ATI RN
ATI Comprehensive Exit Exam 2023
1. A nurse is caring for a client who has a prescription for enoxaparin. Which of the following actions should the nurse take?
- A. Inject the medication into the deltoid muscle
- B. Inject the medication deep into subcutaneous tissue
- C. Massage the injection site for 2 minutes after administration
- D. Insert the needle at a 10-degree angle
Correct answer: B
Rationale: The correct action the nurse should take when administering enoxaparin is to inject the medication deep into subcutaneous tissue. This method helps ensure proper absorption of the medication and prevents tissue irritation. Injecting into the deltoid muscle (Choice A) is not recommended for enoxaparin administration. Massaging the injection site (Choice C) can lead to tissue damage and bruising. Inserting the needle at a 10-degree angle (Choice D) is not the correct technique for administering enoxaparin.
2. A nurse is planning to administer a blood transfusion to a client. Which of the following should the nurse do to prevent an adverse transfusion reaction?
- A. Verify the client's blood type with the provider's prescription
- B. Ensure the client's consent for the transfusion is on file
- C. Administer a diuretic prior to starting the transfusion
- D. Check the client's temperature prior to the transfusion
Correct answer: A
Rationale: The correct answer is to verify the client's blood type with the provider's prescription. This is crucial to prevent an adverse transfusion reaction due to incompatibility. Ensuring the blood type matches before starting the transfusion is a standard safety practice. Option B, ensuring client consent, is important but not directly related to preventing a transfusion reaction. Option C, administering a diuretic, is unnecessary and can be harmful in this context. Option D, checking the client's temperature, is important for general assessment but not specifically focused on preventing a transfusion reaction.
3. A nurse is caring for a client who has depression and reports taking St. John's wort along with citalopram. The nurse should monitor the client for which of the following conditions as a result of an interaction between these substances?
- A. Serotonin syndrome
- B. Tardive dyskinesia
- C. Pseudo-parkinsonism
- D. Acute dystonia
Correct answer: A
Rationale: The correct answer is A: Serotonin syndrome. When a client takes St. John's wort, a herbal supplement, along with citalopram, a selective serotonin reuptake inhibitor (SSRI), there is a risk of developing serotonin syndrome. Serotonin syndrome is a potentially life-threatening condition characterized by symptoms such as confusion, agitation, fever, sweating, shivering, tremors, muscle rigidity, and in severe cases, seizures and coma. It is crucial for the nurse to monitor the client for these symptoms. Choices B, C, and D are incorrect because tardive dyskinesia is associated with long-term use of antipsychotic medications, pseudo-parkinsonism is a side effect of antipsychotic medications like haloperidol, and acute dystonia is a side effect of antipsychotic medications characterized by sustained muscle contractions.
4. A client with a new diagnosis of Crohn's disease is receiving teaching from a nurse. Which statement by the client demonstrates an understanding of the teaching?
- A. I should eat more fiber to help with my bowel movements.
- B. I will need to have routine colonoscopies to monitor my condition.
- C. I will limit my intake of whole grains.
- D. I should consume a low-fat diet.
Correct answer: B
Rationale: The correct answer is B. Clients with Crohn's disease require routine colonoscopies to monitor disease progression and complications. This helps healthcare providers assess the status of the disease and make informed treatment decisions. Choice A is incorrect because while fiber may be beneficial for some digestive conditions, it can exacerbate symptoms in Crohn's disease. Choice C is incorrect as whole grains can be a good source of nutrients unless they individually trigger symptoms in the client. Choice D is also incorrect since a low-fat diet is not a specific requirement for managing Crohn's disease.
5. A nurse is reviewing the medical record of a client who is scheduled for surgery. Which of the following findings should the nurse report to the provider?
- A. Client reports taking warfarin
- B. Client has a history of hypertension
- C. Client ate a light breakfast 2 hours prior
- D. Client reports a history of smoking 10 cigarettes a day
Correct answer: A
Rationale: The correct answer is A. Warfarin is an anticoagulant that increases the risk of bleeding during surgery. It is crucial for the provider to be informed about the client taking warfarin to adjust the treatment plan accordingly. Choices B, C, and D are not as critical to report for surgical planning. A history of hypertension (B) is important but may not require immediate intervention for surgery. Eating a light breakfast 2 hours prior (C) is a normal preoperative instruction. Smoking history (D) is relevant for overall health assessment but is not as urgent as the use of warfarin before surgery.
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