ATI RN
ATI RN Exit Exam Quizlet
1. A nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of the following instructions should the nurse include?
- A. You should avoid consuming foods high in vitamin K.
- B. Take this medication at the same time each day.
- C. Monitor for signs of bruising and bleeding.
- D. Have your INR checked every 4 weeks.
Correct answer: A
Rationale: The correct instruction the nurse should include is to advise the client to avoid consuming foods high in vitamin K. Foods rich in vitamin K, such as leafy greens, can interfere with the effectiveness of warfarin, an anticoagulant medication. Therefore, it is important for clients on warfarin therapy to maintain consistent vitamin K intake to keep their INR levels stable. The other options are also important but not the priority in the context of warfarin therapy. Ingesting foods high in vitamin K can affect the medication's efficacy, making it crucial to highlight this dietary consideration during client education.
2. How should a healthcare professional manage a patient with hypertension who is non-compliant with medication?
- A. Provide education on the importance of medication
- B. Refer the patient to a specialist
- C. Discontinue the medication
- D. Explore alternative treatment options
Correct answer: A
Rationale: Providing education on the importance of medication is crucial in managing hypertension in patients who are non-compliant. By educating the patient about the significance of taking medication as prescribed, the healthcare professional can help improve the patient's understanding and motivation to adhere to the treatment plan. Referring the patient to a specialist (Choice B) may be necessary in some cases but addressing non-compliance should start with education. Discontinuing the medication (Choice C) without addressing the root cause of non-compliance can worsen the patient's condition. Exploring alternative treatment options (Choice D) should come after ensuring the patient understands the importance of the current treatment regimen.
3. 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.
4. A healthcare provider is assessing a client who has pneumonia. Which of the following findings is the priority for the healthcare provider to report?
- A. Crackles in the lung bases
- B. Blood pressure of 100/64 mm Hg
- C. Respiratory rate of 26/min
- D. Heart rate of 86/min
Correct answer: C
Rationale: A respiratory rate of 26/min is a sign of respiratory distress and should be reported promptly in a client with pneumonia. Rapid breathing can indicate inadequate oxygenation and ventilation, which may lead to respiratory failure. Crackles in the lung bases are common in pneumonia but may not be as urgent as a high respiratory rate. A blood pressure of 100/64 mm Hg is slightly low but may not be immediately life-threatening. A heart rate of 86/min is within the normal range for an adult and is not the most critical finding to report.
5. What is the best initial action when a patient presents with confusion?
- A. Administer IV fluids
- B. Perform a neurological assessment
- C. Administer electrolytes
- D. Prepare for a CT scan
Correct answer: B
Rationale: When a patient presents with confusion, the best initial action is to perform a neurological assessment. This assessment helps in identifying potential causes of confusion such as neurological issues, infections, metabolic abnormalities, or medication side effects. Administering IV fluids (Choice A) may be necessary based on assessment findings, but it is not the first step. Administering electrolytes (Choice C) would also depend on the assessment results. Preparing for a CT scan (Choice D) may be indicated later in the diagnostic process but is not the initial action when a patient presents with confusion.
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