ATI RN
ATI Comprehensive Exit Exam 2023 With NGN
1. A client, 12 hours postpartum, reports not having a bowel movement for 4 days. Which medication should the nurse administer?
- A. Bisacodyl 10 mg rectal suppository.
- B. Magnesium hydroxide 30 ml PO.
- C. Famotidine 20 mg PO.
- D. Loperamide 4 mg PO.
Correct answer: A
Rationale: In this scenario, the nurse should administer Bisacodyl 10 mg rectal suppository. The client's report of not having a bowel movement for 4 days indicates constipation, and Bisacodyl is a stimulant laxative that helps initiate bowel movements. Magnesium hydroxide is an antacid and osmotic laxative used for indigestion, not for constipation. Famotidine is an H2 receptor antagonist used to reduce stomach acid production and treat heartburn, not constipation. Loperamide is an antidiarrheal agent and would be contraindicated in a client experiencing constipation.
2. A nurse is planning a menu for a client with a folic acid deficiency anemia. Which food should the nurse recommend that is high in folate?
- A. 4 slices of roast beef
- B. ½ cup of asparagus
- C. 1 cup part-skim mozzarella cheese
- D. ¼ cup of olives
Correct answer: B
Rationale: The correct answer is B: ½ cup of asparagus. Asparagus is high in folate, making it a suitable recommendation for clients with folic acid deficiency anemia. Folate is essential in the production of red blood cells, which is crucial in managing anemia. Choices A, C, and D do not contain as much folate as asparagus and are not the best options for addressing a folic acid deficiency anemia.
3. The physician orders a maintenance dose of 5,000 units of subcutaneous heparin (an anticoagulant) daily. Nursing responsibilities for Mrs. Mitchell now include:
- A. Reviewing daily activated partial thromboplastin time (APTT) and prothrombin time.
- B. Reporting an APTT above 45 seconds to the physician
- C. Assessing the patient for signs and symptoms of frank and occult bleeding
- D. All of the above
Correct answer: D
Rationale: The correct answer is D. When a physician orders a maintenance dose of subcutaneous heparin, nursing responsibilities include reviewing daily activated partial thromboplastin time (APTT) and prothrombin time to monitor the patient's coagulation status, reporting an APTT above 45 seconds to the physician as it may indicate a risk of bleeding, and assessing the patient for signs and symptoms of frank and occult bleeding, which are potential adverse effects of anticoagulant therapy. Therefore, all the options listed are essential nursing responsibilities when a patient is on subcutaneous heparin therapy.
4. A client has a pleural chest tube. Which action should the nurse take to ensure safe use of this equipment?
- A. Never strip the tubing to maintain patency.
- B. Secure tubing junctions with tape to prevent accidental disconnections.
- C. Set wall suction at the level recommended by the device manufacturer.
- D. Keep padded clamps at the bedside for use if the drainage system is interrupted.
Correct answer: D
Rationale: To ensure safe use of a pleural chest tube, the nurse should keep padded clamps at the bedside for use if the drainage system becomes dislodged or is interrupted. Stripping the tubing should never be done to maintain patency. Tubing junctions should be secured with tape, not clamps. Wall suction should be set at the level recommended by the device manufacturer, not the provider.
5. A client has a prescription for Hydralazine. Which of the following instructions should the nurse include?
- A. Take the medication at bedtime.
- B. Monitor your blood pressure regularly.
- C. Expect to have increased energy levels.
- D. Avoid foods high in potassium.
Correct answer: B
Rationale: The correct answer is to monitor blood pressure regularly. Hydralazine is an antihypertensive medication that helps lower blood pressure. Monitoring blood pressure regularly is essential to ensure it remains within the target range and to assess the effectiveness of the medication. Choice A is incorrect because the timing of taking Hydralazine is usually not specified as bedtime. Choice C is incorrect because increased energy levels are not an expected effect of Hydralazine. Choice D is incorrect because Hydralazine does not interact with potassium in the same way as other medications like potassium-sparing diuretics.
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