ATI RN
ATI RN Exit Exam Quizlet
1. A nurse is assessing a client who is receiving furosemide for heart failure. Which of the following findings is the priority to report to the provider?
- A. Blood pressure of 98/58 mm Hg
- B. Urine output of 50 mL/hr
- C. Serum potassium level of 3.2 mEq/L
- D. Weight loss of 0.5 kg (1.1 lb) in 24 hours
Correct answer: C
Rationale: The correct answer is C. A serum potassium level of 3.2 mEq/L indicates hypokalemia, a potential complication of furosemide therapy, and should be reported immediately. Hypokalemia can lead to serious cardiac dysrhythmias. Choices A, B, and D are important assessments but are not as critical as managing serum potassium levels in a client receiving furosemide for heart failure.
2. A nurse is preparing an in-service for a group of nurses about malpractice issues in nursing. Which of the following examples should the nurse include in the teaching?
- A. Leaving a nasogastric tube clamped after administering oral medication.
- B. Documenting communication with a provider in the progress notes of the client's medical records.
- C. Administering potassium via IV bolus.
- D. Placing a yellow bracelet on a client who is at risk for falls.
Correct answer: C
Rationale: Administering potassium via IV bolus is a malpractice issue due to the risk of cardiac complications. Option A is incorrect as leaving a nasogastric tube clamped after administering oral medication can lead to complications but is not directly linked to malpractice. Option B is incorrect as documenting communication with a provider in the progress notes is a necessary part of nursing practice. Option D is incorrect as placing a yellow bracelet on a client at risk for falls is a safety measure to prevent falls and is not related to malpractice issues.
3. A nurse is planning care for a group of clients. Which of the following clients should the nurse plan to assess first?
- A. A client who has a fractured femur and reports feeling short of breath.
- B. A client who is postoperative and has abdominal distention.
- C. A client who is receiving IV fluids and has a temperature of 38.5°C (101.3°F).
- D. A client who has cancer and has been receiving radiation therapy.
Correct answer: A
Rationale: The correct answer is A. A client with a fractured femur and reports feeling short of breath is at risk for a fat embolism, which is a medical emergency. The nurse should assess this client first to rule out this serious complication. Choice B may indicate paralytic ileus, which is important but not immediately life-threatening compared to a fat embolism. Choice C has a fever, which indicates infection but is not as urgent as a potential fat embolism. Choice D, a client receiving radiation therapy, is not experiencing an acute, life-threatening complication that requires immediate assessment compared to a fat embolism.
4. A nurse is assessing a client who is experiencing auditory hallucinations. What question should the nurse ask?
- A. Do you understand the voices are not real?
- B. Why do you think the voices are talking to you?
- C. Have you tried going to a quiet place when this occurs?
- D. What helps you ignore the voices?
Correct answer: D
Rationale: Exploring strategies to ignore the hallucinations can help clients manage symptoms.
5. A nurse is assessing a client who is 2 hours postoperative following a gastrectomy. Which of the following findings should the nurse report to the provider?
- A. Heart rate of 94/min
- B. Oxygen saturation of 88%
- C. Respiratory rate of 18/min
- D. Temperature of 37.6°C (99.7°F)
Correct answer: B
Rationale: An oxygen saturation of 88% indicates hypoxemia, which is a serious condition post-gastrectomy. Hypoxemia can lead to inadequate oxygen delivery to tissues, potentially causing complications like organ dysfunction or failure. This finding requires immediate attention to prevent further deterioration. The heart rate, respiratory rate, and temperature are within normal ranges for a client post-gastrectomy, so they do not require immediate reporting to the provider.
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