ATI RN
ATI Comprehensive Exit Exam 2023 With NGN
1. A nurse is preparing to administer potassium chloride IV to a client who has hypokalemia. Which of the following actions should the nurse take?
- A. Give the medication as a bolus over 10 minutes.
- B. Dilute the medication before administration.
- C. Infuse the medication at a rate of 10 mEq/hr.
- D. Administer the medication undiluted.
Correct answer: C
Rationale: The correct action the nurse should take when administering potassium chloride IV to a client with hypokalemia is to infuse the medication at a rate of 10 mEq/hr. This slow infusion rate is crucial to prevent the development of hyperkalemia, a potentially dangerous condition. Option A is incorrect because giving the medication as a bolus over 10 minutes can lead to adverse effects. Option B is incorrect as potassium chloride does not necessarily need to be diluted before administration in this scenario. Option D is incorrect as administering the medication undiluted can also increase the risk of hyperkalemia.
2. A nurse is reviewing the laboratory results of a client who has heart failure. Which of the following findings should the nurse report to the provider?
- A. Potassium 4.0 mEq/L
- B. Hemoglobin 12 g/dL
- C. BUN 18 mg/dL
- D. Sodium 137 mEq/L
Correct answer: B
Rationale: The correct answer is B: Hemoglobin 12 g/dL. In a client with heart failure, a decrease in hemoglobin levels can indicate anemia, which can exacerbate heart failure symptoms. Reporting this finding to the provider is crucial for appropriate management. Choice A, Potassium 4.0 mEq/L, is within the normal range (3.5-5.0 mEq/L) and does not typically require immediate reporting. Choice C, BUN 18 mg/dL, and Choice D, Sodium 137 mEq/L, are also within normal ranges and not directly related to heart failure management. Therefore, the hemoglobin level is the most critical finding to report in this scenario.
3. A nurse is caring for a client who has a new prescription for levothyroxine. Which of the following laboratory values should the nurse monitor to determine the effectiveness of the medication?
- A. Calcium
- B. Sodium
- C. Thyroid-stimulating hormone (TSH)
- D. Magnesium
Correct answer: C
Rationale: The correct answer is C: Thyroid-stimulating hormone (TSH). Monitoring TSH levels is crucial to assess the effectiveness of levothyroxine in clients with hypothyroidism. TSH is produced by the pituitary gland and stimulates the thyroid gland to produce thyroid hormones. In hypothyroidism, where the thyroid gland is underactive, administering levothyroxine helps to normalize thyroid hormone levels. Monitoring TSH levels allows the healthcare provider to adjust the levothyroxine dosage to ensure that thyroid hormone levels are within the therapeutic range. Choices A, B, and D (Calcium, Sodium, and Magnesium) are not directly related to assessing the effectiveness of levothyroxine therapy in hypothyroidism and would not provide relevant information regarding the medication's efficacy.
4. Which of the following is a sign of digoxin toxicity?
- A. Bradycardia
- B. Hypertension
- C. Tachycardia
- D. Tachypnea
Correct answer: A
Rationale: The correct answer is A, Bradycardia. Bradycardia, or a slower than normal heart rate, is a classic sign of digoxin toxicity. Digoxin is a medication commonly used to treat heart conditions, but an excess of digoxin in the body can lead to toxicity. This toxicity can manifest as various symptoms, with bradycardia being one of the most common ones. Hypertension (high blood pressure) and tachycardia (fast heart rate) are not typical signs of digoxin toxicity. Tachypnea, which refers to rapid breathing, is also not a common sign of digoxin toxicity.
5. 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.
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