ATI RN
ATI Fundamentals
1. A client has global aphasia affecting both receptive and expressive language abilities. Which intervention should NOT be included in the client's care plan?
- A. Speak to the client at a slower rate.
- B. Assist the client in using flash cards with pictures.
- C. Speak to the client in a loud voice.
- D. Give instructions one step at a time.
Correct answer: C: Speak to the client in a loud voice.
Rationale: Individuals with global aphasia have difficulty understanding and expressing language. Speaking loudly may not improve comprehension and can be perceived as aggressive. Therefore, it is important not to speak loudly to a client with global aphasia. Speaking at a slower rate, using visual aids like flash cards, and breaking down instructions into simple steps can facilitate communication and understanding for the client.
2. A nurse in the PACU is caring for a client who has received general anesthesia and has a manifestation of malignant hyperthermia. The nurse should expect to administer which of the following medications?
- A. Acetaminophen
- B. Ibuprofen
- C. Dantrolene
- D. Diazepam
Correct answer: C
Rationale: Corrected Rationale: Dantrolene is the medication of choice to treat malignant hyperthermia, a life-threatening reaction to general anesthesia. It works by inhibiting the release of calcium ions in skeletal muscle cells, preventing muscle contracture and hypermetabolism. Acetaminophen (Choice A) and ibuprofen (Choice B) are not indicated for treating malignant hyperthermia. Diazepam (Choice D) may be used to control muscle spasms but is not the first-line treatment for malignant hyperthermia.
3. A nurse is teaching a client who has a new prescription for Spironolactone. Which of the following adverse effects should the nurse instruct the client to monitor?
- A. Hyperkalemia
- B. Hypoglycemia
- C. Hypocalcemia
- D. Hyponatremia
Correct answer: A
Rationale: Spironolactone is a potassium-sparing diuretic, so the nurse should monitor the client for hyperkalemia, which can cause muscle weakness and cardiac dysrhythmias.
4. A client with a DNR order has requested resuscitation during a visit from the family. What is the nurse's best course of action?
- A. Follow the family's request and perform CPR.
- B. Explain to the family that the DNR must be honored.
- C. Call the healthcare provider to cancel the DNR order.
- D. Delay resuscitation until further clarification can be made.
Correct answer: B
Rationale: The correct course of action for the nurse is to explain to the family that the DNR (Do Not Resuscitate) order must be honored. It is essential for the nurse to uphold the client's wishes as documented in the DNR order. Performing CPR against the client's expressed wishes in the DNR order would violate ethical and legal standards. Calling the healthcare provider to cancel the DNR order without the client's consent is inappropriate and goes against the client's autonomy. Delaying resuscitation can be detrimental in an emergency situation and may not align with the client's wishes as outlined in the DNR order.
5. In a 70-year-old man with a history of chronic obstructive pulmonary disease (COPD) reporting increasing shortness of breath, wheezing, and cough, which finding would indicate a potential exacerbation of his COPD?
- A. Increased wheezing
- B. Decreased respiratory rate
- C. Improved exercise tolerance
- D. Decreased sputum production
Correct answer: A
Rationale: The correct answer is A: Increased wheezing. In COPD exacerbations, there is a worsening of symptoms such as increased wheezing due to airway inflammation and narrowing. Choices B, C, and D are incorrect. Decreased respiratory rate would not be expected in COPD exacerbation as it is usually a compensatory mechanism to maintain oxygenation. Improved exercise tolerance is not a typical finding in exacerbations but rather a sign of improvement. Decreased sputum production is also not indicative of exacerbation, as exacerbations are often associated with increased sputum production.
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