ATI RN
ATI RN Exit Exam 2023
1. A nurse is reviewing the medication record of a client with chronic kidney disease. Which of the following medications should the nurse question?
- A. Calcium carbonate
- B. Furosemide
- C. Epoetin alfa
- D. Spironolactone
Correct answer: D
Rationale: The correct answer is D, Spironolactone. Spironolactone is a potassium-sparing diuretic, which may lead to hyperkalemia in clients with chronic kidney disease. Therefore, its use should be questioned in this population. Choice A, Calcium carbonate, is commonly used to manage phosphate levels in chronic kidney disease. Choice B, Furosemide, is a loop diuretic that helps with fluid retention but should be used with caution in kidney disease. Choice C, Epoetin alfa, is a medication used to stimulate red blood cell production in clients with chronic kidney disease and anemia.
2. What is the best way to manage a patient with suspected deep vein thrombosis (DVT)?
- A. Administer anticoagulants
- B. Apply compression stockings
- C. Encourage ambulation
- D. Monitor oxygen saturation
Correct answer: A
Rationale: The correct answer is A: Administer anticoagulants. Administering anticoagulants is crucial in managing patients with suspected DVT as it helps prevent further clot formation and reduces the risk of complications like pulmonary embolism. Choice B, applying compression stockings, is more focused on preventing DVT in high-risk patients rather than managing an established case. Encouraging ambulation, choice C, is beneficial in the prevention of DVT but is not the primary management for suspected cases. Monitoring oxygen saturation, choice D, is important in overall patient care but is not the primary intervention for suspected DVT.
3. A nurse is reviewing the medical record of a client who has a new prescription for enalapril. Which of the following findings should the nurse report to the provider?
- A. Serum potassium 4.0 mEq/L
- B. Sodium 138 mEq/L
- C. Serum creatinine 3.8 mg/dL
- D. Hemoglobin 13 g/dL
Correct answer: C
Rationale: The correct answer is C. An elevated serum creatinine level can indicate impaired kidney function, which is crucial to report before administering enalapril. Enalapril, an ACE inhibitor, can affect kidney function, especially in patients with pre-existing renal impairment. Choices A, B, and D are within normal ranges and do not directly impact the initiation of enalapril therapy.
4. What is the most important nursing action when a patient has a central line?
- A. Monitor for infection
- B. Monitor the central line dressing
- C. Monitor for redness
- D. Monitor for swelling
Correct answer: A
Rationale: The most important nursing action when a patient has a central line is to monitor for infection. Central line-associated bloodstream infections are a serious complication that can lead to severe outcomes. Monitoring for infection involves assessing the patient for signs and symptoms such as fever, chills, and hypotension. While monitoring the central line dressing, redness, and swelling are also important aspects of care, they are secondary to monitoring for infection as the primary focus should be on preventing serious complications.
5. A nurse is preparing to administer a cleansing enema to a client. Which of the following actions should the nurse take?
- A. Position the client on their left side.
- B. Insert the enema tubing 8 cm (3.1 in) into the client's rectum.
- C. Hold the container of the enema solution 61 cm (24 in) above the client.
- D. Advance the enema tubing 15 cm (6 in) into the client's rectum.
Correct answer: C
Rationale: The correct action the nurse should take when administering a cleansing enema is to hold the container of the enema solution 61 cm (24 in) above the client. This height facilitates the proper flow of the solution into the client's rectum. Positioning the client on their left side helps facilitate the administration process, but it is not the specific action related to the enema solution. Inserting the enema tubing 8 cm (3.1 in) into the rectum is incorrect as it may not deliver the solution effectively. Advancing the enema tubing 15 cm (6 in) into the client's rectum is excessive and could cause trauma.
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