ATI COMPREHENSIVE EXIT EXAM
l l l
(NGN ATI)l
(Detailed Exam Prep Solutions and Resources f
l l l l l l
or the test in 2024) l l l l
1. Treatlfirstlanylimmediatelthreatsltolalpatient'slsurvivallorlsafety.
Ex.lobstructedlairway,llossloflconsciousness,lpsychologicallepisodelorlanxietylattack.lA
BC's.
2. Next,ltreatlactuallproblems.lEx.lnausea,lfulllbowellorlbladder,lcomfortlmeasures.
3. Then,ltreatlrelativelylurgentlactuallorlpotentiallproblemslthatlthelpatientlorlfamilyldoeslnotlrecogni
ze.lEx.lMonitoringlforlpost-
oplcomplications,lanticipatinglteachinglneedsloflalpatientlthatlmaylbelunawareloflsideleffectsloflmeds.
4. Lastly,ltreatlactuallorlpotentiallproblemslwherelhelplmaylbelneededlinlthelfuture.
ExlTeachinglforlself-carelinlthelhome.
Herelarelsomelgreatlprinciplesltolhelplyoulaslyoulprioritize:
,SystemiclbeforellocallA
cutelbeforelchroniclAct
uallbeforelpotentiallList
enldon'tlassume
Recognizelfirstlthenlapplylclinicallknowledgel
Maslow'slHierarchyloflNeeds:
PrioritizelaccordingltolMaslowlwithlphysiologicallandlsafetylissueslbeforelpsychologicallesteemliss
ues.
Variantlanginal(Prinzmetal'slangina)
Dueltolalcoronarylarterylspasm,lofteningloccurringlduringlperiodsloflrest.
Unstablelangina
Occurslwithlexerciselorlemotionallstress,lbutlitlincreaseslinloccurrence,lseverity,landldurationlove
rltime.
Stablelangina
Occurslwithlexerciselorlemotionallstresslandlislrelievedlbylrestlorlnitroglycerinl(Nitrostat).
electrolytelimbalancelmanifestations:lh
ypocakelmia-->lflatlTlwaveslonlECG
hypercalcemia--
>ldecreasedldeepltendonlreflexesl(DTRs)lhypocalcemia--
>ltetany
hyperkalemia-->ltalllpeakedlTlwaveslonlECG
Addison'sldisease
Decreasedlaldosteronelandlrenin
Hypothyroidism
Decreasedltriiodothyroninel(T3)landlthyroxine
,Cushing'sldiseasel
Elevatedlcortisol
DiabeteslInsipidusl(DI)lDecrease
dlurinelspecificlgravity
Diabeteslmelitus
Elevatedlglycosylatedlhemoglobinl(HbA1c)
SyndromeloflInappropriatelSecretionloflAntidiureticlHormonelI
ncreasedlurinelosmolality
Cataract
Progressivelandlpainlessllossloflvision
Angle-
closurelglaucomalRapidlonse
tloflelevatedlIOP
macularldegenerationl
Centralllossloflvision
Open-
anglelgalucomalLossloflp
eripherallvision
Retinalldetachment
Suddenllossloflvisionlwithoutlpain
Commonldisease'slmanifestationsl
Cholecystitis-->lMurphy'slsign
Pancreatitis-->lTurner'slsign
PepticlUlcerlDisease-->lUpperlepigastriclpainl1-
2lhourslafterlmealslAppendicits-->lPainlatlMcBurney'slpoint
Decorticate
, Decerebrate
Hepatitisldiseaseltransmissions
HepatitislA--
>lIngestionslolcontaminatedlfood/waterlHepatitislB--
>lUnprotectedlsexuallcontact
NonvirallHepatits-->lDrugltoxicity
HeartlFailure
Symptoms:lShortnessloflbreath,lfatigue,ljugularlveinldistention,landlanlS3larelsigns/symptomsloflhear
tlfailurelresultinglfromltheldecreasedlpumpinglabilityloflthelheartlandlincreasedlfluidlvolume.
Hypovolemiclshock
position:lSupinelwithllegslelevatedl(shocklposition)
Below-the-kneelamputation
Position:lThelclientlshouldlbelplacedlinlthelpronelpositionlseveralltimeslaldayltolpreventlhiplflexi
onlcontractions.
Chestltube
-
Continuouslbublinglinlthelwaterlseallchamperslindicateslanlairlleak.lIflthislislobserved,lthelnurselsho
uldlattemptltollocatedlthelsourceloflthelairlleaklandlintervenelaccordinglyl(tightenlthelconnections,lr
eplaceldrainagelsystem)
Compartmentlsyndrome
Symptoms:lPulselessnessl(latelsign),lIncreasedlpainlunrelievedlwithlelevationlorlbylpainlme
dication
Leftlhomonymouslhemianopsia
hasllostlthelleftlvisuallfieldloflbothleyes.lTheylarelunableltolvisualizelanythingltolthelleftloflmidli
neloflthelbody.
dialysislfistula
clientlteaching:lavoidlliftinglheavylobjectslwithlaccess-
sitelarm,lavoidlcarryinglobjectslthatlcompresslthelextremity,lavoidlsleepinglonltoploflthelextremityl
withlthelaccessldevice,lperform
l l l
(NGN ATI)l
(Detailed Exam Prep Solutions and Resources f
l l l l l l
or the test in 2024) l l l l
1. Treatlfirstlanylimmediatelthreatsltolalpatient'slsurvivallorlsafety.
Ex.lobstructedlairway,llossloflconsciousness,lpsychologicallepisodelorlanxietylattack.lA
BC's.
2. Next,ltreatlactuallproblems.lEx.lnausea,lfulllbowellorlbladder,lcomfortlmeasures.
3. Then,ltreatlrelativelylurgentlactuallorlpotentiallproblemslthatlthelpatientlorlfamilyldoeslnotlrecogni
ze.lEx.lMonitoringlforlpost-
oplcomplications,lanticipatinglteachinglneedsloflalpatientlthatlmaylbelunawareloflsideleffectsloflmeds.
4. Lastly,ltreatlactuallorlpotentiallproblemslwherelhelplmaylbelneededlinlthelfuture.
ExlTeachinglforlself-carelinlthelhome.
Herelarelsomelgreatlprinciplesltolhelplyoulaslyoulprioritize:
,SystemiclbeforellocallA
cutelbeforelchroniclAct
uallbeforelpotentiallList
enldon'tlassume
Recognizelfirstlthenlapplylclinicallknowledgel
Maslow'slHierarchyloflNeeds:
PrioritizelaccordingltolMaslowlwithlphysiologicallandlsafetylissueslbeforelpsychologicallesteemliss
ues.
Variantlanginal(Prinzmetal'slangina)
Dueltolalcoronarylarterylspasm,lofteningloccurringlduringlperiodsloflrest.
Unstablelangina
Occurslwithlexerciselorlemotionallstress,lbutlitlincreaseslinloccurrence,lseverity,landldurationlove
rltime.
Stablelangina
Occurslwithlexerciselorlemotionallstresslandlislrelievedlbylrestlorlnitroglycerinl(Nitrostat).
electrolytelimbalancelmanifestations:lh
ypocakelmia-->lflatlTlwaveslonlECG
hypercalcemia--
>ldecreasedldeepltendonlreflexesl(DTRs)lhypocalcemia--
>ltetany
hyperkalemia-->ltalllpeakedlTlwaveslonlECG
Addison'sldisease
Decreasedlaldosteronelandlrenin
Hypothyroidism
Decreasedltriiodothyroninel(T3)landlthyroxine
,Cushing'sldiseasel
Elevatedlcortisol
DiabeteslInsipidusl(DI)lDecrease
dlurinelspecificlgravity
Diabeteslmelitus
Elevatedlglycosylatedlhemoglobinl(HbA1c)
SyndromeloflInappropriatelSecretionloflAntidiureticlHormonelI
ncreasedlurinelosmolality
Cataract
Progressivelandlpainlessllossloflvision
Angle-
closurelglaucomalRapidlonse
tloflelevatedlIOP
macularldegenerationl
Centralllossloflvision
Open-
anglelgalucomalLossloflp
eripherallvision
Retinalldetachment
Suddenllossloflvisionlwithoutlpain
Commonldisease'slmanifestationsl
Cholecystitis-->lMurphy'slsign
Pancreatitis-->lTurner'slsign
PepticlUlcerlDisease-->lUpperlepigastriclpainl1-
2lhourslafterlmealslAppendicits-->lPainlatlMcBurney'slpoint
Decorticate
, Decerebrate
Hepatitisldiseaseltransmissions
HepatitislA--
>lIngestionslolcontaminatedlfood/waterlHepatitislB--
>lUnprotectedlsexuallcontact
NonvirallHepatits-->lDrugltoxicity
HeartlFailure
Symptoms:lShortnessloflbreath,lfatigue,ljugularlveinldistention,landlanlS3larelsigns/symptomsloflhear
tlfailurelresultinglfromltheldecreasedlpumpinglabilityloflthelheartlandlincreasedlfluidlvolume.
Hypovolemiclshock
position:lSupinelwithllegslelevatedl(shocklposition)
Below-the-kneelamputation
Position:lThelclientlshouldlbelplacedlinlthelpronelpositionlseveralltimeslaldayltolpreventlhiplflexi
onlcontractions.
Chestltube
-
Continuouslbublinglinlthelwaterlseallchamperslindicateslanlairlleak.lIflthislislobserved,lthelnurselsho
uldlattemptltollocatedlthelsourceloflthelairlleaklandlintervenelaccordinglyl(tightenlthelconnections,lr
eplaceldrainagelsystem)
Compartmentlsyndrome
Symptoms:lPulselessnessl(latelsign),lIncreasedlpainlunrelievedlwithlelevationlorlbylpainlme
dication
Leftlhomonymouslhemianopsia
hasllostlthelleftlvisuallfieldloflbothleyes.lTheylarelunableltolvisualizelanythingltolthelleftloflmidli
neloflthelbody.
dialysislfistula
clientlteaching:lavoidlliftinglheavylobjectslwithlaccess-
sitelarm,lavoidlcarryinglobjectslthatlcompresslthelextremity,lavoidlsleepinglonltoploflthelextremityl
withlthelaccessldevice,lperform