ATI COMPREHENSIVE EXIT EXAM
180 NGN QUESTIONS AND VERIFIED ANSWERS & RATIONALES
WELL GRADED, BEST ATI COMPREHENSIVE
1. NGN: What assessment findings are consistent with Crohn's disease, ulcer-
ative colitis, or peritonitis?
Temperature (100F) Weight
(-9.7 lbs)
Albumin level (2.4)
WBC (14)
Bowel pattern (freq. loose stools) Abdominal
pain location (RLQ)
Heart rate (105):
Ans>>
Temperature: Crohn's, UC & peritonitis.
-Elevation can occur with all three due to inflammation and infection.
Weight: Crohn's & UC.
,-Unintended weight loss can occur due to malabsorption in the GI tract.
Bowel pattern: Crohn's.
-If the patient reported there was blood in the stool, it would be UC. Crohn's doesn't cause
tarry stools.
WBC: Crohn's, UC & peritonitis.
-Elevation can occur due to inflammation and infection.
Heart rate: peritonitis.
-Tachycardia can occur due to inflammation, infection, and dehydration.
Albumin level: Crohn's & UC.
-Because of the malabsorption in the GI tract, the body isn't receiving enough protein.
Abdominal pain location: Crohn's.
-Because it is in the RLQ, it is more consistent with Crohn's. With patients that have
peritonitis, they experience generalized abd. pain that radiates to the shoulder and back.
2. NGN: What assessment findings can indicate a transfusion reaction in a patient
receiving blood?
Urine output (150mL of clear, yellow) Skin
(pale, cool and dry)
Anxiety
,Vital signs (within normal range)
Headache
Back pain:
Ans>> Back pain, headache & anxiety.
Hemolytic reaction S/S: back pain, headache, anxiety, fever, chills, chest pain, tachycardia,
dyspnea, hypotension.
3. NGN: Patient arrives with palpitations, difficulty breathing, and reports feel- ing
faint. Reports constipation and joint pain for x2 days. In childhood, patient experienced
physical abuse, and emotionally detached parents. Reports ner- vousness and only
leaving home when necessary.
PMH: freq. hospital visits due to headaches and GI distress.
Bowtie
Ans>> Condition: somatic symptom disorder
-due to physical inactivity & joint pain
Interventions: Monitor physical manifestations & assess for presence of 2nd gains from their
illness
-disorder is characterized by the presence of other real manifestations like dizziness, nausea,
back pain, and joint pain.
Monitor: Vital signs & pain.
,4. NGN: What actions should the nurse take when her pedi patient is exhibiting
symptoms of an allergic reaction?
Administer 0.9% NS IV
Administer epi IM
Monitor urine output q2hrs DC
supplemental oxygen Monitor
vital signs frequently
DC IV medication:
Ans>>
Administer 0.9% NS IV Administer epi IM
Monitor vital signs frequently DC
IV medication
-Nurse should DC the Rocephin and give IV NS to help restore fluids because fluid shifts can
occur quickly during a reaction. Administering epi IM is the first line of therapy for
anaphylactic reactions because it constricts blood vessels and dilates bronchioles. Monitoring
vital sings frequently will allow the nurse to monitor for signs of shock.
,5. NGN: What 5 actions should the nurse plan to take with a patient experienc-
ing hallucinations, following alcohol withdrawal?
Administer thiamine
Maintain a low-stimulation environment
Administer chlordiazepoxide
Initiate seizure precautions
Perform a CIWA-Ar
Administer disulfiram:
Ans>>
Administer thiamine Maintain a low-stimulation
environment Administer chlordiazepoxide
Initiate seizure precautions
Perform a CIWA-Ar
-Nurse should plan interventions that keep the patient safe and treat the physical
manifestations of withdrawal. Use the CIWA-Ar to determine the severity of the withdrawal.
Withdrawal seizures can occur 12-24hrs after cessation of alcohol use, therefore initiate
seizure precautions to prevent injury. Administer chlordiazepox- ide (a benzodiazepine) and
place patient in a low-stim environment to decrease agitation and the risk for seizures.
Administering thiamine can prevent Wernicke syndrome.
6. NGN: A post-op patient is experiencing right lower extremity pain and itching,
following an emergent appy. Reports right lower extremity pain that has been
intermittent for x2 months.
,Assessment: Bilat lower extremities warm to touch, pedal pulses 2+ bilat. Spider veins
noted. Distended veins noted on right lower extremity. Vital signs are within normal
limits.
Bowtie:: Condition: Varicose veins.
-due to edema & pruritis
Interventions: Elevate extremity & apply compression stockings
-to promote venous return & circulation
Monitor: Pruritis & edema
7. NGN: Which assessment findings require an immediate follow-up in a schiz-
ophrenic patient?
,Hyperactive bowel sounds x4
Last HCP appointment was 6 months ago Client
AO x2
Agitated
Speech disorganized
Involuntary tongue movement and foot tremor Increase in
urination and one episode of incontinence
Family c/o increased agitation and delusions: Involuntary tongue movement and foot
tremor
Frequent urination and incontinence Increase in
agitation
-Patient is experiencing tardive dyskinesia
8. A home health nurse is evaluation a school-age child who has cystic fibro- sis. The
nurse should initiate a request for a high-frequency chest compres- sion vest in
response to which of the following parent statements?
A. "My child doesn't like to sit still for nebulizer treatments."
B. "I think that my child has been running a fever over the last couple of days."
C. "My child only has a small amount of mucus after percussion therapy."
D. "I am concerned about my child's future participation in team sports.": C. "My
child has only a small amount of mucus after percussion therapy."
-The nurse should recommend a high-frequency vest for a child who has inadequate results
from other airway clearance therapy techniques. Older children often require other techniques
in addition to percussion and postural drainage to achieve ade- quate mucus expectoration.
,-The nurse should teach the parent techniques for administration for nebulizer treatments to
the child.
-The nurse should follow-up on reports of fever, as this could indicate a pulmonary infection.
-The nurse should discuss participation in sports activities in relation to the child's current
physical and pulmonary health.
9. NGN: A patient who is x2 post-op, following a surgical repair of a left
hip fracture, is c/o of intermittent abdominal pain. Rates 5/10 on left side of
abdomen. Pain began after eating dinner. Last bowel movement was 5 days
, prior. Reports usual pattern is x1 daily.
Assessment: Abdomen distended, dull to percussion, firm and non-tender on
palpation. Hypoactive bowel sounds x4. Vital signs are within normal limits.
Bowtie:: Condition: Intestinal obstruction
-bowel sounds hypoactive x4, last BM was 5 days prior, intermittent to constant pain.
Interventions: Assist patient in semi-Fowler's & prepare to administer IV fluids.
-to relieve the pressure from the distention and reduce risk of developing fluid/elec- trolyte
imbalance.
Monitor: Bowel sounds & urine output.
10. A nurse is caring for a patient who has a new prescription for clonidine. The nurse
should inform the patient that which of the following findings is an adverse effect of
this medication?
A. Diarrhea
B. Dry mouth
C. Photophobia
D. Bruising: B. Dry mouth
-Clonidine is an indirect-acting anti-adrenergic agent used for HTN, severe pain, and ADD. Dry
mouth (or xerostomia) is common.
-Constipation, dry eyes, and rashes are common adverse effects.
