ATI RN
ATI RN Comprehensive Exit Exam
1. A nurse is planning care for a client who has a new prescription for warfarin. Which of the following laboratory values should the nurse monitor to determine the effectiveness of the therapy?
- A. Serum calcium level
- B. Platelet count
- C. INR
- D. WBC count
Correct answer: C
Rationale: Corrected Rationale: The nurse should monitor the client's INR to determine the effectiveness of warfarin therapy. INR monitoring is crucial as it reflects the blood's ability to clot properly. Warfarin is commonly used as an anticoagulant, and maintaining the INR within the therapeutic range ensures that the client is protected from both clotting and bleeding events. Monitoring serum calcium levels, platelet count, or WBC count is not directly related to assessing the effectiveness of warfarin therapy.
2. The 6-year-old child scheduled for an orchiopexy shyly asks the nurse, 'What are they going to do to me 'down there'? What is the nurse's best response?
- A. They are going to fix you up 'down there'.
- B. They will move your testicle from your abdomen to your scrotum.
- C. What do you think your doctor is going to do?
- D. You shouldn't worry. Your doctor knows exactly what to do.
Correct answer: C
Rationale: The nurse should encourage the child to express his thoughts and feelings about the upcoming surgery. This approach helps the child feel heard and understood while providing an opportunity to address any misconceptions or fears. By asking the child what he thinks the doctor will do, the nurse engages the child in a conversation that can help alleviate anxiety and build trust. School-age children often have fears related to bodily harm, and open communication can help alleviate such concerns. Choices A and D do not encourage open communication or address the child's concerns directly. Choice B provides too much detail that may overwhelm the child and is not age-appropriate for a 6-year-old.
3. When assessing a client with a pneumothorax and a chest tube, which finding should the nurse notify the provider about?
- A. Movement of the trachea toward the unaffected side
- B. Bubbling of the water in the water seal chamber with exhalation
- C. Crepitus in the area above and surrounding the insertion site
- D. Eyelets not visible
Correct answer: A: Movement of the trachea toward the unaffected side
Rationale: The movement of the trachea toward the unaffected side is concerning as it can indicate a tension pneumothorax, a life-threatening emergency that requires immediate intervention. The trachea should be midline, so any deviation should be reported promptly to the provider for further evaluation and intervention.
4. What clinical manifestation(s) should the nurse expect to see as shock progresses in a child and becomes decompensated shock?
- A. Thirst
- B. Irritability
- C. Apprehension
- D. Confusion and somnolence
Correct answer: D
Rationale: As shock progresses and decompensation occurs, confusion and somnolence are indicative of reduced cerebral perfusion. Early signs include thirst and irritability, while confusion and altered consciousness appear as the condition worsens.
5. Which of the following factors may affect successful communication?
- A. Cultural background
- B. Organizational structure
- C. Method of communication
- D. All of the above
Correct answer: D
Rationale: Various factors can influence successful communication. Cultural background is crucial as different cultures may have distinct communication styles and norms. Organizational structure plays a role by determining the flow of information within an organization. The method of communication chosen can impact the clarity and effectiveness of the message being conveyed. Therefore, all the options provided - cultural background, organizational structure, and method of communication - can affect successful communication, making 'All of the above' the correct answer.
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