ATI RN
ATI Exit Exam 180 Questions Quizlet
1. 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.
2. 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.
3. A client with diabetes mellitus is experiencing hypoglycemia. Which of the following findings should the nurse expect?
- A. Polyuria
- B. Warm, dry skin
- C. Irritability
- D. Hyperventilation
Correct answer: C
Rationale: Irritability is a common finding in clients with hypoglycemia due to decreased glucose levels in the brain. Polyuria (excessive urination) is not typically associated with hypoglycemia, but rather with hyperglycemia. Warm, dry skin is not a typical finding in hypoglycemia; instead, the skin may be cool and clammy. Hyperventilation is not a common finding in hypoglycemia; instead, shallow breathing or difficulty breathing may occur.
4. A nurse is reviewing the laboratory results of a client who has Cushing's disease. The nurse should expect an increase in which of the following laboratory values?
- A. Serum glucose level
- B. Serum potassium level
- C. Serum calcium level
- D. Serum sodium level
Correct answer: A
Rationale: The correct answer is A: Serum glucose level. In Cushing's disease, there is increased cortisol production, leading to elevated blood glucose levels. This occurs due to the role of cortisol in promoting gluconeogenesis and insulin resistance. Choices B, C, and D are incorrect because Cushing's disease is not typically associated with alterations in serum potassium, calcium, or sodium levels.
5. A nurse is preparing to insert an IV catheter for a client. Which of the following actions should the nurse take?
- A. Apply a tourniquet above the insertion site
- B. Shave the area around the insertion site
- C. Insert the catheter at a 15-degree angle
- D. Use an 18-gauge needle for insertion
Correct answer: C
Rationale: The correct answer is to insert the catheter at a 15-degree angle. This angle allows for easier venous access by ensuring proper catheter placement into the vein. Applying a tourniquet above the insertion site can help distend the vein for better visualization but is not the immediate action required for the insertion process. Shaving the area around the insertion site is not necessary unless there is excessive hair that may interfere with the insertion. Using an 18-gauge needle for insertion is a specific detail related to the equipment rather than the technique of insertion.
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