ATI RN
ATI RN Comprehensive Exit Exam
1. What is the best intervention for a patient with a suspected pulmonary embolism?
- A. Administer oxygen
- B. Administer anticoagulants
- C. Reposition the patient
- D. Administer bronchodilators
Correct answer: A
Rationale: Administering oxygen is the best intervention for a patient with a suspected pulmonary embolism because it helps alleviate respiratory distress and improve oxygenation. Oxygen therapy is crucial to ensure adequate oxygen levels in the blood due to the obstruction in the pulmonary circulation caused by the embolism. Administering anticoagulants (choice B) is a treatment for confirmed pulmonary embolism rather than a suspected case. Repositioning the patient (choice C) or administering bronchodilators (choice D) would not directly address the underlying issue of impaired gas exchange and oxygen delivery associated with pulmonary embolism.
2. A client has deep vein thrombosis (DVT). Which of the following actions should the nurse take?
- A. Administer thrombolytics as prescribed.
- B. Massage the affected extremity every 2 hours.
- C. Apply warm compresses to the affected extremity.
- D. Place the client in a supine position with the legs elevated.
Correct answer: C
Rationale: The correct action for a nurse caring for a client with deep vein thrombosis (DVT) is to apply warm compresses to the affected extremity. Warm compresses help reduce swelling and pain in clients with DVT. Administering thrombolytics (Choice A) is not typically done without specific orders due to the risk of bleeding. Massaging the affected extremity (Choice B) can dislodge blood clots and lead to complications. Placing the client in a supine position with the legs elevated (Choice D) may increase the risk of clot dislodgment.
3. A client with a nasogastric tube receiving continuous enteral feedings is at risk for aspiration. Which of the following actions should the nurse take to prevent aspiration?
- A. Elevate the head of the bed to 15 degrees
- B. Check gastric residual volumes every 6 hours
- C. Monitor the pH of gastric aspirate
- D. Instill 10 mL of air into the tube before feeding
Correct answer: B
Rationale: Checking gastric residual volumes every 6 hours is essential in preventing aspiration in clients receiving continuous enteral feedings. This practice helps determine if the stomach is adequately emptying, reducing the risk of regurgitation and aspiration. Elevating the head of the bed to 30 degrees, not 15 degrees, is recommended to further prevent aspiration by reducing the risk of reflux. Monitoring the pH of gastric aspirate is important to assess tube placement but does not directly prevent aspiration. Instilling air into the tube before feeding is not a recommended practice and does not prevent aspiration.
4. A nurse is caring for a child who has cystic fibrosis and is receiving postural drainage. Which of the following actions should the nurse take?
- A. Perform the procedure after meals.
- B. Administer bronchodilators before the procedure.
- C. Hold hand flat to perform percussion.
- D. Perform the procedure twice a day.
Correct answer: C
Rationale: The correct action the nurse should take when caring for a child with cystic fibrosis receiving postural drainage is to hold the hand flat to perform percussion. This technique allows for effective chest physiotherapy. Choice A is incorrect because postural drainage should be performed before meals to prevent vomiting during the procedure. Choice B is incorrect because bronchodilators are typically administered before postural drainage to help open up the airways. Choice D is incorrect as the frequency of postural drainage may vary depending on the individual's condition, so performing it twice a day may not be appropriate for all patients.
5. How should a healthcare provider manage a patient with chronic pain?
- A. Administer analgesics
- B. Encourage physical activity
- C. Administer non-pharmacological interventions
- D. Encourage deep breathing exercises
Correct answer: A
Rationale: Administering prescribed analgesics is a crucial aspect of managing chronic pain effectively. Analgesics help alleviate pain symptoms and improve the patient's quality of life. While physical activity and non-pharmacological interventions can also play a role in pain management, the immediate need for relief in chronic pain often requires pharmacological intervention. Encouraging deep breathing exercises may provide some relief in certain situations, but it may not be as effective as analgesics for managing chronic pain.
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