ATI RN
ATI Exit Exam
1. A charge nurse is teaching a group of nurses about delegation. Which task should the nurse delegate to assistive personnel (AP)?
- A. Teaching a new mother how to breastfeed.
- B. Assisting a client with ambulation post-surgery.
- C. Helping with medication administration.
- D. Delegating IV medication administration.
Correct answer: B
Rationale: The correct answer is B. Assisting a client with ambulation post-surgery is a task that can be appropriately delegated to assistive personnel (AP) as it falls within their scope of duties. Teaching a new mother how to breastfeed and helping with medication administration involve assessments and critical thinking that are typically within the scope of licensed nursing staff, not AP. Delegating IV medication administration involves a higher level of skill and knowledge that should be performed by licensed nursing staff.
2. The nurse is caring for a patient with an advanced stage of breast cancer and the patient has recently learned that her cancer has metastasized. The nurse enters the room and finds the patient struggling to breathe and the nurse’s rapid assessment reveals that the patient’s jugular veins are distended. The nurse should suspect the development of what oncologic emergency?
- A. Increased intracranial pressure
- B. Superior vena cava syndrome (SVCS)
- C. Spinal cord compression
- D. Metastatic tumor of the neck
Correct answer: B
Rationale: Superior vena cava syndrome (SVCS) occurs when the superior vena cava, the large vein responsible for returning blood from the upper body to the heart, becomes obstructed or compressed, often due to a tumor, such as metastasized breast cancer. SVCS results in impaired venous drainage, leading to symptoms like distended jugular veins, facial swelling, difficulty breathing (dyspnea), and upper body edema. It is a medical emergency that requires prompt intervention to restore blood flow and alleviate symptoms.
3. A nurse is caring for a client who has Raynaud's disease. Which action should the nurse take?
- A. Provide information about stress management.
- B. Maintain a warm temperature in the client's room.
- C. Administer epinephrine for acute episodes.
- D. Give glucocorticoid steroids twice a day.
Correct answer: A
Rationale: The correct action for the nurse to take when caring for a client with Raynaud's disease is to provide information about stress management. Raynaud's disease is a condition where the blood vessels narrow in response to cold or stress, leading to reduced blood flow to certain areas of the body, usually the fingers and toes. Stress management helps reduce triggers for Raynaud's disease by minimizing emotional stress, which can trigger vasospasms. Choice B is incorrect as maintaining a warm temperature, rather than a cool one, is recommended for individuals with Raynaud's disease to prevent triggering vasospasms. Choice C is incorrect because epinephrine is not typically used to manage Raynaud's disease, as it can further constrict blood vessels. Choice D is incorrect as glucocorticoid steroids are not a first-line treatment for Raynaud's disease.
4. What classification of drug is Penicillin?
- A. Antiarrhythmic
- B. Anticonvulsant
- C. Antibacterial
- D. Mood stabilizer
Correct answer: C
Rationale: Penicillin is classified as an antibacterial drug, specifically used to treat bacterial infections. It works by inhibiting the growth of bacteria, making it an effective treatment for various bacterial infections. Choices A, B, and D are incorrect as Penicillin does not belong to these drug classifications. Penicillin does not have any direct effect on heart rhythm (antiarrhythmic), does not treat seizures (anticonvulsant), and is not used to stabilize mood (mood stabilizer).
5. How should the nurse manage the client's pain if a client with a history of substance abuse is requesting pain medication?
- A. Administer the medication as requested
- B. Assess the patient's pain level first
- C. Administer a placebo to the client
- D. Refuse to give any medication to the client
Correct answer: B
Rationale: When a client with a history of substance abuse requests pain medication, the nurse should first assess the patient's pain level. It is important to determine the nature and intensity of the pain before administering any medication to ensure appropriate pain management. Administering medication without assessing the pain level can lead to unnecessary drug administration or inadequate pain relief. Administering a placebo would be unethical and ineffective. Refusing to give any medication without proper assessment can compromise the client's comfort and recovery. Therefore, the correct approach is to assess the patient's pain level first before deciding on the most suitable pain management intervention.
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