ATI RN
ATI RN Comprehensive Exit Exam 2023
1. A nurse is caring for a client who is receiving oxytocin to augment labor. The client's contractions are occurring every 2 minutes with a duration of 90 seconds. Which of the following actions should the nurse take?
- A. Increase the oxytocin infusion.
- B. Maintain the oxytocin infusion.
- C. Discontinue the oxytocin infusion.
- D. Provide reassurance to the client.
Correct answer: C
Rationale: The correct action for the nurse to take in this situation is to discontinue the oxytocin infusion. With contractions occurring every 2 minutes and lasting 90 seconds, this pattern indicates hyperstimulation, which can be harmful to the fetus. Discontinuing the oxytocin infusion is essential to prevent further harm. Increasing the oxytocin infusion would exacerbate the situation, maintaining it would continue the risk, and providing reassurance to the client, although important, does not address the need for immediate action to ensure the safety of the fetus.
2. A nurse is assessing a client who has pneumonia. Which of the following findings should the nurse expect?
- A. Bradycardia
- B. Crackles in the lung bases
- C. Dependent edema
- D. Productive cough
Correct answer: C
Rationale: Dependent edema is a common finding in clients with pneumonia due to fluid retention and decreased mobility. Bradycardia (Choice A) is not typically associated with pneumonia. Crackles in the lung bases (Choice B) are more commonly heard in conditions like heart failure or pulmonary edema. A productive cough (Choice D) can be seen in pneumonia but is not as specific as dependent edema.
3. A client with a history of heart failure is receiving furosemide. Which of the following laboratory values should the nurse monitor?
- A. Sodium 140 mEq/L
- B. Calcium 9.0 mg/dL
- C. Potassium 3.2 mEq/L
- D. Chloride 100 mEq/L
Correct answer: C
Rationale: The correct answer is C: Potassium 3.2 mEq/L. A potassium level of 3.2 mEq/L is below the normal range and should be monitored in clients receiving furosemide due to the risk of hypokalemia. Furosemide is a loop diuretic that can cause potassium depletion, leading to hypokalemia. Monitoring potassium levels is crucial to prevent complications such as cardiac arrhythmias. Choices A, B, and D are not directly impacted by furosemide therapy in the same way as potassium levels, making them less relevant for monitoring in this scenario.
4. A healthcare provider is teaching a client who has a new prescription for levothyroxine. Which of the following instructions should the healthcare provider include?
- A. Take this medication with meals.
- B. Take this medication at the same time every day.
- C. Report any chest pain to your healthcare provider immediately.
- D. Take an antacid if indigestion occurs.
Correct answer: B
Rationale: The correct instruction for a client prescribed levothyroxine is to take the medication at the same time every day. This consistency is important for maintaining stable thyroid hormone levels. Choice A is incorrect because levothyroxine should be taken on an empty stomach to ensure proper absorption. Choice C is important but not directly related to the administration of levothyroxine. Choice D is incorrect as antacids can interfere with the absorption of levothyroxine.
5. A female client with deteriorating neurologic function states, “I am worried I will not be able to care for my young children.” How does the nurse respond?
- A. “Caring for your children is a priority. You may not want to ask for help, but you have to.”
- B. “Our community has resources that may help you with some household tasks so you have energy to care for your children.”
- C. “You seem distressed. Would you like to talk to a psychologist about adjusting to your changing status?”
- D. “Give me more information about what worries you, so we can see if we can do something to make adjustments.”
Correct answer: “Give me more information about what worries you, so we can see if we can do something to make adjustments.”
Rationale: When a client expresses worry about not being able to care for her children due to deteriorating neurologic function, the most appropriate response from the nurse is to gather more information from the client. This open-ended approach allows the nurse to better understand the client's specific concerns and needs, leading to tailored interventions and support. Choice A is dismissive and may make the client feel guilty for needing help. Choice B focuses on external resources without addressing the client's worries directly. Choice C suggests a psychological referral without exploring the client's concerns further. Therefore, the correct response is to gather more information to provide personalized support.
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