ATI RN
ATI RN Exit Exam Test Bank
1. 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.
2. A nurse is caring for a client who has Alzheimer's disease and demonstrates confusion and wandering behavior. Which of the following interventions should the nurse include in the plan of care?
- A. Place the client in a well-lit area to reduce wandering.
- B. Use physical restraints to prevent wandering.
- C. Ensure that the client wears an identification bracelet at all times.
- D. Keep the client's bed in the lowest position.
Correct answer: C
Rationale: The correct intervention for a client with Alzheimer's disease who demonstrates confusion and wandering behavior is to ensure that the client wears an identification bracelet at all times. This helps prevent wandering and ensures the client's safety. Placing the client in a well-lit area may be beneficial for orientation but does not directly address wandering behavior. Using physical restraints is not recommended as it can lead to agitation and other complications. Keeping the client's bed in the lowest position is important for fall prevention but does not specifically address the issue of wandering behavior.
3. A client is being taught about patient-controlled analgesia (PCA). Which statement should be included in the teaching?
- A. The PCA will deliver a double dose of medication when you push the button twice.
- B. Continuous PCA infusion is designed to allow fluctuating plasma medication levels.
- C. You should push the button before physical activity to allow maximum pain control.
- D. You can adjust the amount of pain medication you receive by pushing on the keypad.
Correct answer: D
Rationale: The correct statement to include in the teaching about PCA is that the client can adjust the amount of pain medication they receive by pushing on the keypad. This empowers the client to control their pain management effectively. Choice A is incorrect because PCA systems are programmed to prevent double dosing when the button is pressed multiple times in quick succession. Choice B is incorrect as continuous PCA infusion aims to maintain a steady plasma medication level. Choice C is incorrect because it is not necessary to push the button before physical activity to ensure maximum pain control; the client should use the PCA as needed for pain relief.
4. A nurse is caring for a client who has a new prescription for enalapril. Which of the following findings should the nurse identify as an adverse effect of the medication?
- A. Cough.
- B. Dry mouth.
- C. Urinary retention.
- D. Insomnia.
Correct answer: A
Rationale: Corrected Rationale: A persistent cough is a known adverse effect of enalapril, an ACE inhibitor. Enalapril can cause the accumulation of bradykinin, leading to a dry, persistent cough in some patients. Dry mouth (choice B) and urinary retention (choice C) are not typically associated with enalapril use. Insomnia (choice D) is also not a common adverse effect of enalapril. Therefore, the correct answer is A.
5. A client who has a prescription for insulin glargine is talking to a nurse. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will mix this insulin with my regular insulin before injecting it.
- B. I will store this insulin in the refrigerator after opening it.
- C. I will take this insulin twice a day.
- D. I will inject this insulin when my blood glucose is above 200 mg/dL.
Correct answer: B
Rationale: The correct answer is B because insulin glargine should be stored in the refrigerator after opening to maintain its potency. Choice A is incorrect as insulin glargine should not be mixed with other insulins. Choice C is incorrect because insulin glargine is typically taken once a day. Choice D is incorrect because insulin glargine is usually taken regardless of blood glucose levels.
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