ATI RN
ATI RN Comprehensive Exit Exam
1. What is the first intervention for a patient experiencing anaphylactic shock?
- A. Administer epinephrine
- B. Administer oxygen
- C. Administer corticosteroids
- D. Administer antihistamines
Correct answer: A
Rationale: The correct answer is to administer epinephrine. Epinephrine is the first-line treatment for anaphylactic shock as it helps reverse the severe allergic reaction by constricting blood vessels, increasing heart rate, and opening airways for improved breathing. Oxygen (Choice B) can be administered after epinephrine to support oxygenation. Corticosteroids (Choice C) may be used to prevent a biphasic reaction but are not the initial intervention. Antihistamines (Choice D) can help with itching and hives but do not address the life-threatening symptoms of anaphylaxis.
2. A nurse is preparing to perform postmortem care for a client. Which of the following actions should the nurse take?
- A. Place the client's dentures in a labeled container
- B. Remove the client's IV lines
- C. Place the client's body in a semi-fowler's position
- D. Lower the client's head of the bed
Correct answer: B
Rationale: The correct action for the nurse to take when preparing to perform postmortem care is to remove the client's IV lines. This step is essential to help maintain the dignity and appearance of the body. Placing the client's dentures in a labeled container (Choice A) is not a priority during postmortem care as the focus is on the body's preparation. While positioning the body in a semi-fowler's position (Choice C) or lowering the client's head of the bed (Choice D) are common practices for living clients to prevent aspiration, they are not necessary after death. Therefore, the immediate action of removing IV lines is most appropriate in this situation.
3. A client is 2 days postoperative following a hip replacement surgery. Which of the following findings should the nurse report to the provider?
- A. Heart rate of 88/min
- B. Redness and warmth in the calf
- C. Urine output of 30 mL/hr
- D. Heart rate of 96/min
Correct answer: B
Rationale: Redness and warmth in the calf can indicate a deep vein thrombosis (DVT), which is a serious complication following hip replacement surgery. It is crucial to report this finding promptly for further evaluation and intervention. The other options, heart rates of 88/min and 96/min, are within normal limits for an adult and may not require immediate reporting. A urine output of 30 mL/hr is concerning for decreased kidney perfusion, but the priority in this case is the potential DVT due to its severe implications.
4. A healthcare professional is assessing a client who is receiving opioid analgesics. Which of the following findings should the professional report to the provider?
- A. Oxygen saturation of 94%
- B. Blood pressure of 110/70 mm Hg
- C. Respiratory rate of 12/min
- D. Heart rate of 88/min
Correct answer: C
Rationale: A respiratory rate of 12/min may indicate respiratory depression, a potential side effect of opioid analgesics. Respiratory depression can be a serious complication that requires immediate intervention. Monitoring the respiratory rate is crucial in clients receiving opioids to prevent adverse events. Oxygen saturation, blood pressure, and heart rate are important parameters to assess, but a low respiratory rate is a more critical finding that warrants immediate reporting to the healthcare provider.
5. A nurse is providing teaching to a client who has a new prescription for clopidogrel. Which of the following instructions should the nurse include?
- A. Avoid eating foods high in potassium.
- B. Avoid drinking alcohol while taking this medication.
- C. Take this medication with a full glass of water.
- D. Take this medication with a full glass of water.
Correct answer: C
Rationale: The correct answer is C. Clients taking clopidogrel should take the medication with a full glass of water to prevent gastrointestinal irritation. Choice A is incorrect because there is no specific recommendation to avoid foods high in potassium with clopidogrel. Choice B is unrelated to the medication's administration. Choice D is a duplication of choice C, providing no additional information.
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