ATI RN
ATI Exit Exam 180 Questions Quizlet
1. A nurse is assessing a newborn who has a blood glucose level of 30 mg/dl. Which of the following manifestations should the nurse expect?
- A. Loose stools.
- B. Jitteriness.
- C. Hypertonia.
- D. Abdominal distention.
Correct answer: B
Rationale: Corrected Rationale: Jitteriness is a common manifestation of hypoglycemia in newborns. Choice A, 'Loose stools,' is not typically associated with hypoglycemia in newborns. Choice C, 'Hypertonia,' is not a common manifestation of hypoglycemia in newborns; instead, hypotonia may be observed. Choice D, 'Abdominal distention,' is not a typical manifestation of hypoglycemia in newborns.
2. A nurse is caring for a client who is 36 hours postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?
- A. Heart rate of 92/min
- B. Serosanguineous wound drainage
- C. Yellow wound drainage
- D. Blood pressure of 118/76 mm Hg
Correct answer: C
Rationale: Yellow wound drainage can indicate infection, especially 36 hours postoperative, and should be reported to the provider promptly. Serosanguineous drainage is a normal finding in the early stages of wound healing, and a heart rate of 92/min and a blood pressure of 118/76 mm Hg are within normal ranges for a postoperative client. Therefore, the nurse should prioritize reporting the yellow wound drainage as it may require immediate intervention.
3. A nurse is caring for a client with deep vein thrombosis who is prescribed warfarin. Which of the following client statements indicates a need for further teaching?
- A. I will avoid vitamin K-rich foods.
- B. I will avoid using aspirin while on this medication.
- C. I will monitor my blood pressure regularly.
- D. I will increase my intake of leafy greens.
Correct answer: D
Rationale: The correct answer is D. Warfarin's effectiveness is reduced by high intake of vitamin K-rich foods, so increasing their intake would contradict the treatment plan. Choices A, B, and C are all appropriate statements for a client on warfarin therapy. Avoiding vitamin K-rich foods helps maintain the medication's effectiveness, avoiding aspirin reduces the risk of bleeding, and monitoring blood pressure is essential for overall health monitoring.
4. A client has a new prescription for digoxin. Which of the following statements should the nurse include?
- A. You should take this medication on an empty stomach.
- B. You should avoid taking this medication with antacids.
- C. Take your pulse before taking this medication.
- D. You should contact your provider if you experience visual changes.
Correct answer: C
Rationale: The correct statement for the nurse to include when teaching a client about digoxin is to 'Take your pulse before taking this medication.' This is essential because clients taking digoxin need to monitor their pulse to detect signs of bradycardia, a common adverse effect of the medication. Option A is incorrect because digoxin is usually recommended to be taken with food to avoid gastrointestinal upset. Option B is incorrect because antacids can interfere with the absorption of digoxin. Option D is incorrect because contacting the provider for visual changes is important, but monitoring the pulse is crucial for digoxin administration.
5. A nurse is assessing a client who is receiving enteral nutrition via a nasogastric tube. Which of the following findings should the nurse report to the provider?
- A. Gastric pH of 2.5.
- B. Bowel sounds every 4 hours.
- C. Diarrhea of 250 mL in 24 hours.
- D. Gastric residual of 150 mL.
Correct answer: D
Rationale: A gastric residual of 150 mL may indicate delayed gastric emptying and should be reported to the provider.
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