ATI RN
ATI Exit Exam RN
1. How should fluid balance be assessed in a patient with heart failure?
- A. Monitor daily weight
- B. Monitor input and output
- C. Check for edema
- D. Monitor blood pressure
Correct answer: A
Rationale: In patients with heart failure, monitoring daily weight is the most accurate method for assessing fluid balance. Weight gain can indicate fluid retention, a common issue in heart failure patients. Monitoring input and output (B) is essential but may not always accurately reflect fluid balance. Checking for edema (C) is important as it can indicate fluid accumulation, but daily weight monitoring is more precise. Monitoring blood pressure (D) is important in heart failure management but does not directly assess fluid balance.
2. A client has a prescription for digoxin. Which of the following instructions should the nurse include?
- A. Take this medication with food.
- B. Avoid taking antacids at the same time as this medication.
- C. Take this medication if your heart rate is above 100/min.
- D. Notify your provider if you experience nausea or visual changes.
Correct answer: D
Rationale: The correct instruction the nurse should include for a client prescribed digoxin is to notify the provider if they experience nausea or visual changes, as these symptoms can indicate digoxin toxicity. Option A is incorrect because digoxin should be taken on an empty stomach for better absorption. Option B is incorrect as antacids can interfere with the absorption of digoxin. Option C is incorrect as taking digoxin based on heart rate alone is not appropriate.
3. A nurse is caring for a client who is postoperative following a bowel resection. Which of the following findings should the nurse report to the provider?
- A. Bowel sounds present in all four quadrants
- B. Temperature of 37.5°C (99.5°F)
- C. Scant urine output
- D. Serosanguineous wound drainage
Correct answer: D
Rationale: The correct answer is D: 'Serosanguineous wound drainage.' Serosanguineous drainage should be reported in postoperative clients as it may indicate complications such as infection or impaired wound healing. Options A, B, and C are expected findings in a postoperative client. Bowel sounds present in all four quadrants indicate normal gastrointestinal function, a temperature of 37.5°C (99.5°F) is within the normal range, and scant urine output may be expected initially due to factors like anesthesia and fluid shifts postoperatively.
4. A healthcare provider is reviewing laboratory results for a client who is receiving heparin therapy. Which of the following results indicates that the medication is effective?
- A. Platelets 250,000/mm³
- B. aPTT 60 seconds
- C. Hemoglobin 15 g/dL
- D. INR 1.5
Correct answer: B
Rationale: An aPTT of 60 seconds indicates that the client is receiving an effective dose of heparin. The activated partial thromboplastin time (aPTT) measures the time it takes for blood to clot and is used to monitor heparin therapy. A therapeutic range for aPTT during heparin therapy is usually 1.5 to 2 times the control value, which is around 25-35 seconds. Platelets, hemoglobin, and INR values are not direct indicators of the effectiveness of heparin therapy.
5. How should fluid overload in a patient with heart failure be managed?
- A. Administer diuretics
- B. Increase fluid intake
- C. Provide oral fluids
- D. Provide chest physiotherapy
Correct answer: A
Rationale: Administering diuretics is the appropriate management for fluid overload in a patient with heart failure. Diuretics help to reduce fluid retention by increasing urine output, thereby alleviating the fluid overload. Choices B, C, and D are incorrect. Increasing fluid intake would worsen the condition by adding more fluid to an already overloaded system. Providing oral fluids is not specific enough to address the excess fluid in the body, and chest physiotherapy is not indicated for managing fluid overload in heart failure patients.
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