ATI RN
ATI RN Exit Exam 2023
1. A client has deep vein thrombosis (DVT). Which of the following actions should the nurse take?
- A. Administer thrombolytics as prescribed.
- B. Massage the affected extremity every 2 hours.
- C. Apply warm compresses to the affected extremity.
- D. Place the client in a supine position with the legs elevated.
Correct answer: C
Rationale: The correct action for a nurse caring for a client with deep vein thrombosis (DVT) is to apply warm compresses to the affected extremity. Warm compresses help reduce swelling and pain in clients with DVT. Administering thrombolytics (Choice A) is not typically done without specific orders due to the risk of bleeding. Massaging the affected extremity (Choice B) can dislodge blood clots and lead to complications. Placing the client in a supine position with the legs elevated (Choice D) may increase the risk of clot dislodgment.
2. The client on warfarin has an INR of 1.2. What is the nurse’s priority action?
- A. Increase the dose of warfarin
- B. Administer vitamin K
- C. Monitor for signs of bleeding
- D. Hold the next dose and notify the healthcare provider
Correct answer: A
Rationale: The correct answer is to increase the dose of warfarin. An INR of 1.2 is below the therapeutic range for a client on warfarin, indicating that the dose is subtherapeutic. The priority action in this situation is to adjust the dose to achieve the target therapeutic INR range (usually 2-3) to prevent thromboembolic events. Administering vitamin K is not necessary as the INR is low, and there are no signs of bleeding. Monitoring for signs of bleeding is important but not the priority in this case since the INR is subtherapeutic. Holding the next dose and notifying the healthcare provider would delay the intervention needed to adjust the dose and achieve the therapeutic range.
3. A client has a new prescription for hydrochlorothiazide. Which of the following instructions should the nurse include?
- A. Take this medication at bedtime to prevent dizziness.
- B. Increase your intake of potassium-rich foods.
- C. Take this medication with food to prevent gastrointestinal upset.
- D. This medication can increase your blood pressure.
Correct answer: B
Rationale: The correct instruction that the nurse should include for a client prescribed hydrochlorothiazide is to increase their intake of potassium-rich foods. Hydrochlorothiazide is a diuretic that can lead to potassium depletion, so increasing potassium-rich foods helps prevent hypokalemia. Option A is incorrect because hydrochlorothiazide is usually taken in the morning to prevent diuresis at night. Option C is not necessary as hydrochlorothiazide can be taken with or without food. Option D is incorrect because hydrochlorothiazide is used to lower blood pressure, not increase it.
4. A nurse is evaluating the effectiveness of teaching regarding care of a child with minimal change nephrotic syndrome (MCNS) that is in remission after the administration of prednisone. The nurse realizes further teaching is required if the parents state what?
- A. We will keep our child away from anyone who is ill.
- B. We will be sure to administer the prednisone as ordered.
- C. We will encourage our child to eat a balanced diet, but we will watch his salt intake.
- D. We understand our child will not be able to attend school, so we will arrange for homeschooling.
Correct answer: D
Rationale: Children with MCNS who are in remission can usually attend school and participate in normal activities with precautions to avoid infections. Home schooling may not be necessary, and this indicates a misunderstanding of the condition's management.
5. A client with type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?
- A. I'll take this medicine with my meals.
- B. I'll take this medicine 30 minutes before I eat.
- C. I'll take this medicine just before I go to bed.
- D. I'll take this medicine as soon as I wake up in the morning.
Correct answer: B
Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. To ensure the insulin is available when food is digested, the client should take this medication 30 minutes before each meal. This timing aligns the medication with the expected postprandial rise in blood glucose levels, optimizing its effectiveness in controlling blood sugar levels. Choices A, C, and D are incorrect because taking Repaglinide with meals, just before bed, or as soon as waking up does not align with the medication's mechanism of action and timing needed for optimal effectiveness.
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