ATI COMPREHENSIVE EXIT EXAM 2023
Questions 1 - 200
Advanced / Hard / Mixed Difficulty
Comprehensive Nursing Review Covering Medical-Surgical, Mental
Health, Maternity, Pediatrics, Pharmacology, and Leadership
1. A nurse is caring for a client who is 1 hour postoperative following a
thyroidectomy. The client reports a tingling sensation around the
mouth and numbness in the fingers. Which of the following actions
should the nurse take first?
A. Administer calcium gluconate IV
B. Assess the client's surgical incision
C. Check the client's serum calcium level
D. Notify the healthcare provider
Valid answer:A
Explanation: Tingling around the mouth and numbness in the fingers
are signs of hypocalcemia, which can occur after thyroidectomy due to
accidental removal or damage to the parathyroid glands. This can lead
to life-threatening laryngospasm. The nurse should administer IV
calcium gluconate first, as this is a critical intervention to prevent
respiratory compromise. While checking serum calcium and notifying
the provider are important, the immediate threat of hypocalcemic
tetany requires prompt treatment.
2. A nurse is caring for a client who has a new diagnosis of heart
failure and is prescribed furosemide. Which of the following
laboratory values should the nurse monitor closely?
1
,A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Valid answer:B
Explanation: Furosemide is a loop diuretic that inhibits sodium and
chloride reabsorption in the ascending loop of Henle, leading to
increased potassium excretion. Hypokalemia is a significant side effect
that can precipitate cardiac arrhythmias, especially in clients with heart
failure who may also be on digoxin. Monitoring serum potassium is
essential to prevent life-threatening complications.
3. A nurse is providing discharge teaching to a client who has a new
prescription for warfarin. Which of the following statements by the
client indicates an understanding of the teaching?
A. "I will increase my intake of green leafy vegetables."
B. "I will take ibuprofen for my headaches."
C. "I will use an electric razor for shaving."
D. "I will stop taking the medication if I notice bruising."
Valid answer:C
Explanation: Warfarin is an anticoagulant that increases the risk of
bleeding. Using an electric razor minimizes the risk of nicks and cuts
that could lead to bleeding. Clients should maintain a consistent intake
of vitamin K-rich foods, avoid NSAIDs like ibuprofen, and should not stop
the medication without consulting the provider. Bruising is an expected
side effect and should be reported, but the medication should not be
stopped abruptly.
2
,4. A nurse is assessing a client who is receiving a blood transfusion.
The client reports chills, lower back pain, and a feeling of impending
doom. Which of the following actions should the nurse take first?
A. Stop the blood transfusion
B. Notify the healthcare provider
C. Administer an antihistamine
D. Obtain a urine specimen
Valid answer:A
Explanation: The client's symptoms are consistent with an acute
hemolytic transfusion reaction, which is a life-threatening emergency.
The priority action is to stop the blood transfusion immediately to
prevent further complications. The nurse should then notify the provider,
maintain IV access with normal saline, and monitor the client's vital
signs. Administering antihistamines and obtaining a urine specimen are
secondary actions.
5. A nurse is caring for a client who has a nasogastric tube attached to
continuous low suction. The nurse notes that the client's abdomen is
distended and bowel sounds are absent. Which of the following
actions should the nurse take?
A. Irrigate the NG tube with 30 mL of normal saline
B. Position the client on the left side
C. Notify the healthcare provider
D. Clamp the NG tube for 15 minutes
Valid answer:C
Explanation: A distended abdomen and absent bowel sounds in a client
3
, with an NG tube may indicate a bowel obstruction or paralytic ileus,
which are serious complications. The nurse should notify the provider
immediately. Irrigating the tube or clamping it could worsen the
obstruction or cause reflux and aspiration. Positioning may help with
comfort but does not address the underlying issue.
6. A nurse is providing teaching to a client who has type 1 diabetes
mellitus about sick-day management. Which of the following
statements by the client indicates a need for further teaching?
A. "I will test my urine for ketones every 4 hours."
B. "I will continue to take my insulin even if I am not eating."
C. "I will drink fluids that contain sugar to prevent dehydration."
D. "I will check my blood glucose every 2 to 4 hours."
Valid answer:C
Explanation: During sick days, the client should consume fluids that are
sugar-free or contain electrolytes to prevent dehydration without raising
blood glucose excessively. The client should continue insulin, check blood
glucose frequently, and test for ketones. Drinking sugar-containing fluids
can worsen hyperglycemia and lead to diabetic ketoacidosis.
7. A nurse is assessing a client who has chronic obstructive pulmonary
disease (COPD) and is receiving oxygen at 3 L/min via nasal cannula.
The client is lethargic and has a respiratory rate of 8 breaths/min.
Which of the following actions should the nurse take?
A. Increase the oxygen flow rate to 5 L/min
B. Administer a bronchodilator
C. Reduce the oxygen flow rate to 2 L/min
4
Questions 1 - 200
Advanced / Hard / Mixed Difficulty
Comprehensive Nursing Review Covering Medical-Surgical, Mental
Health, Maternity, Pediatrics, Pharmacology, and Leadership
1. A nurse is caring for a client who is 1 hour postoperative following a
thyroidectomy. The client reports a tingling sensation around the
mouth and numbness in the fingers. Which of the following actions
should the nurse take first?
A. Administer calcium gluconate IV
B. Assess the client's surgical incision
C. Check the client's serum calcium level
D. Notify the healthcare provider
Valid answer:A
Explanation: Tingling around the mouth and numbness in the fingers
are signs of hypocalcemia, which can occur after thyroidectomy due to
accidental removal or damage to the parathyroid glands. This can lead
to life-threatening laryngospasm. The nurse should administer IV
calcium gluconate first, as this is a critical intervention to prevent
respiratory compromise. While checking serum calcium and notifying
the provider are important, the immediate threat of hypocalcemic
tetany requires prompt treatment.
2. A nurse is caring for a client who has a new diagnosis of heart
failure and is prescribed furosemide. Which of the following
laboratory values should the nurse monitor closely?
1
,A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Valid answer:B
Explanation: Furosemide is a loop diuretic that inhibits sodium and
chloride reabsorption in the ascending loop of Henle, leading to
increased potassium excretion. Hypokalemia is a significant side effect
that can precipitate cardiac arrhythmias, especially in clients with heart
failure who may also be on digoxin. Monitoring serum potassium is
essential to prevent life-threatening complications.
3. A nurse is providing discharge teaching to a client who has a new
prescription for warfarin. Which of the following statements by the
client indicates an understanding of the teaching?
A. "I will increase my intake of green leafy vegetables."
B. "I will take ibuprofen for my headaches."
C. "I will use an electric razor for shaving."
D. "I will stop taking the medication if I notice bruising."
Valid answer:C
Explanation: Warfarin is an anticoagulant that increases the risk of
bleeding. Using an electric razor minimizes the risk of nicks and cuts
that could lead to bleeding. Clients should maintain a consistent intake
of vitamin K-rich foods, avoid NSAIDs like ibuprofen, and should not stop
the medication without consulting the provider. Bruising is an expected
side effect and should be reported, but the medication should not be
stopped abruptly.
2
,4. A nurse is assessing a client who is receiving a blood transfusion.
The client reports chills, lower back pain, and a feeling of impending
doom. Which of the following actions should the nurse take first?
A. Stop the blood transfusion
B. Notify the healthcare provider
C. Administer an antihistamine
D. Obtain a urine specimen
Valid answer:A
Explanation: The client's symptoms are consistent with an acute
hemolytic transfusion reaction, which is a life-threatening emergency.
The priority action is to stop the blood transfusion immediately to
prevent further complications. The nurse should then notify the provider,
maintain IV access with normal saline, and monitor the client's vital
signs. Administering antihistamines and obtaining a urine specimen are
secondary actions.
5. A nurse is caring for a client who has a nasogastric tube attached to
continuous low suction. The nurse notes that the client's abdomen is
distended and bowel sounds are absent. Which of the following
actions should the nurse take?
A. Irrigate the NG tube with 30 mL of normal saline
B. Position the client on the left side
C. Notify the healthcare provider
D. Clamp the NG tube for 15 minutes
Valid answer:C
Explanation: A distended abdomen and absent bowel sounds in a client
3
, with an NG tube may indicate a bowel obstruction or paralytic ileus,
which are serious complications. The nurse should notify the provider
immediately. Irrigating the tube or clamping it could worsen the
obstruction or cause reflux and aspiration. Positioning may help with
comfort but does not address the underlying issue.
6. A nurse is providing teaching to a client who has type 1 diabetes
mellitus about sick-day management. Which of the following
statements by the client indicates a need for further teaching?
A. "I will test my urine for ketones every 4 hours."
B. "I will continue to take my insulin even if I am not eating."
C. "I will drink fluids that contain sugar to prevent dehydration."
D. "I will check my blood glucose every 2 to 4 hours."
Valid answer:C
Explanation: During sick days, the client should consume fluids that are
sugar-free or contain electrolytes to prevent dehydration without raising
blood glucose excessively. The client should continue insulin, check blood
glucose frequently, and test for ketones. Drinking sugar-containing fluids
can worsen hyperglycemia and lead to diabetic ketoacidosis.
7. A nurse is assessing a client who has chronic obstructive pulmonary
disease (COPD) and is receiving oxygen at 3 L/min via nasal cannula.
The client is lethargic and has a respiratory rate of 8 breaths/min.
Which of the following actions should the nurse take?
A. Increase the oxygen flow rate to 5 L/min
B. Administer a bronchodilator
C. Reduce the oxygen flow rate to 2 L/min
4
