ATI RN Comprehensive Predictor Exam
Pediatric Nursing (Santa Fe College)
1. The nurse is calculating intake and output on a patient. The patient drinks 150 mL of
orange juice at breakfast, voids 125 mL after breakfast, vomits 250 mL of greenish fluid,
sucks on 60 mL of ice chips, and for lunch consumes 75 mL of chicken broth. Which totals
for intake and output will the nurse document in the patient’s medical record?
a. Intake 255; output 375
b. Intake 285; output 375
c. Intake 505; output 125
d. Intake 535; output 125
Answer: A
Rationale:
Intake = 150 mL of orange juice, 60 mL of ice chips (but only counts as 30 since ice chips are
half of the amount), and 75 mL of chicken broth; 150 + 30 + 75 = 255. Output = 125 mL of
urine (void) and 250 mL of vomitus; 125 + 250 = 375.
2. A nurse is assessing a patient. Which assessment finding should cause a nurse to further
assess for extracellular fluid volume deficit?
a. Moist mucous membranes
b. Postural hypotension
c. Supple skin turgor
d. Pitting edema
Answer: B
Rationale:
Physical examination findings of deficit include postural hypotension, tachycardia, thready
pulse, dry mucous membranes, and poor skin turgor. Pitting edema indicates that the patient
may be retaining excess extracellular fluid.
3. A patient is to receive 1000 mL of 0.9% sodium chloride intravenously at a rate of 125
mL/hr. The nurse is using microdrip gravity drip tubing. Which rate will the nurse calculate
for the minute flow rate (drops/min)?
a. 12 drops/min
b. 24 drops/min
c. 125 drops/min
d. 150 drops/min
Answer: C
Rationale:
Microdrip tubing delivers 60 drops/mL. Calculation for a rate of 125 mL/hr using microdrip
tubing: (125 mL/1 hr)(60 drops/1 mL)(1 hr/60 min) = 125 drop/min.
4. A nurse begins infusing a 250-mL bag of IV fluid at 1845 on Monday and programs the
pump to infuse at 50 mL/hr. At what time should the infusion be completed?
a. 2300 Monday
b. 2345 Monday
c. 0015 Tuesday
d. 0045 Tuesday
Answer: B
Rationale:
250 mL ÷ 50 mL/hr = 5 hr
1845 + 5 hr = 2345, which would be 2345 on Monday.
5. A nurse is caring for a diabetic patient with a bowel obstruction and has orders to ensure
that the volume of intake matches the output. In the past 4 hours, the patient received
dextrose 5% with 0.9% sodium chloride through a 22-gauge catheter infusing at 150 mL/hr
and has eaten 200 mL of ice chips.
The patient also has an NG suction tube set to low continuous suction that had 300-mL
output. The patient has voided 400 mL of urine. After reporting these values to the health care
provider, which order does the nurse anticipate?
a. Add a potassium supplement to replace loss from output.
b. Decrease the rate of intravenous fluids to 100 mL/hr. 205
c. Administer a diuretic to prevent fluid volume excess.
d. Discontinue the nasogastric suctioning.
Answer: A
Rationale:
The total fluid intake and output equals 700 mL, which meets the provider goals. Patients
with nasogastric suctioning are at risk for potassium deficit, so the nurse would anticipate a
potassium supplement to correct this condition. Remember to record half the volume of ice
chips when calculating intake. The other measures would be unnecessary because the net
fluid volume is equal.
6. A nurse is caring for a patient who is receiving peripheral intravenous (IV) therapy. When
the nurse is flushing the patient’s peripheral IV, the patient reports pain. Upon assessment, the
nurse notices a red streak that is warm to the touch. What is the nurse’s initial action?
a. Record a phlebitis grade of 4.
b. Assign an infiltration grade.
c. Apply moist compress.
d. Discontinue the IV.
Answer: D
Rationale:
The IV site has phlebitis. The nurse should discontinue the IV. The phlebitis score is 3. The
site has phlebitis, not infiltration. A moist compress may be needed after the IV is
discontinued.
