ATI RN
ATI Comprehensive Exit Exam 2023 With NGN
1. A client is being discharged with a new prescription for metoprolol. Which of the following instructions should the nurse include?
- A. Do not discontinue this medication suddenly.
- B. Take this medication in the evening to decrease the risk of falls.
- C. Monitor your heart rate before taking this medication.
- D. Avoid grapefruit juice while taking this medication.
Correct answer: C
Rationale: The correct instruction for a client prescribed metoprolol is to monitor their heart rate before taking the medication. Metoprolol is a beta-blocker that can cause bradycardia (slow heart rate), so it is essential for clients to check their heart rate before each dose. Choice A is incorrect because abruptly stopping metoprolol can lead to adverse effects, so it should not be discontinued suddenly. Choice B is incorrect because there is no specific recommendation to take metoprolol at night to reduce falls. Choice D is incorrect because grapefruit juice can interact with metoprolol, affecting its absorption, and should be avoided.
2. An occurrence of too high a concentration of which of the following electrolytes is associated with cardiac arrhythmias?
- A. chloride
- B. phosphorus
- C. potassium
- D. sodium
Correct answer: potassium
Rationale: The correct answer is potassium. High levels of potassium in the blood, known as hyperkalemia, can lead to cardiac arrhythmias by affecting the electrical activity of the heart. This can disrupt the normal rhythm of the heart and lead to serious complications. Chloride, phosphorus, and sodium imbalances are not typically associated with cardiac arrhythmias, making them incorrect choices.
3. A healthcare professional is caring for a group of clients receiving antimicrobial therapy. Which of the following clients should the professional plan to monitor for manifestations of antibiotic toxicity?
- A. An adolescent client with a sinus infection
- B. An older adult client with prostatitis
- C. A client who is postpartum with mastitis
- D. A middle-aged client with a urinary tract infection
Correct answer: B
Rationale: An older adult client with prostatitis who is receiving antibiotics should be monitored for toxicity due to age-related reductions in medication metabolism and excretion. Older adults are more susceptible to antibiotic toxicity, making them a high-risk group for adverse effects.
4. A 35-year-old male has enlarged lymph nodes in the neck and a mediastinal mass. He was diagnosed with Hodgkin lymphoma. Which of the following abnormal cells would the nurse expect to find with this disease?
- A. Merkel cell
- B. Schwann cell
- C. Reed-Sternberg cell
- D. Kupffer cell
Correct answer: C
Rationale: Reed-Sternberg cells are characteristic of Hodgkin lymphoma. These large abnormal cells have a bi-lobed or multi-lobed nucleus and are essential for diagnosing Hodgkin lymphoma through histological examination. Merkel cells are associated with Merkel cell carcinoma, Schwann cells are related to nerve sheaths, and Kupffer cells are liver macrophages. Therefore, choices A, B, and D are incorrect for Hodgkin lymphoma.
5. Where is the impulse from the SA node delayed, enabling atrial contraction to complete before the ventricles are stimulated and contract?
- A. AV node
- B. Bundle of His
- C. SA node
- D. Aorta
Correct answer: A
Rationale: The correct answer is AV node. The AV node is responsible for delaying the impulse from the SA node, allowing the atria to contract before the ventricles. This delay ensures the effective pumping of blood in a coordinated manner. Choices B, C, and D are incorrect because the Bundle of His is responsible for transmitting the impulse to the Purkinje fibers, the SA node is the pacemaker of the heart responsible for initiating the heartbeat, and the aorta is the main artery carrying oxygenated blood from the heart to the body, respectively, none of which are involved in delaying the impulse to allow atrial contraction before ventricular contraction.
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