ATI RN
ATI Comprehensive Exit Exam 2023
1. A nurse is caring for a client who has a new prescription for metformin. Which of the following findings in the client's medical history should the nurse report to the provider?
- A. History of hypertension
- B. History of polycystic ovary syndrome
- C. History of asthma
- D. History of kidney disease
Correct answer: D
Rationale: The correct answer is D, history of kidney disease. Metformin should be used with caution in clients with kidney disease due to the risk of lactic acidosis, a serious complication. Reporting this finding to the provider is crucial for assessing the appropriateness of continuing metformin therapy. Choices A, B, and C do not contraindicate the use of metformin, so they are not the priority for reporting.
2. A nurse is caring for a client who has a new prescription for metformin. Which of the following instructions should the nurse include?
- A. Take this medication on an empty stomach.
- B. You should avoid eating foods high in potassium.
- C. You should take this medication with meals to improve absorption.
- D. Take this medication before bed to prevent drowsiness.
Correct answer: C
Rationale: The correct instruction for a client prescribed metformin is to take the medication with meals to improve absorption and reduce gastrointestinal upset. Metformin is typically recommended to be taken with food to minimize side effects. Option A is incorrect as taking metformin on an empty stomach may increase the risk of gastrointestinal side effects. Option B is unrelated as metformin does not interact with potassium-rich foods. Option D is also incorrect as metformin does not cause drowsiness, so there is no need to take it before bed.
3. A nurse in an emergency department is assessing a newly admitted client who is experiencing drooling and hoarseness following a burn injury. Which of the following actions should the nurse take first?
- A. Obtain a baseline ECG
- B. Obtain a blood specimen for ABG analysis
- C. Insert an 18-gauge IV catheter
- D. Administer 100% humidified oxygen
Correct answer: D
Rationale: In a client experiencing drooling and hoarseness following a burn injury, the priority action for the nurse is to administer 100% humidified oxygen. This is crucial to maintain the airway and address respiratory distress, which takes precedence over obtaining an ECG, collecting blood for ABG analysis, or inserting an IV catheter. Providing oxygen therapy is essential in ensuring the client's oxygenation and respiratory function are optimized in this emergency situation.
4. A healthcare provider is reviewing the laboratory report of a client with a prescription for digoxin. Which result requires withholding the medication?
- A. Digoxin 0.8 ng/mL
- B. Sodium 145 mEq/L
- C. BUN 20 mg/dL
- D. Potassium 3.1 mEq/L
Correct answer: D
Rationale: The correct answer is D. A low potassium level (3.1 mEq/L) can increase the risk of digoxin toxicity. Hypokalemia can potentiate the effects of digoxin on the heart, leading to serious dysrhythmias. Choices A, B, and C are within normal ranges and do not indicate a need to withhold digoxin.
5. A client post-thyroidectomy reports tingling in their lips and fingers. The nurse should identify this finding as an indication of which of the following complications?
- A. Hypokalemia
- B. Hypocalcemia
- C. Hyponatremia
- D. Hyperglycemia
Correct answer: B
Rationale: Tingling in the lips and fingers is a classic sign of hypocalcemia, which can occur as a complication following a thyroidectomy due to inadvertent damage to the parathyroid glands that regulate calcium levels. Hypokalemia (Choice A) presents with muscle weakness and cardiac issues, not tingling. Hyponatremia (Choice C) typically manifests with confusion, seizures, and muscle cramps. Hyperglycemia (Choice D) is associated with increased thirst, frequent urination, and fatigue.
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