ATI RN
ATI RN Exit Exam Test Bank
1. How should a healthcare professional monitor a patient on furosemide for fluid balance?
- A. Monitor daily weight
- B. Check for edema
- C. Monitor input and output
- D. Monitor blood pressure
Correct answer: A
Rationale: Monitoring a patient's daily weight is crucial when assessing fluid balance in individuals prescribed furosemide. Furosemide is a diuretic that helps the body eliminate excess fluid and salt. Changes in weight can reflect fluid shifts, making daily weight monitoring a reliable indicator of fluid status. While checking for edema and monitoring input and output are essential aspects of fluid balance assessment, they may not provide as immediate and quantifiable information as daily weight measurements. Monitoring blood pressure is important in patients on furosemide due to its potential to affect blood pressure levels, but it is not as directly indicative of fluid balance as daily weight monitoring.
2. A nurse is preparing to administer vancomycin IV to a client. Which of the following actions should the nurse take?
- A. Administer the medication over 30 minutes.
- B. Monitor the client for a decrease in blood pressure during administration.
- C. Assess the IV site for infiltration during administration.
- D. Premedicate the client with an antiemetic prior to administration.
Correct answer: C
Rationale: The correct action the nurse should take when administering vancomycin IV is to assess the IV site for infiltration during administration. Vancomycin is known to cause tissue damage if it infiltrates, making close monitoring crucial. Administering the medication over 30 minutes (Choice A) is a common practice but not the priority in preventing infiltration. Monitoring for a decrease in blood pressure (Choice B) is not directly related to vancomycin administration. Premedicating with an antiemetic (Choice D) is not typically required for vancomycin administration.
3. A patient is being cared for by a nurse who has a history of angina and is experiencing chest pain. Which of the following actions should the nurse take first?
- A. Administer oxygen at 2 L/min via nasal cannula.
- B. Administer nitroglycerin sublingually.
- C. Obtain a 12-lead ECG.
- D. Notify the healthcare provider.
Correct answer: C
Rationale: In a patient with a history of angina experiencing chest pain, the priority action for the nurse is to obtain a 12-lead ECG. This helps in assessing for myocardial infarction, a serious condition that requires immediate attention. Administering oxygen, nitroglycerin, or notifying the healthcare provider can be important interventions but obtaining the ECG comes first to determine the presence of myocardial infarction and guide further management.
4. How should a healthcare professional care for a patient with a central line to prevent infection?
- A. Change the dressing daily
- B. Monitor for redness
- C. Check the central line site every shift
- D. Flush the line with saline
Correct answer: A
Rationale: Corrected Rationale: Changing the central line dressing daily is crucial in preventing infection at the insertion site. This practice helps maintain a clean and sterile environment around the central line, reducing the risk of pathogens entering the bloodstream. Monitoring for redness (choice B) is important but may not directly prevent infection. Checking the central line site every shift (choice C) is essential for early detection of any issues but does not solely prevent infection. Flushing the line with saline (choice D) is a necessary procedure for maintaining central line patency but does not primarily prevent infection.
5. A nurse is planning care for a client who practices Orthodox Judaism and is observing the Passover holiday. Which of the following actions should the nurse include in the plan of care?
- A. Provide chicken with cream sauce.
- B. Avoid serving fish with fins and scales.
- C. Provide unleavened bread.
- D. Avoid serving foods containing lamb.
Correct answer: C
Rationale: During the Passover holiday, individuals practicing Orthodox Judaism follow dietary restrictions that include avoiding leavened bread. Providing unleavened bread aligns with these restrictions and ensures the client's observance of the holiday. Choices A, B, and D are incorrect because serving chicken with cream sauce, avoiding fish with fins and scales, and avoiding foods containing lamb are not specific dietary requirements related to observing Passover in Orthodox Judaism.
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