ATI RN
ATI RN Exit Exam
1. A nurse is planning care for a client who has pneumonia. Which of the following interventions should the nurse include to promote airway clearance?
- A. Encourage the client to increase fluid intake.
- B. Suction the client every 2 hours.
- C. Perform chest physiotherapy every 8 hours.
- D. Administer oxygen via nasal cannula.
Correct answer: A
Rationale: Encouraging the client to increase fluid intake is essential to promote airway clearance in pneumonia. Adequate hydration helps to thin respiratory secretions, making them easier to expectorate. Suctioning every 2 hours may be too frequent and can lead to airway trauma and irritation. Chest physiotherapy is not typically indicated for pneumonia unless there are specific complications. Administering oxygen via nasal cannula may be necessary to maintain oxygen saturation but does not directly promote airway clearance.
2. What is the best intervention for a patient presenting with respiratory distress?
- A. Administer oxygen
- B. Administer bronchodilators
- C. Reposition the patient
- D. Provide humidified air
Correct answer: A
Rationale: Administering oxygen is the most critical intervention for a patient in respiratory distress as it helps improve oxygenation levels. Oxygen therapy aims to increase oxygen saturation in the blood, providing relief and support during episodes of respiratory distress. Administering bronchodilators may be beneficial in some cases, but oxygen therapy takes precedence in addressing the underlying issue of inadequate oxygenation. Repositioning the patient may help optimize ventilation but does not directly address the primary need for increased oxygen. Providing humidified air can offer comfort but does not address the urgent need for improved oxygen levels in a patient experiencing respiratory distress.
3. How should a healthcare professional prepare a patient for a colonoscopy?
- A. Provide clear instructions on diet
- B. Explain the procedure in detail
- C. Ensure the patient has an empty stomach
- D. Give a bowel prep solution
Correct answer: D
Rationale: Giving a bowel prep solution is essential to clean out the colon thoroughly before a colonoscopy. This process is crucial as it helps to achieve a clear view of the colon during the procedure. Providing clear instructions on diet (Choice A) and ensuring the patient has an empty stomach (Choice C) are important steps in the preparation process but may not be sufficient on their own to adequately cleanse the colon. Explaining the procedure in detail (Choice B) is helpful for patient education but does not directly contribute to the physical preparation required for a successful colonoscopy.
4. A nurse is providing teaching to a client who has type 1 diabetes mellitus about foot care. Which of the following instructions should the nurse include?
- A. Soak your feet in warm water daily.
- B. Wear cotton socks.
- C. Trim your toenails straight across.
- D. Apply lotion to your feet after bathing.
Correct answer: C
Rationale: The correct answer is C: 'Trim your toenails straight across.' Trimming toenails straight across helps prevent ingrown toenails, which is important for clients with diabetes to prevent infections. Choice A is incorrect because soaking feet in warm water can lead to skin breakdown and infections. Choice B is incorrect as cotton socks can retain moisture, increasing the risk of fungal infections. Choice D is also incorrect as applying lotion between the toes can create a moist environment, increasing the risk of infections.
5. What is the most important nursing action when a patient experiences a fall?
- A. Assess the patient for injuries
- B. Call for help
- C. Document the fall
- D. Notify the healthcare provider
Correct answer: A
Rationale: The most important nursing action when a patient experiences a fall is to assess the patient for injuries. This is critical to identify any potential harm or underlying issues that may require immediate attention. Calling for help and notifying the healthcare provider are important steps, but assessing the patient's condition takes precedence to ensure prompt and appropriate care. Documenting the fall is also necessary but should follow the initial assessment and care provided to the patient.
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