ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation
1. A home care nurse prepares to administer intravenous medication to a client. The nurse assesses the site and reviews the clients chart prior to administering the medication: Client: Thomas Jackson DOB: 5/3/1936 Gender: Male January 23 (Today): Right uppe
- A. Notify the health care provider
- B. . Administer the prescribed medication.
- C. Discontinue the PICC
- D. Switch the medication to the oral route
Correct answer: . Administer the prescribed medication.
Rationale:
2. When Mateo was born prematurely to Yvonne, a cocaine addict, what can his caregivers expect?
- A. He will be very attentive to the environment
- B. His cries will be abnormally shrill and piercing
- C. He will overcome the harmful effects of drug exposure by age 3
- D. His motor development will be especially rapid during the first year
Correct answer: B
Rationale: Mateo, being born prematurely to a cocaine-addicted mother, is at risk for several health issues. One common effect of prenatal drug exposure is a higher likelihood of sensory and regulatory problems, such as having abnormally shrill and piercing cries. This is a potential outcome that Mateo's caregivers can expect due to his circumstances. Choice A is incorrect as there is no direct correlation between being born prematurely to a cocaine-addicted mother and being very attentive to the environment. Choice C is incorrect as overcoming harmful effects of drug exposure by age 3 is overly optimistic and may not be the case for all children exposed to drugs prenatally. Choice D is incorrect as rapid motor development is not typically associated with prenatal drug exposure.
3. Which information would indicate more teaching is needed regarding hypersensitivity reactions? Type _______ hypersensitivity reactions involve an antibody response.
- A. I
- B. II
- C. III
- D. IV
Correct answer: D
Rationale: The correct answer is D: Type IV hypersensitivity reactions involve cell-mediated immunity, not an antibody response. This question tests knowledge of hypersensitivity reactions and their classification. Type I hypersensitivity reactions involve IgE antibodies, Type II involves IgG or IgM antibodies, and Type III involves immune complex deposition. Type IV hypersensitivity reactions are delayed and involve T cells, not antibodies. Therefore, if a person believes that Type IV hypersensitivity reactions involve an antibody response, more teaching is required.
4. 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.
5. The caregiver is teaching a parent of a young child with a newly diagnosed seizure disorder. The child is prescribed valproic acid (Depakote) for control of seizures. Which parental statement indicates the need for further education?
- A. I will not use carbonated beverages to dilute his medication.
- B. I will give his medication with food to minimize gastrointestinal upset.
- C. I will not let him chew his tablet.
- D. I will bring him to the physician's office for regular blood work to check his blood levels.
Correct answer: B
Rationale: The correct answer is B. Valproic acid should be administered with food to reduce the risk of gastrointestinal upset. Giving it on an empty stomach may increase the likelihood of adverse effects. The other statements are correct: A - Carbonated beverages should not be used to dilute the medication, C - The tablet should not be chewed, and D - Regular blood work is necessary to monitor valproic acid levels and potential side effects.
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