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 caring for a client who is at risk for developing a deep vein thrombosis (DVT). Which of the following interventions should the nurse implement?
- A. Massage the client's legs every 2 hours.
- B. Instruct the client to sit with the legs crossed.
- C. Administer prophylactic antibiotics.
- D. Apply sequential compression devices to the client's legs.
Correct answer: D
Rationale: The correct answer is D: Apply sequential compression devices to the client's legs. Sequential compression devices help prevent venous stasis and reduce the risk of DVT by promoting blood flow in the legs. Massaging the client's legs every 2 hours (choice A) may dislodge a clot if present, leading to a higher risk of embolism. Instructing the client to sit with the legs crossed (choice B) can impede blood flow and increase the risk of DVT. Administering prophylactic antibiotics (choice C) is not indicated for preventing DVT, as antibiotics are used to treat infections caused by bacteria, not to prevent blood clots.
3. A client who has a new diagnosis of type 2 diabetes mellitus is being taught about foot care by a nurse. Which of the following statements should the nurse include?
- A. Use lotion on your feet to prevent dry, cracked skin, avoiding application between the toes.
- B. Avoid soaking your feet in warm water daily to prevent dry skin.
- C. Trim your toenails straight across to prevent injury.
- D. Do not apply a heating pad to your feet if they feel cold.
Correct answer: C
Rationale: The correct answer is C. Trimming toenails straight across is essential for clients with diabetes to prevent the risk of ingrown toenails and injury. Using lotion on feet can be beneficial but should not be applied between the toes to avoid moisture buildup, which can lead to infections. Soaking feet in warm water can lead to dry skin, increasing the risk of cracks and other complications. Applying a heating pad to feet when they feel cold is not recommended for clients with diabetes due to impaired sensation, which can result in burns and other injuries.
4. A nurse is caring for a client who has Raynaud's disease. Which of the following actions should the nurse take?
- A. Provide information about stress management.
- B. Maintain a warm temperature in the client's room.
- C. Administer epinephrine for acute episodes.
- D. Give glucocorticoid steroids twice a day.
Correct answer: A
Rationale: Corrected Rationale: Providing information about stress management is essential when caring for a client with Raynaud's disease because stress can trigger episodes. Stress management techniques can help the client avoid triggers and reduce the frequency of episodes. Choice B is incorrect because maintaining a warm temperature, rather than a cool one, helps prevent vasoconstriction and can be beneficial for clients with Raynaud's disease. Choice C is incorrect because epinephrine is not a standard treatment for Raynaud's disease; it is more commonly used for severe allergic reactions. Choice D is incorrect because glucocorticoid steroids are not typically used in the management of Raynaud's disease.
5. A nurse is caring for a client who has tuberculosis. Which of the following actions should the nurse take?
- A. Place the client in a negative pressure room.
- B. Wear a surgical mask when entering the client's room.
- C. Place the client in droplet isolation.
- D. Place a surgical mask on the client when transporting them.
Correct answer: A
Rationale: The correct answer is to place the client in a negative pressure room. This action is necessary to prevent the spread of tuberculosis, as it is transmitted via airborne particles. Placing the client in droplet isolation (choice C) is not sufficient for tuberculosis, as it requires airborne precautions. Wearing a surgical mask (choice B) when entering the client's room may not provide adequate protection against airborne transmission. Placing a surgical mask on the client when transporting them (choice D) does not address the need for environmental controls to contain infectious particles.
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