ATI Exit Exam ( ATI Comprehensive Predictor)

Correct Answer:

D. 24

Explanation:

BMI is calculated using the formula:

$\mathrm{BMI} = \frac{\mathrm{Weight} \left(\mathrm{kg}\right)}{\mathrm{Height} {\left(\mathrm{m}\right)}^2}$

    $\frac{75}{1.8^2}= 23.15$

Rounded to the nearest whole number = 24

Why Other Options Are Incorrect:

A. 42

This would indicate severe obesity. A person weighing 75 kg with a height of 1.8 m cannot have a BMI this high.

B. 28

This would reflect an overweight status, but the actual BMI is lower. The math does not support this value.

C. 32

This is in the obese range, which is not correct based on the given weight and height.

D. 24

This is the correct and calculated value. It reflects a normal BMI.

Correct Answer: Number of patient falls

Detailed Explanation of the Correct Answer:

Number of patient falls

 The number of patient falls is a key quality indicator in long-term care and other healthcare settings. Falls can lead to significant injuries, increased healthcare costs, and decreased patient satisfaction. A reduction in the number of falls over time is a measurable and objective way to demonstrate improvement in the quality of care. Tracking and reporting fall rates helps facilities evaluate the effectiveness of fall prevention programs and overall patient safety initiatives.

Explanation of Incorrect Options:

Number of medication errors

Although medication errors are important to track, they are typically used to assess medication safety systems, not overall quality of care. Furthermore, reporting of medication errors can be inconsistent due to underreporting, which can make trend analysis less reliable as a sole indicator of care improvement.

 Number of staff turnover

Staff turnover is more of an indicator of workforce stability and management practices than direct patient care quality. High turnover may indirectly affect care, but it is not the most direct or accurate measure for showing improvement in patient care outcomes.

Number of resident complaints

While this is a valuable qualitative indicator, it is subjective and can vary depending on individual perception, communication issues, or unrelated dissatisfaction. It is useful for identifying trends but does not directly measure improvements in clinical outcomes or safety.

Summary:

To demonstrate improvement in the quality of care, the number of patient falls is the most relevant and objective indicator among the options. It directly reflects patient safety and effectiveness of preventative care practices in the facility.

Correct Answer:

C. Clopidogrel

Explanation:

C. Clopidogrel

Saw palmetto is an herbal supplement often used for symptoms of BPH. It has antiplatelet effects, which can increase the risk of bleeding when combined with other anticoagulant or antiplatelet medications like clopidogrel. Therefore, using both together may lead to an increased risk of bleeding complications.

Why Other Options Are Incorrect:

A. Penicillin

There is no known significant interaction between saw palmetto and penicillin.

B. Zolpidem

Zolpidem, a sedative-hypnotic used for insomnia, does not have a known interaction with saw palmetto.

D. Ipratropium

Ipratropium is an inhaled anticholinergic medication used for respiratory conditions. It does not interact adversely with saw palmetto.

Correct Answers:

B. Add water to the water seal chamber as it evaporates.

C. Mark the drainage output on the collection chamber.

Explanation:

B. Add water to the water seal chamber as it evaporates

Maintaining the correct water level in the water seal chamber is essential to ensure proper functioning and to maintain a one-way seal that prevents air from entering the pleural space.

C. Mark the drainage output on the collection chamber

Documenting the amount and characteristics of drainage regularly helps monitor for complications like excessive bleeding or infection and evaluates the effectiveness of the chest tube.

Why Other Options Are Incorrect:

A. Clamp the chest tube every 2 hr to assess the amount of drainage

Clamping a chest tube is contraindicated unless specifically ordered for certain procedures (like changing the drainage system). Routine clamping can lead to a tension pneumothorax.

D. Maintain the collection chamber above the level of the client's waist

The collection chamber should always be kept below the level of the chest to allow gravity drainage and prevent backflow into the pleural cavity.

E. Strip the chest tube vigorously to dislodge blood clots

Stripping the chest tube is not recommended as it creates high negative pressure, which can damage lung tissue. If clotting is suspected, the nurse should follow facility protocol, which may involve milking the tube gently or notifying the provider.

Correct Answer B: Offer support and create a safe, trusting environment.

Explanation:

When a nurse suspects intimate partner abuse, the priority action is to establish a safe, supportive, and trusting environment where the client feels secure and respected. This therapeutic approach encourages the client to disclose sensitive information voluntarily and builds the foundation for effective assessment, intervention, and planning. Without a trusting environment, the client may feel unsafe or reluctant to share details that are critical for further help.

Why the Other Options Are Incorrect:

A. Provide information about moving to a shelter

While providing shelter resources is important and necessary, it should only be done after establishing trust and ensuring the client is ready to receive and act on that information. Offering this prematurely may cause fear or lead the client to shut down communication.

C. Document the client's injury and include a photograph

Thorough documentation is a key legal and ethical responsibility, and including photographs (with consent) strengthens the record. However, this is not the first step. The client must feel emotionally and physically safe before any documentation or evidence collection occurs.

D. Determine if there is a gun in the client's home

Assessing for access to weapons and overall safety risk is essential in abuse cases, especially in planning for the client’s protection. However, this line of questioning should come after trust has been established. Asking this too early may intimidate the client or make them feel interrogated.

Summary:

The correct answer is B. Offer support and create a safe, trusting environment. This action is the foundation of all subsequent interventions, allowing the nurse to assess the situation thoroughly and guide the client to appropriate resources without escalating fear or resistance.

Correct Answer:

A. "Let's talk about what you already know about immunizing your baby."

Explanation:

A. "Let's talk about what you already know about immunizing your baby."

This is a therapeutic, nonjudgmental approach that encourages open communication and allows the nurse to assess the parents’ current knowledge, beliefs, and concerns. It helps build trust and opens the door for accurate education and respectful dialogue.

Why Other Options Are Incorrect:

B. "Your baby's immunizations should be up to date before they are able to travel with you by airplane."

This is presumptive and not supportive. While vaccinations are important for public health, the response doesn’t address the parents’ reasoning or invite discussion.

C. "You don't have to immunize your baby against diseases that are no longer common."

This is inaccurate and misleading. Many vaccine-preventable diseases are still present and can resurge if vaccination rates drop.

D. "The provider can give you a referral for your baby to see an infectious disease provider."

This may come off as dismissive or punitive, and it's not necessary unless there is a complex medical concern. The priority is education and understanding, not escalation.

Correct Answer: Vomiting

Detailed Explanation of the Correct Answer:

Vomiting

This is the correct answer because vomiting 24 hours post-op with a clamped NG tube and while resuming a clear liquid diet may indicate delayed gastric emptying, bowel obstruction, or ileus. The NG tube is typically clamped to assess the patient's ability to tolerate oral intake. Vomiting suggests that the stomach contents are not passing through the GI tract properly and can lead to complications such as aspiration, electrolyte imbalance, or wound dehiscence. This finding should be immediately reported to the provider for further evaluation and possible intervention.

Detailed Explanation of Incorrect Options:

Increased bowel sounds

This is an expected and positive sign postoperatively. It indicates the return of gastrointestinal motility, which is necessary before resuming oral intake. This finding does not require reporting unless accompanied by other abnormal symptoms.

Complaints of thirst

Thirst is common after surgery due to NPO status, fluid shifts, and medication effects. While uncomfortable, it is not abnormal or dangerous, and it does not indicate a complication of diet advancement.

Passage of flatus

This is another expected and favorable sign of returning bowel function. It indicates that the GI tract is beginning to resume activity, and typically supports the decision to initiate oral intake.

Summary:

Postoperative vomiting after clamping an NG tube and restarting a clear liquid diet may indicate gastrointestinal dysfunction and must be reported. Other signs like bowel sounds and flatus are expected and indicate recovery, while thirst is common but not concerning.

Correct Answer:

C. Elevate the client's scrotum on a pillow.

Explanation:

C. Elevate the client's scrotum on a pillow

After hernia repair, especially inguinal hernia surgery, scrotal swelling is common. Elevating the scrotum helps reduce edema, promotes venous return, and enhances comfort. This is a standard postoperative intervention for male clients following this type of surgery.

Why Other Options Are Incorrect:

A. Place a warm pack on the incisional area

Warm packs are not recommended immediately after surgery due to the risk of increased blood flow and bleeding. Cold packs are more appropriate in the early postoperative period to reduce swelling and pain.

B. Restrict fluids to 1,200 mL per day

Fluid restriction is not necessary after a hernia repair unless there is another condition like renal or heart failure. Adequate hydration supports healing and prevents complications like constipation.

D. Encourage the client to sit to void

There is no specific need to sit while voiding after a hernia repair. Clients can void in their usual position unless they have difficulty urinating, in which case further assessment is required.

Correct Answer:

A. "Preventing readmissions will decrease overutilization of services."

Explanation:

A. "Preventing readmissions will decrease overutilization of services"

Preventing hospital readmissions is a key strategy in cost-effective care. It reduces duplicated care, limits unnecessary resource use, and improves patient outcomes, ultimately saving money for the healthcare system and enhancing care efficiency.

Why Other Options Are Incorrect:

B. "Hiring travel nurses is an effective method of cost containment"

Hiring travel nurses is often more expensive than employing permanent staff and is generally used as a temporary staffing solution, not a cost-containment strategy.

C. "Purchasing more expensive items will improve quality health outcomes"

More expensive does not always equal better outcomes. Cost-effectiveness means choosing resources that provide the best value — balancing cost with benefit — not simply opting for the most expensive products.

D. "Planning a 10-year budget will ensure cost-effective care"

Long-term budgeting is important, but too long a time frame can reduce flexibility in responding to changing technologies, patient needs, and economic shifts, making it less effective for ensuring cost-effective care. Budgeting should be strategic and adaptive.