ATI RN
ATI RN Exit Exam Test Bank
1. How should a healthcare professional care for a patient with a central line?
- A. Flush the line daily
- B. Monitor for infection
- C. Change the dressing weekly
- D. Replace the central line every week
Correct answer: B
Rationale: When caring for a patient with a central line, monitoring for infection is crucial. This is because central lines can introduce bacteria into the bloodstream, leading to serious infections. While flushing the line daily and changing the dressing weekly are important aspects of central line care, monitoring for infection takes precedence. Infections can occur rapidly and have severe consequences, so early detection through vigilant monitoring is key. Replacing the central line every week is not a standard practice and should only be done when clinically indicated, such as in cases of infection or malfunction.
2. A nurse is planning care for a client who has a stage 3 pressure injury. Which of the following interventions should the nurse include in the plan of care?
- A. Cleanse the wound with povidone-iodine solution daily.
- B. Irrigate the wound with hydrogen peroxide.
- C. Reposition the client every 4 hours.
- D. Use a moisture barrier ointment.
Correct answer: D
Rationale: The correct answer is to use a moisture barrier ointment. This intervention helps protect the skin and promote healing in clients with stage 3 pressure injuries. Cleansing the wound with povidone-iodine solution daily (Choice A) can be too harsh and may delay healing by damaging the surrounding skin. Irrigating the wound with hydrogen peroxide (Choice B) is not recommended as it can be cytotoxic to healing tissue. While repositioning the client every 4 hours (Choice C) is an essential intervention in preventing pressure injuries, it is not directly related to the care of an existing stage 3 pressure injury.
3. A healthcare professional is preparing to administer a blood transfusion to a client. Which of the following actions should the healthcare professional take first?
- A. Obtain the client's vital signs.
- B. Ensure the client's IV access is patent.
- C. Prime the IV tubing with 0.9% sodium chloride.
- D. Verify the client's identity.
Correct answer: D
Rationale: Verifying the client's identity is the first crucial action the healthcare professional should take before administering a blood transfusion. This step ensures that the right blood is given to the right client, helping prevent errors. Obtaining vital signs, ensuring IV access, and priming IV tubing are important steps in the process but verifying the client's identity takes precedence for patient safety and accurate care delivery.
4. A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse report to the provider?
- A. Oxygen saturation of 91%
- B. Use of pursed-lip breathing
- C. Productive cough with green sputum
- D. Decreased breath sounds in the right lower lobe
Correct answer: D
Rationale: The correct finding the nurse should report to the provider is decreased breath sounds in the right lower lobe. This can indicate a respiratory infection or atelectasis in clients with COPD, requiring further evaluation and intervention. Choice A, an oxygen saturation of 91%, although slightly lower than normal, does not necessarily require immediate reporting unless the client's baseline is significantly higher. Choice B, the use of pursed-lip breathing, is actually a beneficial technique for clients with COPD to improve oxygenation and reduce shortness of breath, so it does not need reporting. Choice C, a productive cough with green sputum, can be common in clients with COPD and may indicate an infection, but it is not as concerning as decreased breath sounds in a specific lung lobe which may signify a more acute issue.
5. What is the most appropriate nursing intervention for 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 the most appropriate nursing intervention for a patient with suspected DVT because it helps prevent further clot formation and complications. Applying compression stockings (choice B) can be a preventive measure but is not the primary intervention for treating DVT. Encouraging ambulation (choice C) is beneficial for preventing DVT but is not the immediate intervention for a suspected case. Monitoring oxygen saturation (choice D) is important for assessing respiratory function but is not the primary intervention for DVT treatment.
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