ATI Comprehensive Exam
Pt has a PE and is being given heparin continuously via IV at 1,200 units/hr and
warfarin 5mg PO daily. The labs show aPTT of 98sec and INR of 1.8 - Answers -Should
withhold the heparin infusion because the aPTT is to high, the normal therapeutic range
while receiving heparin is 60-80sec
Pt in urgent care reports impaired vision in one eye. What would indicate a detached
retina? - Answers -A floating dark spot is one of the manifestations due to bulges, folds,
or holes in the affected retina
Infant with hydrocephalus and is 6hr post-op following a placement of
ventriculoperitoneal shunt (VP). What finding should be reported to the HCP? - Answers
-Irritability when being held, this is a manifestation of increased ICP. This indicates that
the VP shunt is malfunctioning and should be reported
A pt is taking phenelzine, what food recommendation should be given? - Answers --
Phenelzine is an MAOI, while taking the pt should avoid foods containing tyramine
- Foods the pt can eat include broccoli, yogurt, cream cheese
- Foods that do contain tyramine include processed like pepperoni and bologna
A pt is 20wks of gestation and the nurse is discussing common prenatal discomforts.
Which statement indicates understanding? - Answers -- Wearing a supportive bra
overnight, this will help with the breast changes
- Increase intake of high-fiber foods, this will help with constipation
- Development of face rash is normal, anti-inflammatory ointment doesn't help this
- Sleep on side to help with back pain
A nurse is providing discharge teaching to a pt receiving home oxygen therapy. What
should the nurse include in the teaching? - Answers -- Check the function of the
equipment daily
- Wear cotton clothing while oxygen is in use, this decreases static electricity from the
clothing and risk of fire
-Apply water-soluble lubricants to the nares vs. oil based
- Store tanks in an upright position
, Pt receiving continuous bladder irrigation following a transuretheral resection of the
prostate. The pt reports bladder spasms and there is decreased urinary output. What
should be done? - Answers -- Irrigate the catheter with 0.9% sodium chloride irrigation
- This indicates internal obstruction of the catheter
Child with sickle cell anemia who is having vaso-occlusive crisis. What intervention
should be done first? - Answers -- Infuse IV fluids, this promotes hydration and
circulation, decreases the tissue and organ ischemia
A nurse is teaching a pt about basal body temp. method of birth control. What
information should the nurse include? - Answers -- The body temp. might decrease
slightly just prior to ovulation
A nurse is assessing for hypocalcemia, where should the nurse tap on the face to elicit
a positive Chvostek's sign? - Answers -- The nurse should tap the pts facial nerve about
an inch from the tragus of the ear. Facial twitching is positive finding for hypocalcemia
A pt has acute glomerulonephritis, which of the following findings in the urine should be
expected? - Answers -- Protein is expected
- Increased glomerular permeability allows protein to filter into the urine
A nurse on an oncology unit is administering doxorubicin to a pt with breast cancer.
Which action should be taken? - Answers -- Inspect the pts mucosa for petechiae q8hr
- This medication causes thrombocytopenia and increases the risk of bleeding
- Should also assess for hematuria, guaiac, and bruising
The nurse recognizes that a sedentary lifestyle is a risk factor for osteoporosis in older
adult pts. What should this pt be taught? - Answers -- The nurse should encourage the
pt to engage in weight-bearing exercises to promote bone health, this will increase
calcium and phosphorus levels
Isolation precautions - Answers -- A pt with measles should be placed on airborne
precautions
- A pt with airborne precautions should be placed in a negative-pressure airflow room
- A pt with C-diff should be placed on contact plus precautions
A child is taking valproic acid, what diagnostic test should be expected for the HCP to
order? - Answers -- Serum liver enzyme levels
Pt has a PE and is being given heparin continuously via IV at 1,200 units/hr and
warfarin 5mg PO daily. The labs show aPTT of 98sec and INR of 1.8 - Answers -Should
withhold the heparin infusion because the aPTT is to high, the normal therapeutic range
while receiving heparin is 60-80sec
Pt in urgent care reports impaired vision in one eye. What would indicate a detached
retina? - Answers -A floating dark spot is one of the manifestations due to bulges, folds,
or holes in the affected retina
Infant with hydrocephalus and is 6hr post-op following a placement of
ventriculoperitoneal shunt (VP). What finding should be reported to the HCP? - Answers
-Irritability when being held, this is a manifestation of increased ICP. This indicates that
the VP shunt is malfunctioning and should be reported
A pt is taking phenelzine, what food recommendation should be given? - Answers --
Phenelzine is an MAOI, while taking the pt should avoid foods containing tyramine
- Foods the pt can eat include broccoli, yogurt, cream cheese
- Foods that do contain tyramine include processed like pepperoni and bologna
A pt is 20wks of gestation and the nurse is discussing common prenatal discomforts.
Which statement indicates understanding? - Answers -- Wearing a supportive bra
overnight, this will help with the breast changes
- Increase intake of high-fiber foods, this will help with constipation
- Development of face rash is normal, anti-inflammatory ointment doesn't help this
- Sleep on side to help with back pain
A nurse is providing discharge teaching to a pt receiving home oxygen therapy. What
should the nurse include in the teaching? - Answers -- Check the function of the
equipment daily
- Wear cotton clothing while oxygen is in use, this decreases static electricity from the
clothing and risk of fire
-Apply water-soluble lubricants to the nares vs. oil based
- Store tanks in an upright position
, Pt receiving continuous bladder irrigation following a transuretheral resection of the
prostate. The pt reports bladder spasms and there is decreased urinary output. What
should be done? - Answers -- Irrigate the catheter with 0.9% sodium chloride irrigation
- This indicates internal obstruction of the catheter
Child with sickle cell anemia who is having vaso-occlusive crisis. What intervention
should be done first? - Answers -- Infuse IV fluids, this promotes hydration and
circulation, decreases the tissue and organ ischemia
A nurse is teaching a pt about basal body temp. method of birth control. What
information should the nurse include? - Answers -- The body temp. might decrease
slightly just prior to ovulation
A nurse is assessing for hypocalcemia, where should the nurse tap on the face to elicit
a positive Chvostek's sign? - Answers -- The nurse should tap the pts facial nerve about
an inch from the tragus of the ear. Facial twitching is positive finding for hypocalcemia
A pt has acute glomerulonephritis, which of the following findings in the urine should be
expected? - Answers -- Protein is expected
- Increased glomerular permeability allows protein to filter into the urine
A nurse on an oncology unit is administering doxorubicin to a pt with breast cancer.
Which action should be taken? - Answers -- Inspect the pts mucosa for petechiae q8hr
- This medication causes thrombocytopenia and increases the risk of bleeding
- Should also assess for hematuria, guaiac, and bruising
The nurse recognizes that a sedentary lifestyle is a risk factor for osteoporosis in older
adult pts. What should this pt be taught? - Answers -- The nurse should encourage the
pt to engage in weight-bearing exercises to promote bone health, this will increase
calcium and phosphorus levels
Isolation precautions - Answers -- A pt with measles should be placed on airborne
precautions
- A pt with airborne precautions should be placed in a negative-pressure airflow room
- A pt with C-diff should be placed on contact plus precautions
A child is taking valproic acid, what diagnostic test should be expected for the HCP to
order? - Answers -- Serum liver enzyme levels
