ATI RN
ATI RN Custom Exams Set 1
1. The nurse is caring for a client in a sickle cell crisis. Which is the pain regimen of choice to relieve the pain?
- A. Frequent aspirin (acetylsalicylic acid) and a non-narcotic analgesic
- B. Motrin (ibuprofen), an NSAID, PRN
- C. Demerol (meperidine), a narcotic analgesic, every four (4) hours
- D. Morphine, a narcotic analgesic, every two (2) to three (3) hours PRN
Correct answer: D
Rationale: In a sickle cell crisis, morphine is the preferred analgesic due to its potency and effectiveness in managing severe pain. Choice A is incorrect because aspirin is contraindicated in sickle cell disease due to its potential to cause a further decrease in blood flow. Choice B, Motrin (ibuprofen), is also not the ideal choice as NSAIDs can exacerbate renal complications in sickle cell patients. Choice C, Demerol (meperidine), is not recommended for sickle cell pain management due to its toxic metabolite accumulation which can cause seizures and other complications.
2. A nurse is providing discharge teaching to a client following a heart transplant. Which of the following information should the nurse include in the teaching?
- A. Immunosuppressant medications need to be taken for up to 1 year
- B. Shortness of breath might be an indication of transplant rejection
- C. The surgical site will heal in 3 to 4 weeks after surgery
- D. Begin 45 minutes of moderate aerobic exercise per day following discharge
Correct answer: B
Rationale: The correct answer is B. Shortness of breath is an important sign of transplant rejection. Other manifestations of rejection include fatigue, edema, bradycardia, and hypotension. Choices A, C, and D are incorrect because: A) Immunosuppressant medications are typically required for life, not just up to 1 year. C) The surgical site healing time can vary and may take longer than 3 to 4 weeks. D) Starting a specific exercise regimen should be individualized and guided by healthcare providers; a general recommendation like 45 minutes of exercise per day may not be suitable for all heart transplant recipients.
3. Which of the following is an indication for tracheostomy?
- A. Drainage of pleural effusion
- B. Hemorrhage
- C. Infections
- D. Acute respiratory failure
Correct answer: D
Rationale: Tracheostomy is a surgical procedure where an incision is made in the windpipe to help with breathing. Acute respiratory failure, which can occur due to various reasons such as upper airway obstruction, is a common indication for tracheostomy. While drainage of pleural effusion, hemorrhage, and infections may require medical intervention, they are not direct indications for a tracheostomy like acute respiratory failure.
4. A nurse is caring for a client who has cancer and is receiving total parenteral nutrition (TPN). Which of the following lab values indicates the treatment is effective?
- A. Hct 43%
- B. WBC 8,000/uL
- C. Albumin 4.2 g/dL
- D. Calcium 9.4 mg/dL
Correct answer: Albumin 4.2 g/dL
Rationale: The correct answer is Albumin 4.2 g/dL. Albumin is a protein produced by the liver and is a key indicator of nutritional status. In a client receiving total parenteral nutrition (TPN), an increase in albumin level indicates that the treatment is effective in providing adequate nutrition support. Hct (hematocrit), WBC (white blood cell count), and calcium levels are not direct indicators of the effectiveness of TPN in this context.
5. A client has a central venous catheter. Which of the following actions should be taken to prevent an air embolism?
- A. Keep the catheter clamped when not in use
- B. Have the client perform the Valsalva maneuver while the catheter is removed
- C. Use a non-coring needle to access the catheter
- D. Flush the catheter with 0.9% sodium chloride every 24 hours
Correct answer: B
Rationale: The correct action to prevent an air embolism in a client with a central venous catheter is to have the client perform the Valsalva maneuver while the catheter is removed. This maneuver helps to close the airway and prevent air from entering the bloodstream. Keeping the catheter clamped at all times (Choice A) is not necessary and may lead to clot formation. Using a non-coring needle (Choice C) is important for accessing the catheter but does not specifically prevent air embolism. Flushing the catheter with 0.9% sodium chloride (Choice D) helps maintain patency but does not directly prevent air embolism.