ATI RN
ATI Exit Exam 2023
1. A client with heart failure is receiving digoxin. Which of the following findings should the nurse report to the provider?
- A. Heart rate of 78/min.
- B. Vision changes.
- C. Respiratory rate of 16/min.
- D. Blood pressure of 120/80 mm Hg.
Correct answer: B
Rationale: The correct answer is B: Vision changes. Vision changes are a classic sign of digoxin toxicity and should be reported immediately to the provider for further evaluation and management. A heart rate of 78/min, a respiratory rate of 16/min, and a blood pressure of 120/80 mm Hg are within normal ranges and are not typically associated with digoxin toxicity. Therefore, they would not be the priority findings to report in this situation.
2. A client has a prescription for gentamicin for the treatment of an infection. Which finding indicates a potential adverse reaction to the medication?
- A. Blood pressure 160/90 mm Hg
- B. Presence of red blood cells in the urine
- C. Urine output of 35 mL/hr
- D. Respiratory rate of 22/min
Correct answer: B
Rationale: The presence of red blood cells in the urine can indicate nephrotoxicity, which is a potential adverse effect of gentamicin. Gentamicin can cause damage to the kidneys, leading to the presence of red blood cells in the urine as a sign of renal impairment. Monitoring for this finding is crucial to detect and manage adverse reactions promptly. High blood pressure (Choice A) is not typically associated with gentamicin use. Low urine output (Choice C) is more suggestive of kidney injury rather than nephrotoxicity specifically related to gentamicin. Respiratory rate (Choice D) is not a common indicator of adverse reactions to gentamicin.
3. A technique used to eliminate negative behavior by ignoring the behavior is known as __________.
- A. Punishment
- B. Extinction
- C. Shaping
- D. Equity
Correct answer: B
Rationale: The correct answer is B, 'Extinction.' Extinction is a behavioral psychology technique where undesirable behavior is ignored, leading to its eventual decrease or elimination. This process involves withholding reinforcement that was previously maintaining the behavior. Choice A, 'Punishment,' involves applying negative consequences to reduce unwanted behavior, which is different from extinction. Choice C, 'Shaping,' is a method of gradually molding or reinforcing behaviors to reach a desired behavior, not ignoring negative behavior. Choice D, 'Equity,' refers to fairness and equal treatment, which is unrelated to eliminating negative behavior through ignoring it.
4. A patient has developed a decubitus ulcer on the coccyx. What defense mechanism is most affected by this homeostatic change?
- A. The mucous membrane is affected.
- B. The respiratory tract is affected.
- C. The skin is affected.
- D. The gastrointestinal tract is affected.
Correct answer: C
Rationale: In this scenario, a decubitus ulcer on the coccyx indicates a breakdown of the skin's integrity due to prolonged pressure. The skin is the primary defense mechanism of the body against external pathogens. When the skin is compromised, it can lead to infections and other complications. The mucous membrane (Choice A) plays a role in protecting internal surfaces, not the skin. The respiratory tract (Choice B) is involved in breathing and not directly related to the skin's defense. The gastrointestinal tract (Choice D) is responsible for digestion and absorption of nutrients, not the primary defense mechanism against external threats like the skin.
5. A nurse is assessing a client who has a chest tube. Which of the following findings should the nurse report to the provider?
- A. Constant bubbling in the water seal chamber.
- B. Intermittent bubbling in the suction control chamber.
- C. Tidaling in the water seal chamber.
- D. Drainage of 75 mL in the first 24 hours.
Correct answer: A
Rationale: The correct answer is A: Constant bubbling in the water seal chamber. Constant bubbling in the water seal chamber can indicate an air leak, which compromises the integrity of the chest tube system and should be reported to the provider for immediate intervention. Choices B, C, and D are incorrect. Intermittent bubbling in the suction control chamber is an expected finding indicating that the system is working appropriately. Tidaling in the water seal chamber is a normal fluctuation of fluid level with inspiration and expiration, indicating that the system is functioning correctly. Drainage of 75 mL in the first 24 hours is within the expected range for chest tube drainage and does not require immediate reporting unless accompanied by other concerning symptoms.
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