ATI RN
ATI RN Comprehensive Exit Exam
1. A client is receiving heparin therapy. Which of the following laboratory results indicates the client is receiving an effective dose of heparin?
- A. INR 1.5
- B. aPTT 60 seconds
- C. Platelets 150,000/mm³
- D. Potassium 4.0 mEq/L
Correct answer: B
Rationale: An aPTT of 60 seconds indicates the client is receiving an effective dose of heparin. The activated partial thromboplastin time (aPTT) measures the time it takes for a clot to form, and a therapeutic range for heparin therapy is usually 1.5 to 2 times the control value, which is around 60-80 seconds. An INR of 1.5 is not related to heparin therapy, as it is commonly used to monitor warfarin therapy. Platelet count and potassium levels are not direct indicators of the effectiveness of heparin therapy.
2. What is the priority nursing action for a patient with confusion post-surgery?
- A. Administer oxygen
- B. Reposition the patient
- C. Check oxygen saturation
- D. Perform a neurological exam
Correct answer: A
Rationale: The correct answer is to administer oxygen. Post-surgery, confusion in a patient could be due to hypoxia, a condition where the body is deprived of an adequate oxygen supply. Administering oxygen helps address hypoxia promptly, improving oxygen levels in the body and potentially resolving the confusion. Repositioning the patient, checking oxygen saturation, and performing a neurological exam may be important interventions but addressing hypoxia with oxygen administration takes precedence as the priority action.
3. What is the most important nursing action for a patient post-surgery?
- A. Monitor vital signs
- B. Monitor the surgical site
- C. Check blood pressure
- D. Check oxygen saturation
Correct answer: A
Rationale: The most crucial nursing action for a patient post-surgery is to monitor vital signs. Monitoring vital signs helps in detecting early signs of complications such as hemorrhage, shock, or infection. While monitoring the surgical site is important for assessing wound healing and signs of infection, it is secondary to monitoring vital signs. Checking blood pressure and oxygen saturation are also important, but they are components of monitoring vital signs.
4. What is the first intervention for a patient experiencing anaphylactic shock?
- A. Administer epinephrine
- B. Administer oxygen
- C. Administer corticosteroids
- D. Administer antihistamines
Correct answer: A
Rationale: The correct answer is to administer epinephrine. Epinephrine is the first-line treatment for anaphylactic shock as it helps reverse the severe allergic reaction by constricting blood vessels, increasing heart rate, and opening airways for improved breathing. Oxygen (Choice B) can be administered after epinephrine to support oxygenation. Corticosteroids (Choice C) may be used to prevent a biphasic reaction but are not the initial intervention. Antihistamines (Choice D) can help with itching and hives but do not address the life-threatening symptoms of anaphylaxis.
5. How should a healthcare professional handle a patient who is refusing to take a prescribed medication?
- A. Immediately give the medication
- B. Assess the reasons for refusal
- C. Document refusal
- D. Explore alternative treatment options
Correct answer: B
Rationale: Assessing the reasons for refusal is crucial as it allows the healthcare professional to understand the patient's concerns, which can range from fear of side effects to cost issues. By identifying the underlying reasons, the healthcare professional can tailor their approach to address these specific concerns, potentially improving medication adherence. Giving the medication immediately (Choice A) without understanding the patient's reasons for refusal can lead to further non-compliance. While documenting refusal (Choice C) is important for legal and tracking purposes, it does not directly address the patient's concerns. Exploring alternative treatment options (Choice D) may be considered after understanding the reasons for refusal, but it is not the initial step in managing medication refusal.
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