ATI RN
ATI Exit Exam RN
1. A client with asthma is prescribed a corticosteroid inhaler. Which of the following instructions should the nurse include?
- A. Use the inhaler as needed for acute symptoms.
- B. Rinse the mouth after each use.
- C. Take the medication only during asthma attacks.
- D. Administer a bronchodilator after using the corticosteroid.
Correct answer: B
Rationale: The correct instruction is to rinse the mouth after each use of a corticosteroid inhaler to prevent oral candidiasis (thrush). Choice A is incorrect because corticosteroid inhalers are usually used on a regular schedule to control asthma symptoms, not just for acute symptoms. Choice C is incorrect as corticosteroid inhalers are typically used for long-term management, not just during asthma attacks. Choice D is incorrect as administering a bronchodilator after using a corticosteroid is not a standard practice and is not necessary for the effectiveness of the corticosteroid inhaler.
2. A nurse is assessing a client who is postoperative following a thyroidectomy. The nurse should identify which of the following findings as an indication of hypocalcemia?
- A. Tingling in the fingers.
- B. Elevated blood pressure.
- C. Positive Chvostek's sign.
- D. Positive Kernig's sign.
Correct answer: A
Rationale: The correct answer is A: Tingling in the fingers. Tingling in the fingers is a common sign of hypocalcemia, often seen after a thyroidectomy. Hypocalcemia can occur post-thyroidectomy due to inadvertent damage or removal of the parathyroid glands which regulate calcium levels. Choices B, C, and D are incorrect. Elevated blood pressure is not typically associated with hypocalcemia. Positive Chvostek's sign is a clinical sign of hypocalcemia but is usually assessed as facial muscle twitching, not tingling in the fingers. Positive Kernig's sign is a test for meningitis, not related to hypocalcemia.
3. A nurse is planning care for a client who is 1 day postoperative following a hypophysectomy for the removal of a pituitary tumor. Which of the following findings requires further assessment by the nurse?
- A. Glasgow Coma Scale score of 15
- B. Blood drainage on the initial dressing measuring 3 cm
- C. Report of dry mouth
- D. Urinary output greater than fluid intake
Correct answer: D
Rationale: The correct answer is D. Urinary output greater than fluid intake could indicate diabetes insipidus, a complication following hypophysectomy. Diabetes insipidus is characterized by excessive urination and extreme thirst due to inadequate levels of antidiuretic hormone (ADH). Options A, B, and C are all expected findings in the immediate postoperative period following a hypophysectomy. A Glasgow Coma Scale score of 15 indicates the highest level of consciousness, blood drainage on the initial dressing is a common finding after surgery, and dry mouth can be a side effect of anesthesia and surgical procedures.
4. A nurse is preparing to administer digoxin to 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. Calcium 9.5 mg/dL
- C. Heart rate of 60/min
- D. Sodium 140 mEq/L
Correct answer: C
Rationale: The correct answer is C: Heart rate of 60/min. A heart rate of 60/min is borderline bradycardia, which can be a sign of digoxin toxicity. Digoxin can cause bradycardia, so any further decrease in heart rate should be reported promptly to the healthcare provider. Choices A, B, and D are within the normal range and not specifically related to potential digoxin toxicity, so they do not require immediate reporting.
5. A nurse is caring for a client who is 1 day postoperative following a transurethral resection of the prostate (TURP). Which of the following findings should the nurse report to the provider?
- A. Urine output of 30 mL/hr
- B. Pink-tinged urine
- C. Small blood clots in the urine
- D. Blood pressure of 114/78 mm Hg
Correct answer: C
Rationale: The presence of small blood clots in the urine is an expected finding after a TURP due to the surgical manipulation of the prostate bed and the bladder. However, larger clots can indicate excessive bleeding and should be reported promptly. Urine output of 30 mL/hr is within the expected range for post-TURP clients, indicating adequate kidney perfusion. Pink-tinged urine is also normal after a TURP due to minor bleeding from the surgical site. A blood pressure of 114/78 mm Hg is within normal limits and does not require immediate reporting.
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