ATI RN
ATI Exit Exam 180 Questions Quizlet
1. A nurse is caring for a client who has Raynaud's disease. Which of the following actions should the nurse take?
- A. Provide information about stress management.
- B. Maintain a warm temperature in the client's room.
- C. Administer epinephrine for acute episodes.
- D. Give glucocorticoid steroids twice a day.
Correct answer: A
Rationale: Corrected Rationale: Providing information about stress management is essential when caring for a client with Raynaud's disease because stress can trigger episodes. Stress management techniques can help the client avoid triggers and reduce the frequency of episodes. Choice B is incorrect because maintaining a warm temperature, rather than a cool one, helps prevent vasoconstriction and can be beneficial for clients with Raynaud's disease. Choice C is incorrect because epinephrine is not a standard treatment for Raynaud's disease; it is more commonly used for severe allergic reactions. Choice D is incorrect because glucocorticoid steroids are not typically used in the management of Raynaud's disease.
2. A healthcare professional is preparing to administer an intermittent enteral feeding to a client who has an NG tube. Which of the following actions should the healthcare professional take first?
- A. Check the residual volume.
- B. Flush the tube with 0.9% sodium chloride.
- C. Elevate the head of the bed to 45 degrees.
- D. Warm the formula to body temperature.
Correct answer: C
Rationale: Elevating the head of the bed to 45 degrees is the priority action before administering an enteral feeding through an NG tube. This position helps prevent aspiration by promoting proper flow and digestion of the feeding. Checking the residual volume, flushing the tube, and warming the formula are important steps but come after ensuring the client is in the correct position to minimize the risk of complications.
3. A nurse is caring for a client who is receiving enteral feedings through a nasogastric tube. Which of the following findings should the nurse report to the provider?
- A. Gastric residual of 200 mL or more
- B. pH of gastric contents is 5.0
- C. Bowel sounds are present in all quadrants
- D. Temperature 37.5°C (99.5°F)
Correct answer: A
Rationale: The correct answer is A. A gastric residual of 200 mL or more indicates delayed gastric emptying, which can be a sign of potential complications such as aspiration or intolerance to the enteral feedings. This finding should be reported to the healthcare provider for further evaluation and possible intervention. Choices B, C, and D are within normal limits and do not require immediate reporting. A pH of 5.0 is normal for gastric contents, bowel sounds in all quadrants indicate normal gastrointestinal motility, and a temperature of 37.5°C (99.5°F) is within the normal range.
4. A nurse is teaching a client about self-administration of enoxaparin. Which of the following instructions should the nurse include?
- A. Administer the injection into the muscle of your thigh.
- B. Pinch the skin before inserting the needle.
- C. Rub the injection site after administering the medication.
- D. Administer the injection into the fat tissue of your abdomen.
Correct answer: D
Rationale: The correct instruction for self-administration of enoxaparin is to inject it into the fat tissue of the abdomen for proper absorption. Choice A is incorrect as enoxaparin should not be injected into the muscle. Choice B is unnecessary for enoxaparin administration. Choice C is incorrect as rubbing the injection site after administering the medication is not recommended.
5. A nurse is providing discharge teaching to a client who is postoperative following a hip arthroplasty. Which of the following statements indicates a need for further teaching?
- A. I will avoid sitting in a recliner while recovering.
- B. I will bend at the waist to pick up items from the floor.
- C. I will use a pillow between my legs when lying on my side.
- D. I will avoid crossing my legs when sitting.
Correct answer: B
Rationale: The correct answer is B. Bending at the waist can increase the risk of dislocation following hip arthroplasty. This movement can put strain on the hip joint and potentially lead to complications. Choices A, C, and D are all correct statements that promote proper postoperative care and help prevent complications. Sitting in a recliner, using a pillow between the legs when lying on the side, and avoiding crossing legs when sitting are all appropriate instructions for a client recovering from hip arthroplasty.
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