ATI RN Comprehensive Predictor 2023 CNI College BSN
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Free ATI RN Comprehensive Predictor 2023 CNI College BSN Questions
1. A nurse is assisting a client who lives in a rural community with obtaining health services. Which of the following actions by the nurse demonstrates coordination of care?
- Providing the client with information about transportation services.
- Informing the client about providers who accept their health insurance.
- Arranging an appointment for the client with a mobile health clinic.
- Encouraging the client to become a self-advocate.
Explanation
Coordination of care involves organizing and facilitating access to healthcare services across settings to ensure continuity and efficiency. By arranging an appointment with a mobile health clinic, the nurse takes direct action to link the client with accessible healthcare services. This eliminates barriers related to location and availability, ensuring that the client receives timely and appropriate care. Providing information about transportation or insurance (options A and B) supports access to care but does not directly coordinate it. Encouraging self-advocacy (option D) promotes independence and empowerment but does not constitute active coordination of care.
2. A nurse is teaching a client who has an ileostomy about the care of their stoma site. Which of the following statements made by the client indicates the teaching was effective?
- "I should clean my stoma with moisturizing soap."
- "I should cut my pouch opening 1/8 inch larger than my stoma."
- "I should expect my stoma to be blistered."
- "I should change my stoma pouch 30 minutes after meals."
Explanation
The client should cut the pouch opening about 1/8 inch larger than the stoma to ensure a snug fit. This small gap protects the skin from irritation caused by stoma output while avoiding constriction of the stoma. A properly fitted pouch maintains skin integrity and prevents leakage.
3. A community health nurse is performing a home visit for a client and is evaluating the home environment for safety. Which of the following findings would indicate to the nurse that the client has a proper understanding of safety in the home?
- A small area rug is placed at the front door.
- The water heater is set at 54° C (129.2° F).
- The batteries in the smoke alarms are changed annually.
- A single light fixture hangs along the sidewalk to the house.
Explanation
Changing smoke alarm batteries annually demonstrates proper understanding of fire safety in the home. Functional smoke detectors significantly reduce the risk of injury or death from residential fires. In addition, smoke alarms should be tested monthly to ensure they work properly, and the entire unit should be replaced every 10 years.
4. A nurse is providing teaching to a client who has a new prescription for nitroglycerin topical ointment. Which of the following instructions should the nurse include in the teaching?
- "Apply the ointment to the skin every 4 hr."
- "Spread the ointment in a thin, even layer."
- "Apply the ointment to the forearm."
- "Massage the ointment into the skin."
Explanation
Nitroglycerin ointment should be applied in a thin, even layer to a hairless area of the body, such as the chest, back, or upper arm. The ointment should not be massaged into the skin, as this can alter absorption and cause unpredictable blood levels. The application site should be rotated to prevent skin irritation. The nurse should also ensure the client removes the previous dose before applying a new one to avoid overdose and tolerance.
5. A nurse is providing teaching to a client following surgery to repair a detached retina of the left eye. Which of the following instructions should the nurse include in the teaching?
- "You can lift objects that weigh 15 pounds."
- "Pick up items by bending at the waist."
- "Avoid reading for 3 days following surgery."
- "Take a stool softener daily."
Explanation
After retinal detachment repair, it is critical to avoid activities that increase intraocular pressure (IOP), as increased pressure can disrupt the surgical repair. Taking a stool softener daily helps prevent straining during bowel movements, which could elevate IOP and risk retinal re-detachment. The nurse should also instruct the client to avoid sneezing, coughing forcefully, bending, or heavy lifting.
6. A nurse is talking with the parents of a 2-month-old infant who have chosen not to immunize the infant. Which of the following responses should the nurse make?
- "Let's talk about what you already know about immunizing your baby."
- "Your baby's immunizations should be up to date before they are able to travel with you by airplane."
- "You don't have to immunize your baby against diseases that are no longer common."
- "The provider can give you a referral for your baby to see an infectious disease provider."
Explanation
This response uses therapeutic communication by inviting the parents to share their understanding, concerns, and beliefs about immunization. It opens the door for nonjudgmental dialogue, allowing the nurse to provide accurate, evidence-based information and address misinformation or fears. This approach supports shared decision-making and helps build trust with the family.
7. A nurse is caring for a client who is postpartum and requests information about contraception. Which of the following instructions should the nurse include?
- "You should avoid vaginal spermicides while breastfeeding."
- "The lactation amenorrhea method is effective for your first year postpartum."
- "Place the transdermal birth control patch on your upper outer arm."
- "You can continue to use the diaphragm you used before your pregnancy."
Explanation
A diaphragm can continue to be used after pregnancy; however, the client must have it refitted by a healthcare provider because pregnancy and childbirth can change the shape and size of the cervix and vagina. Once properly fitted, it remains an effective and safe contraceptive method for postpartum women who prefer non-hormonal birth control.
8. A nurse is reviewing laboratory results for a client who is taking warfarin. Which of the following laboratory tests determines if the dose of medication is within the recommended target range?
- Bleeding time
- aPTT
- Factor VIII
- INR
Explanation
The International Normalized Ratio (INR) measures how long it takes blood to clot and is the standard test used to monitor warfarin therapy. The therapeutic INR range for most conditions is 2.0 to 3.0, though some clients (e.g., those with mechanical heart valves) may require a range of 2.5 to 3.5.
9. A nurse is reviewing the BUN result of a client who is taking cyclosporine following a kidney transplant. Which of the following laboratory studies should the nurse recognize as another renal function study that should be monitored?
- Alkaline phosphatase
- Amylase
- Creatinine
- Bilirubin
Explanation
Serum creatinine is a key indicator of kidney function. Cyclosporine, an immunosuppressant used after kidney transplantation, can cause nephrotoxicity, leading to elevated BUN and creatinine levels. Monitoring both values helps assess renal status and detect early signs of kidney impairment. Persistent elevation of creatinine may indicate cyclosporine toxicity or rejection. Alkaline phosphatase and bilirubin assess liver function, while amylase measures pancreatic function, making them unrelated to renal monitoring.
10.
A nurse is assessing a client who was placed in restraints for aggressive behavior. The client is now calm and cooperative. Which of the following actions should the nurse take?
- Offer the client PRN pain medication.
- Encourage the client to attend a group therapy session.
- Remove the restraints from the client.
- Continue to monitor the client every 15 min.
Explanation
Explanation
Restraints must be discontinued as soon as the client is calm, cooperative, and no longer a danger to themselves or others. This follows the least restrictive intervention policy and reduces risk of physical or psychological harm. Removing restraints promptly demonstrates appropriate nursing judgment and adherence to patient rights and safety standards.
Restraints must be discontinued as soon as the client is calm, cooperative, and no longer a danger to themselves or others. This follows the least restrictive intervention policy and reduces risk of physical or psychological harm. Removing restraints promptly demonstrates appropriate nursing judgment and adherence to patient rights and safety standards.
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