ATI RN
ATI RN Comprehensive Exit Exam 2023
1. What is the primary nursing intervention for a patient experiencing hypoglycemia?
- A. Administer IV fluids
- B. Check blood sugar levels
- C. Provide oral glucose
- D. Recheck blood sugar levels in 15 minutes
Correct answer: D
Rationale: The correct answer is to recheck blood sugar levels in 15 minutes. This intervention is crucial to ensure that the hypoglycemia has been effectively corrected after the initial treatment. Administering IV fluids may be necessary in cases of severe dehydration but is not the primary intervention for hypoglycemia. Checking blood sugar levels is important, but the primary intervention should focus on treating the low blood sugar levels first, which is done by providing oral glucose. However, the most critical step after providing initial treatment is to recheck blood sugar levels to confirm that they have improved to safe levels.
2. A nurse is providing discharge instructions to a client who is postoperative following a total hip arthroplasty. Which of the following client statements indicates a need for further teaching?
- A. I will avoid crossing my legs when sitting.
- B. I will use a raised toilet seat.
- C. I will sleep on my affected side.
- D. I will perform leg exercises every hour while awake.
Correct answer: C
Rationale: The correct answer is C. Sleeping on the affected side could increase the risk of dislocation following a hip arthroplasty. It is essential for the client to avoid sleeping on the surgical side to prevent complications. Choices A, B, and D are correct statements that promote proper postoperative care and reduce the risk of complications. Avoiding crossing legs when sitting, using a raised toilet seat for proper positioning, and performing leg exercises regularly help in the recovery process and prevent complications.
3. Which lab value is most critical to monitor in a patient receiving insulin therapy?
- A. Monitor blood glucose
- B. Monitor potassium levels
- C. Monitor calcium levels
- D. Monitor sodium levels
Correct answer: A
Rationale: The correct answer is to monitor blood glucose levels. When a patient is receiving insulin therapy, it is crucial to monitor blood glucose levels regularly to prevent hypoglycemia, a potential side effect of insulin therapy. Monitoring potassium, calcium, or sodium levels is important for different medical conditions or treatments and is not directly related to insulin therapy.
4. A nurse is reviewing the laboratory results of a client who is receiving warfarin therapy for atrial fibrillation. Which of the following laboratory values should the nurse report to the provider?
- A. INR 1.8
- B. Hemoglobin 14 g/dL
- C. Platelets 175,000/mm³
- D. Potassium 3.8 mEq/L
Correct answer: A
Rationale: The correct answer is A. An INR of 1.8 is below the therapeutic range for a client receiving warfarin, indicating a potential risk of blood clots. This value should be reported to the provider for further evaluation and possible adjustment of the warfarin dosage. Choices B, C, and D are within normal ranges and do not directly relate to the effectiveness or safety of warfarin therapy in this scenario, making them less urgent to report.
5. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the therapy?
- A. Serum calcium
- B. Blood glucose
- C. Serum protein
- D. Serum albumin
Correct answer: D
Rationale: The correct answer is D, Serum albumin. Serum albumin levels are a good indicator of the nutritional effectiveness of total parenteral nutrition (TPN). Monitoring serum albumin levels helps assess the client's overall protein status and nutritional adequacy. Choices A, B, and C are not direct indicators of the effectiveness of TPN therapy. Serum calcium levels may be affected by other factors, blood glucose monitoring is more relevant for clients with diabetes or those receiving insulin therapy, and serum protein is not as specific as serum albumin in evaluating TPN effectiveness.
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