ATI RN
ATI Fundamentals Proctored Exam Quizlet
1. A healthcare professional is providing information about tuberculosis to a group of clients at a local community center. Which of the following manifestations should the professional NOT include in the teaching?
- A. Persistent cough
- B. Weight gain
- C. Fatigue
- D. Night sweats
Correct answer: B
Rationale: Weight gain is not a typical manifestation of tuberculosis. The characteristic symptoms of tuberculosis include a persistent cough, fatigue, and night sweats. Weight loss, not weight gain, is a common symptom associated with tuberculosis due to the impact of the infection on the body's metabolism. Therefore, the healthcare professional should exclude weight gain from the teaching on tuberculosis manifestations.
2. In the emergency department, a nurse is assessing a client involved in a motor vehicle crash. Findings include absent breath sounds in the left lower lobe with dyspnea, blood pressure 118/68 mm Hg, heart rate 124/min, respirations 38/min, temperature 38.6 C (101.4 F), and SaO2 92% on room air. What action should the nurse take first?
- A. Obtain a chest X-ray.
- B. Prepare for chest tube insertion.
- C. Administer oxygen via high-flow mask.
- D. Initiate IV access.
Correct answer: C
Rationale: In this scenario, the client is presenting with signs of respiratory distress, including absent breath sounds, dyspnea, and a low SaO2 level. The priority action should be to improve oxygenation by administering oxygen via a high-flow mask. This intervention aims to increase the oxygen supply to the client's lungs, helping to address the hypoxemia. Once oxygenation is optimized, further interventions, such as obtaining a chest X-ray, preparing for chest tube insertion, or initiating IV access, can be considered based on the client's condition and healthcare provider's orders.
3. A client experiencing acute dyspnea and diaphoresis reports anxiety and difficulty breathing. Vital signs include HR 117/min, respirations 38/min, temperature 38.4 C (101.2 F), and blood pressure 100/54 mm Hg. What should the nurse prioritize?
- A. Notify the provider.
- B. Administer heparin via IV infusion.
- C. Administer oxygen therapy.
- D. Obtain a spiral CT scan.
Correct answer: C
Rationale: In a client with acute dyspnea, diaphoresis, tachycardia, tachypnea, fever, and hypotension, the priority is to ensure adequate oxygenation. Administering oxygen therapy helps improve oxygenation levels and stabilize the client's condition. This intervention takes precedence over notifying the provider, administering heparin, or obtaining a CT scan, as oxygen therapy addresses the client's immediate need for respiratory support.
4. A client has a new prescription for heparin therapy. Which of the following statements by the client should indicate an immediate concern for the nurse?
- A. ''I am allergic to morphine.''
- B. ''I take antacids several times a day.''
- C. ''I had a blood clot in my leg several years ago.''
- D. ''It hurts to take a deep breath.''
Correct answer: B
Rationale: The correct answer is the statement 'I take antacids several times a day.' Antacids can alter the absorption of heparin, potentially affecting its effectiveness and increasing the risk of clot formation. This is a significant concern as it can impact the therapeutic outcome of heparin therapy. The other statements are not directly related to potential complications or interactions with heparin therapy.
5. A client has a new diagnosis of tuberculosis and has been placed on a multi-medication regimen. Which of the following instructions should the nurse give the client related to ethambutol?
- A. Your urine can turn a dark orange.
- B. Watch for a change in the sclera of your eyes.
- C. Watch for any changes in vision.
- D. Take vitamin B6 daily.
Correct answer: C
Rationale: Ethambutol is associated with potential vision changes, including optic neuritis. Patients should be instructed to report any visual disturbances immediately to prevent permanent vision loss. Monitoring for changes in vision is crucial to detect any adverse effects early on and prevent serious complications.
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