ATI RN
ATI Exit Exam 180 Questions Quizlet
1. A nurse in an emergency department is assessing a client who reports ingesting thirty diazepam tablets and has a respiratory rate of 10/min. After securing the client's airway and initiating an IV, which of the following actions should the nurse do next?
- A. Monitor the client's IV site for thrombophlebitis
- B. Administer flumazenil to the client
- C. Evaluate the client for further suicidal behavior
- D. Initiate seizure precautions for the client
Correct answer: B
Rationale: Administering flumazenil is the priority to reverse the effects of diazepam overdose. Monitoring the IV site for thrombophlebitis (choice A) is important but not the next immediate action. Evaluating the client for further suicidal behavior (choice C) is important but not the priority at this moment. Initiating seizure precautions (choice D) is not the priority action in this scenario.
2. 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.
3. A nurse is caring for a child who has cystic fibrosis and is receiving postural drainage. Which of the following actions should the nurse take?
- A. Perform the procedure after meals.
- B. Administer bronchodilators before the procedure.
- C. Hold hand flat to perform percussion.
- D. Perform the procedure twice a day.
Correct answer: C
Rationale: The correct action the nurse should take when caring for a child with cystic fibrosis receiving postural drainage is to hold the hand flat to perform percussion. This technique allows for effective chest physiotherapy. Choice A is incorrect because postural drainage should be performed before meals to prevent vomiting during the procedure. Choice B is incorrect because bronchodilators are typically administered before postural drainage to help open up the airways. Choice D is incorrect as the frequency of postural drainage may vary depending on the individual's condition, so performing it twice a day may not be appropriate for all patients.
4. A nurse is providing discharge teaching to a client following a colon resection and a new colostomy. What dietary advice should the nurse provide?
- A. Avoid foods that are high in protein.
- B. Consume foods high in fiber and low in fat.
- C. Eat foods high in vitamin C to promote healing.
- D. Avoid all raw vegetables.
Correct answer: B
Rationale: The correct answer is B: Consume foods high in fiber and low in fat. Following a colon resection and a new colostomy, a high-fiber, low-fat diet is recommended to promote healing and reduce the risk of complications. Foods high in fiber help maintain bowel regularity and prevent constipation, which is crucial after this type of surgery. Choices A, C, and D are incorrect because avoiding foods high in protein, consuming foods high in vitamin C, or avoiding all raw vegetables are not the most appropriate dietary advice in this situation.
5. A client is receiving morphine for pain management. Which of the following findings should the nurse report to the provider?
- A. Heart rate of 88/min
- B. Pain rating of 4 on a scale of 0 to 10
- C. Respiratory rate of 10/min
- D. Temperature of 37.2°C (99°F)
Correct answer: C
Rationale: A respiratory rate of 10/min indicates respiratory depression, a serious adverse effect of morphine that should be reported immediately. While a heart rate of 88/min, pain rating of 4, and a temperature of 37.2°C (99°F) are within normal ranges and do not indicate immediate concern related to morphine administration.
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