ATI RN
ATI RN Custom Exams Set 2
1. Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison’s disease?
- A. Discuss the importance of tapering medications when discontinuing medication
- B. Explain that the dose will need to be decreased during times of stress or infection
- C. Instruct the client to take medication on an empty stomach with a glass of water
- D. Encourage the client to wear a MedicAlert bracelet and carry a card in the wallet
Correct answer: A
Rationale: The correct answer is A because tapering glucocorticoids is crucial to prevent adrenal insufficiency, which can occur if the medication is stopped abruptly. Choice B is incorrect as it refers to dose adjustments during stress or infection, not discontinuation. Choice C is incorrect because it does not specifically address the issue of stopping the medication. Choice D is not directly related to the management of glucocorticoid therapy for Addison’s disease.
2. A 30-year-old has poorly controlled asthma and is taking prednisone 10 mg by mouth once a day. He has been on this regimen for 6 weeks. Abrupt withdrawal or discontinuation of this medication can cause:
- A. adrenal crisis
- B. hypercortisolism
- C. ACTH stimulation
- D. thyroid crisis
Correct answer: adrenal crisis
Rationale: Abrupt withdrawal or discontinuation of prednisone, a corticosteroid, can lead to adrenal crisis. This occurs due to the suppression of the adrenal glands' natural cortisol production caused by prolonged exogenous steroid administration. Adrenal crisis presents with symptoms such as weakness, fatigue, abdominal pain, and hypotension. Hypercortisolism (Cushing syndrome) results from chronic excessive exposure to cortisol, not abrupt withdrawal. ACTH stimulation would be expected in response to low cortisol levels, not as a direct consequence of prednisone withdrawal. Thyroid crisis (thyroid storm) is associated with severe hyperthyroidism and is not directly related to corticosteroid withdrawal.
3. 12. A patient receives aspart (NovoLog) insulin at 8:00 AM. At which time will it be most important for the nurse to monitor for symptoms of hypoglycemia?
- A. 10:00 AM
- B. 12:00 PM
- C. 2:00 PM
- D. 4:00 PM
Correct answer: A
Rationale: After receiving aspart (NovoLog) insulin, which has a rapid onset, it is crucial to monitor the patient for symptoms of hypoglycemia during the peak action time. Typically, the peak action of aspart insulin occurs around 2 hours after administration. Therefore, the nurse should be most vigilant for hypoglycemia symptoms at 10:00 AM. Choice B (12:00 PM) is incorrect as it falls after the expected peak action time. Choices C (2:00 PM) and D (4:00 PM) are also incorrect because the peak action time of aspart insulin typically occurs earlier, around 2 hours post-administration.
4. A client who has a new prescription for ferrous sulfate is being taught by a nurse. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should expect dark tarry stools.
- B. I should expect increased bruising.
- C. I will not get as many infections.
- D. I will expect the color of my urine to be amber.
Correct answer: A
Rationale: The correct answer is A. When taking ferrous sulfate, dark tarry stools can occur as a common side effect due to the iron content in the medication. This is a normal response to the medication and not a cause for concern. Choices B, C, and D are incorrect because increased bruising, reduced infections, and amber-colored urine are not expected side effects of ferrous sulfate.
5. Which clinical manifestations should the nurse anticipate upon assessment for a preschool-age child with a urinary tract infection (UTI)?
- A. Headache, hematuria, and vertigo
- B. Foul-smelling urine, elevated blood pressure (BP), and hematuria
- C. Urgency, dysuria, and fever
- D. Severe flank pain, nausea, and headache
Correct answer: C
Rationale: Preschool-age children with a urinary tract infection commonly present with urgency (feeling the need to urinate urgently), dysuria (painful urination), and fever. These symptoms are indicative of a UTI in this age group and should prompt further assessment and intervention by the nurse. Choice A is incorrect because headache and vertigo are not typical symptoms of UTI in preschool-age children. Choice B is incorrect because while foul-smelling urine and hematuria can be present in UTI, elevated blood pressure is not a common finding in this condition. Choice D is incorrect as severe flank pain and nausea are not typical manifestations of UTI in preschool-age children.