestations of pneumonia and autonomic dysreflexia.
The nurse should analyze cues from the client's manifestations and determine that the client is most likely
experiencing
manifestations of pneumonia and autonomic dysreflexia. A client who has a cervical SCI is at risk for respiratory
ATI RN Comprehensive Online Practice 2023 B
complications because spinal innervation to the respiratory muscles is disrupted. Adventitious breath sounds in the
lower lobes bilaterally and a decrease in oxygen saturation to less than 92% can indicate pneumonia. The client's
sudden increase in blood pressure, bradycardia, flushing of the skin above the area of the injury, headache, and
blurred vision are manifestations of autonomic dysreflexia, which can be a life-threatening condition.
Davieacademia • RN Comprehensive Online Practice 2023 B Page 2 of 93
, 3. A nurse is caring for a client who has abdominal pain
Nurses' Notes
0900
Client reports loss of appetite, weight loss, and fatigue for 1 week. Reports
abdominal pain, 6 on a scale from 0 to 10, for 2 days. Client is a perioperative
nurse, returned 1 week ago from a 2-week mission trip to an underdeveloped
country
1200
Results of antibody studies obtained. Provider prescription for antiviral med-
ication pending.
Physical Examination
0930
Lung sounds clear bilaterally. Skin warm to touch and jau: Hepatitis A: Client's risk from
fecal-oral transmission, laboratory results, and physical examination findings
Hepatitis B: Antiviral treatment, laboratory results, client's risk from bloodborne transmission, physical examination
findings
Hepatitis C: Antiviral treatment, laboratory results, client's risk from bloodborne transmission, and physical
examina-
tion findings
When analyzing cues, the nurse should recognize that manifestations of hepatitis A, hepatitis B, and hepatitis C
include
jaundice, yellow sclerae, right upper quandrant pain upon palpation, dark yellow urine, and elevated AST and ALT
levels. When analyzing cues, the nurse should also recognize the client's risk for contracting hepatitis A through
the
fecal-oral route during recent travel to an underdeveloped country and the client's occupational risk as a
perioperative
ATI RN Comprehensive Online Practice 2023 B
nurse for contracting hepatitis B and hepatitis C through bloodborne transmission. The nurse should recognize that
the current standard of practice for
Davieacademia • RN Comprehensive Online Practice 2023 B Page 3 of 93
, 4. A nurse is caring for a client on a medical-surgical unit
Vital Signs
0700
Temperature 37.6 C (99.7 F)
Heart rate 100/min
Respiratory rate 22/min
Blood pressure mmHg
Oxygen saturation 98% on room air
Nurses' Notes
1100
Client alert and oriented to person, place, and time. Client had episode of
diarrhea, provided perineal care. Noted 2 cm x 2 cm (0.8 in x 0.8 in) painful
edematous area on sacrum. Client repositioned every 4 hr .: Click to highlight the
findings that require follow up. To deselect a finding, click on the finding again.
- Noted 2 cm x 2 cm (0.8 in x 0.8 in) painful edematous area on sacrum
- Client repositioned every 4 hr
When recognizing cues, the nurse should determine that the client's painful edematous area on their sacrum and
that the client has only been repositioned every 4 hr requires follow up. The client has manifestations of a pressure
injury that need to be addressed. The client should be repositioned at least every 2 hr to prevent worsening of the
pressure injury and to relieve pressure from the sacral area.
Davieacademia • RN Comprehensive Online Practice 2023 B Page 4 of 93
Unabridged Formatted Document • Complete Practice Exam Edition
ATI RN Comprehensive Online Practice 2023 B
1. A nurse is caring for a 5-year-old child
Physical Examination:
1510:
Upon visual inspection, throat is inflamed, tonsils appear pink, reddened and
epiglottis is edematous and cherry red in appearance. Skin appears pale.
Stridor noted upon inspiration with diminished bilateral lung sounds.
Nurse's Notes:
1500
Child accompanied to emergency department by caregiver . Caregiver states
child has a sore throat and reports the child has "pain on swallowing" and
denies cough. Child is agitated and lean: Condition: Epiglottis
Actions: Initiate droplet precautions and request a prescription for IV antibiotics
Monitors: Breath sounds and temperature
The nurse should anticipate initiating droplet precautions and requesting a prescription for IV antibiotics. The child
is
most likely experiencing epiglottis because of the clinical manifestations of a high fever, inflammation and redness
of
the throat, pale skin, stridor with inspiration, painful swallowing, no cough, is sitting in tripod position, and drooling.
The nurse should monitor the child's temperature and breath sounds.
Davieacademia • RN Comprehensive Online Practice 2023 B Page 1 of 93
, 2. A nurse is caring for a client who is on the spinal cord injury (SCI) unit
Nurses' Notes
Day 3, 1700
Client admitted to SCI unit 3 days ago following C7 injury. Skin is cool, pale,
and dry to touch. Respirations easy and unlabored. Lung sounds diminished
in lower lobes. Abdomen soft and nondistended with active bowel sounds.
Client passed a small amount of hard formed stool this AM. Indwelling urinary
catheter draining clear yellow urine. Deep tendon reflexes (DTR) are biceps 1+,
triceps 1+, pa: The client is most likely experiencing manifestations of pneumonia and autonomic dysreflexia.
The nurse should analyze cues from the client's manifestations and determine that the client is most likely
experiencing
manifestations of pneumonia and autonomic dysreflexia. A client who has a cervical SCI is at risk for respiratory
ATI RN Comprehensive Online Practice 2023 B
complications because spinal innervation to the respiratory muscles is disrupted. Adventitious breath sounds in the
lower lobes bilaterally and a decrease in oxygen saturation to less than 92% can indicate pneumonia. The client's
sudden increase in blood pressure, bradycardia, flushing of the skin above the area of the injury, headache, and
blurred vision are manifestations of autonomic dysreflexia, which can be a life-threatening condition.
Davieacademia • RN Comprehensive Online Practice 2023 B Page 2 of 93
, 3. A nurse is caring for a client who has abdominal pain
Nurses' Notes
0900
Client reports loss of appetite, weight loss, and fatigue for 1 week. Reports
abdominal pain, 6 on a scale from 0 to 10, for 2 days. Client is a perioperative
nurse, returned 1 week ago from a 2-week mission trip to an underdeveloped
country
1200
Results of antibody studies obtained. Provider prescription for antiviral med-
ication pending.
Physical Examination
0930
Lung sounds clear bilaterally. Skin warm to touch and jau: Hepatitis A: Client's risk from
fecal-oral transmission, laboratory results, and physical examination findings
Hepatitis B: Antiviral treatment, laboratory results, client's risk from bloodborne transmission, physical examination
findings
Hepatitis C: Antiviral treatment, laboratory results, client's risk from bloodborne transmission, and physical
examina-
tion findings
When analyzing cues, the nurse should recognize that manifestations of hepatitis A, hepatitis B, and hepatitis C
include
jaundice, yellow sclerae, right upper quandrant pain upon palpation, dark yellow urine, and elevated AST and ALT
levels. When analyzing cues, the nurse should also recognize the client's risk for contracting hepatitis A through
the
fecal-oral route during recent travel to an underdeveloped country and the client's occupational risk as a
perioperative
ATI RN Comprehensive Online Practice 2023 B
nurse for contracting hepatitis B and hepatitis C through bloodborne transmission. The nurse should recognize that
the current standard of practice for
Davieacademia • RN Comprehensive Online Practice 2023 B Page 3 of 93
, 4. A nurse is caring for a client on a medical-surgical unit
Vital Signs
0700
Temperature 37.6 C (99.7 F)
Heart rate 100/min
Respiratory rate 22/min
Blood pressure mmHg
Oxygen saturation 98% on room air
Nurses' Notes
1100
Client alert and oriented to person, place, and time. Client had episode of
diarrhea, provided perineal care. Noted 2 cm x 2 cm (0.8 in x 0.8 in) painful
edematous area on sacrum. Client repositioned every 4 hr .: Click to highlight the
findings that require follow up. To deselect a finding, click on the finding again.
- Noted 2 cm x 2 cm (0.8 in x 0.8 in) painful edematous area on sacrum
- Client repositioned every 4 hr
When recognizing cues, the nurse should determine that the client's painful edematous area on their sacrum and
that the client has only been repositioned every 4 hr requires follow up. The client has manifestations of a pressure
injury that need to be addressed. The client should be repositioned at least every 2 hr to prevent worsening of the
pressure injury and to relieve pressure from the sacral area.
Davieacademia • RN Comprehensive Online Practice 2023 B Page 4 of 93
