a nurse is preparing to administer a dose of vancomycin iv to a client who has a methicillin resistant staphylococcus aureus mrsa infection which of t a nurse is preparing to administer a dose of vancomycin iv to a client who has a methicillin resistant staphylococcus aureus mrsa infection which of t
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ATI RN

ATI Comprehensive Exit Exam

1. A nurse is preparing to administer a dose of vancomycin IV to a client who has a methicillin-resistant Staphylococcus aureus (MRSA) infection. Which of the following actions should the nurse take?

Correct answer: C

Rationale: The correct action for the nurse to take is to check the client's creatinine level before administering vancomycin. Vancomycin is known to be nephrotoxic, so assessing the client's renal function before administering the medication is crucial to prevent further kidney damage. Administering the medication over 15 minutes (Choice A) is not the priority in this scenario as renal function assessment takes precedence. Monitoring urine output (Choice B) is important for assessing renal function but checking creatinine level directly provides more accurate information. Assessing for allergies to antibiotics (Choice D) is also important but not as essential as checking the creatinine level due to the nephrotoxic nature of vancomycin.

2. In the last weeks of pregnancy, __________.

Correct answer: B

Rationale: In the last weeks of pregnancy, most fetuses assume an upside-down position known as the head-down position or vertex presentation. This position is ideal for a smoother labor and delivery process as it helps the baby move through the birth canal. Fetal growth has already slowed down at this stage, so option C is incorrect. Option A is inaccurate as the fetus typically gains weight in the final weeks. Option D is incorrect because the fetus relies on the mother's immune system while in the womb.

3. Which of the following is not considered an extracellular fluid?

Correct answer: D

Rationale: The correct answer is D. Cerebrospinal fluid and the humors of the eye are not considered extracellular fluids. Extracellular fluids are fluids found outside the cells, such as interstitial fluid and lymph. Cerebrospinal fluid is found within the central nervous system, while the humors of the eye (aqueous humor and vitreous humor) are located within the eyeball, making them distinct from extracellular fluids.

4. A nurse is caring for a client who is postoperative following cataract surgery. The client reports that they do not want to wear their eye shield. What should the nurse do?

Correct answer: B

Rationale: The correct answer is B: Explain the importance of wearing the eye shield. It is important for the nurse to educate the client on the reasons why wearing the eye shield is crucial post cataract surgery, such as protecting the eye from injury and promoting proper healing. This empowers the client with knowledge and helps them make an informed decision. Choice A is incorrect because the nurse should provide necessary information to ensure the client's safety. Choice C is incorrect as removing the eye shield without proper justification can compromise the client's recovery. Choice D is also incorrect as discussing concerns should come after the client is educated on the importance of the eye shield.

5. A patient states he experiences anxiety and has panic attacks at least once a week. What might be helpful for this patient?

Correct answer: C

Rationale: Alprazolam (Xanax) is a medication commonly prescribed to treat anxiety disorders and panic attacks. It belongs to the class of medications known as benzodiazepines, which work by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain to produce a calming effect. Phenytoin is an antiepileptic drug, not typically used for anxiety or panic attacks. Lithium is primarily used to treat bipolar disorder, not anxiety. Spironolactone is a diuretic primarily used to treat conditions like high blood pressure and heart failure, not anxiety or panic attacks.

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