ATI RN
ATI Fundamentals Proctored Exam 2023 Quizlet
1. During a seizure, what is the primary intervention?
- A. Protect the patient from injury
- B. Insert an airway
- C. Elevate the head of the bed
- D. Withdraw all pain medications
Correct answer: A
Rationale: The primary intervention during a seizure is to protect the patient from injury. This involves creating a safe environment by moving harmful objects away, cushioning the head, and staying with the patient until the seizure ends. Inserting an airway is only necessary if the patient's airway is obstructed, not routinely during a seizure. Elevating the head of the bed is not a priority during an active seizure as it won't affect the seizure's outcome. Withdrawing all pain medications is not a standard practice unless there are specific contraindications related to the seizure itself.
2. A nurse is assessing a client who has just received an opioid medication. Which of the following findings should the nurse monitor first?
- A. Constipation.
- B. Drowsiness.
- C. Orthostatic hypotension.
- D. Respiratory depression.
Correct answer: D
Rationale: When a client receives an opioid medication, the nurse should first monitor for respiratory depression as it is a life-threatening adverse effect associated with opioids. This can lead to inadequate ventilation and hypoxia, requiring immediate intervention. Constipation, drowsiness, and orthostatic hypotension are also common side effects of opioids but are not as immediately life-threatening as respiratory depression.
3. A nurse is caring for a client who is receiving oxytocin IV for augmentation of labor. The client's contractions are occurring every 45 seconds with a nine-second duration, and the fetal heart rate is 170 to 180 beats per minute. Which of the following actions should the nurse take?
- A. Discontinue oxytocin infusion
- B. Increase oxytocin infusion
- C. Decrease oxytocin infusion
- D. Maintain oxytocin infusion
Correct answer: A
Rationale: In this scenario, the client is experiencing frequent contractions with a short duration and an elevated fetal heart rate, indicating potential fetal distress. Discontinuing the oxytocin infusion is crucial to prevent further complications and restore normal fetal parameters. Increasing or maintaining the oxytocin infusion could exacerbate the situation, leading to more distress for the fetus. Decreasing the oxytocin infusion may not be sufficient to address the current issue and could delay the improvement of fetal well-being.
4. A nurse is teaching a client who has a new prescription for Etanercept for Rheumatoid Arthritis. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will need to get my blood drawn periodically while on this medication.'
- B. I should stop taking this medication if I develop a rash.'
- C. I will need to limit my alcohol intake to no more than one drink per week.'
- D. I should self-administer this medication subcutaneously into the muscle.'
Correct answer: A
Rationale: Etanercept can cause bone marrow suppression, so it is important to monitor blood counts regularly.
5. A nurse is providing discharge teaching to a client who is postoperative following a hip arthroplasty. Which of the following statements indicates a need for further teaching?
- A. I will avoid sitting in a recliner while recovering.
- B. I will bend at the waist to pick up items from the floor.
- C. I will use a pillow between my legs when lying on my side.
- D. I will avoid crossing my legs when sitting.
Correct answer: B
Rationale: The correct answer is B. Bending at the waist can increase the risk of dislocation following hip arthroplasty. This movement can put strain on the hip joint and potentially lead to complications. Choices A, C, and D are all correct statements that promote proper postoperative care and help prevent complications. Sitting in a recliner, using a pillow between the legs when lying on the side, and avoiding crossing legs when sitting are all appropriate instructions for a client recovering from hip arthroplasty.