a nurse in the emergency department is caring for a client who reports intimate partner violence which of the following interventions is the nurses pr a nurse in the emergency department is caring for a client who reports intimate partner violence which of the following interventions is the nurses pr
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Nursing Elites

ATI RN

ATI Exit Exam 2024

1. A nurse in the emergency department is caring for a client who reports intimate partner violence. Which of the following interventions is the nurse's priority?

Correct answer: A

Rationale: The correct answer is to develop a safety plan with the client. In cases of intimate partner violence, the priority is to ensure the client's immediate safety. While referring the client to a community support group (choice B) and determining if the client has any injuries (choice C) are important interventions, ensuring the client's safety through a safety plan takes precedence. Contacting the client's family about the incident (choice D) may not be appropriate as it can further endanger the client.

2. The client is diagnosed with pericarditis. When assessing the client, the nurse is unable to auscultate a friction rub. Which action should the nurse implement?

Correct answer: C

Rationale: The correct action for the nurse to take when unable to auscultate a pericardial friction rub in a client diagnosed with pericarditis is to ask the client to lean forward and listen again. This position brings the heart closer to the chest wall, making it easier to detect a friction rub if present. Notifying the healthcare provider is not necessary at this point as it may just be a matter of positioning for better auscultation. Documenting that the pericarditis has resolved is premature without proper assessment. Preparing to insert a unilateral chest tube is not indicated based on the absence of a friction rub.

3. Which of the following statements describes an active cellular membrane exchange process?

Correct answer: A: Sodium moving out of cells and potassium moving into cells

Rationale: The correct answer is A. In active transport, energy is expended to move substances against their concentration gradient. Sodium moving out of cells and potassium moving into cells is an example of active transport because it requires energy to pump these ions across the cell membrane against their concentration gradients. Choices B, C, and D describe passive processes where substances move along their concentration gradients without the input of energy.

4. A nurse is teaching a patient about the use of raloxifene (Evista) for the prevention of osteoporosis. What is the primary therapeutic action of this medication?

Correct answer: B

Rationale: The correct answer is B. Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption and increasing bone density. This action helps in preventing osteoporosis by maintaining bone strength. Choice A is incorrect as raloxifene does not affect the absorption of calcium from the intestines. Choice C is incorrect as raloxifene does not increase the excretion of calcium through the kidneys. Choice D is incorrect as raloxifene does not directly stimulate the formation of new bone; instead, it primarily works by reducing bone loss.

5. A healthcare professional is assessing a client who is recovering from a lung biopsy. Which assessment finding requires immediate action?

Correct answer: B

Rationale: Absent breath sounds may indicate a pneumothorax, a serious complication post lung biopsy. This condition requires immediate attention to prevent respiratory distress.

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