ATI RN
ATI Exit Exam 180 Questions Quizlet
1. A patient is scheduled to receive a transfusion of packed RBCs. Which of the following actions should the nurse take?
- A. Prime IV tubing with 0.9% sodium chloride
- B. Use a 24-gauge IV catheter
- C. Obtain filterless IV tubing
- D. Place blood in the warmer for 1 hour
Correct answer: A
Rationale: Priming the IV tubing with 0.9% sodium chloride is crucial before administering packed RBCs as it prevents hemolysis and ensures the safe transfusion of blood. Using a smaller 20- to 22-gauge IV catheter is recommended for packed RBCs to prevent hemolysis due to the small tubing size and faster flow rate. Obtaining filterless IV tubing is incorrect as blood products should be administered through a specialized filter to prevent potential clots or contaminants from reaching the patient. Placing blood in the warmer for an hour is unnecessary and could lead to overheating, potentially causing harm to the patient.
2. A healthcare professional is preparing to administer digoxin to a client with heart failure. Which of the following laboratory values should the professional report to the provider?
- A. Potassium 4.0 mEq/L
- B. Calcium 9.5 mg/dL
- C. Sodium 140 mEq/L
- D. Magnesium 2.0 mg/dL
Correct answer: C
Rationale: The correct answer is C: Sodium 140 mEq/L. An elevated sodium level can affect the effectiveness of digoxin therapy and may lead to toxicity. Therefore, it is crucial to report this value to the provider. Potassium, calcium, and magnesium levels are important as well, but elevated sodium can have a more direct impact on digoxin therapy in this scenario.
3. A healthcare professional is reviewing the medical record of a client who has a new prescription for enoxaparin. Which of the following findings should the healthcare professional report to the provider?
- A. Platelet count 150,000/mm³
- B. aPTT 30 seconds
- C. Sodium 140 mEq/L
- D. Serum creatinine 3.0 mg/dL
Correct answer: D
Rationale: An elevated serum creatinine level indicates impaired kidney function, which can affect the metabolism and excretion of enoxaparin, potentially leading to increased drug levels and risk of bleeding. Therefore, it is crucial to report a high serum creatinine level before administering enoxaparin. Platelet count, aPTT, and sodium levels are not directly related to the administration of enoxaparin and would not impact its use; hence, they do not need to be reported before starting the medication.
4. A nurse is caring for a client who is 12 hours postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?
- A. Serosanguineous drainage on the surgical dressing.
- B. Respiratory rate of 16/min.
- C. Heart rate of 90/min.
- D. WBC count of 15,000/mm3.
Correct answer: D
Rationale: A WBC count of 15,000/mm3 is elevated, which may indicate infection, a common concern postoperatively. An elevated WBC count suggests the body is fighting an infection, and prompt reporting to the provider is essential for further evaluation and treatment. Serosanguineous drainage on the surgical dressing is expected in the immediate postoperative period, respiratory rate of 16/min is within the normal range, and a heart rate of 90/min is also within an acceptable range postoperatively. Therefore, these findings do not raise immediate concerns that necessitate reporting to the provider.
5. A client who is postpartum requests information about contraception. Which of the following instructions should the nurse include?
- A. The lactation amenorrhea method is effective for the first year postpartum.
- B. You should not use the diaphragm used before your pregnancy.
- C. Apply the transdermal birth control patch on your upper arm.
- D. Avoid using vaginal spermicides while breastfeeding.
Correct answer: D
Rationale: The correct answer is to advise the client to avoid using vaginal spermicides while breastfeeding. This instruction is important as spermicides can potentially affect the milk supply and cause irritation. Choice A is incorrect because the effectiveness of the lactation amenorrhea method diminishes after the first six months postpartum. Choice B is incorrect as using the diaphragm used before pregnancy may not fit properly due to changes in the body postpartum. Choice C is incorrect as the transdermal birth control patch is typically applied to the abdomen, buttocks, or upper torso, not specifically the upper arm.
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