ATI RN
ATI RN Exit Exam Quizlet
1. A patient is 1 day postoperative following a hip arthroplasty. Which of the following actions should the nurse take to prevent dislocation of the hip?
- A. Keep the patient in a side-lying position.
- B. Place a pillow between the patient's legs.
- C. Instruct the patient to avoid sitting for long periods.
- D. Elevate the head of the bed to 90 degrees.
Correct answer: B
Rationale: Placing a pillow between the patient's legs is the correct action to prevent dislocation of the hip following arthroplasty. This technique helps maintain proper alignment and stability of the hip joint. Keeping the patient in a side-lying position may not provide the necessary support to prevent hip dislocation. Instructing the patient to avoid sitting for long periods is important for preventing complications like deep vein thrombosis but does not directly prevent hip dislocation. Elevating the head of the bed to 90 degrees is not relevant to preventing hip dislocation in a postoperative hip arthroplasty patient.
2. A nurse is caring for a client who is receiving radiation therapy for breast cancer. Which of the following skin care instructions should the nurse provide?
- A. Wear loose clothing over the radiation site.
- B. Use scented lotions to moisturize the skin.
- C. Apply ice packs to the radiation site for pain relief.
- D. Expose the radiation site to sunlight for 20 minutes daily.
Correct answer: A
Rationale: The correct answer is A: Wear loose clothing over the radiation site. Clients receiving radiation therapy should wear loose clothing over the treatment area to prevent irritation and promote healing. Choice B is incorrect as scented lotions can irritate the skin during radiation therapy. Choice C is incorrect because ice packs should not be applied to the radiation site as they can exacerbate skin reactions. Choice D is incorrect as exposing the radiation site to sunlight can increase skin damage and should be avoided.
3. A nurse is assessing a client with a history of post-traumatic stress disorder (PTSD). Which of the following findings should the nurse expect?
- A. Dependence on family and friends
- B. Loss of interest in usual activities
- C. Ritualistic behavior
- D. Passive-aggressive behavior
Correct answer: B
Rationale: The correct answer is B: Loss of interest in usual activities. Clients with PTSD often exhibit symptoms such as numbing, which can manifest as a loss of interest in activities they once enjoyed. Choice A, dependence on family and friends, is more indicative of seeking support rather than a direct symptom of PTSD. Choice C, ritualistic behavior, is more commonly associated with conditions like obsessive-compulsive disorder. Choice D, passive-aggressive behavior, is not a typical finding in clients with PTSD.
4. A nurse is caring for a client who is receiving oxytocin IV for augmentation of labor. The client's contractions are occurring every 45 seconds with a nine-second duration, and the fetal heart rate is 170 to 180 beats per minute. Which of the following actions should the nurse take?
- A. Discontinue oxytocin infusion
- B. Increase oxytocin infusion
- C. Decrease oxytocin infusion
- D. Maintain oxytocin infusion
Correct answer: A
Rationale: In this scenario, the client is experiencing frequent contractions with a short duration and an elevated fetal heart rate, indicating potential fetal distress. Discontinuing the oxytocin infusion is crucial to prevent further complications and restore normal fetal parameters. Increasing or maintaining the oxytocin infusion could exacerbate the situation, leading to more distress for the fetus. Decreasing the oxytocin infusion may not be sufficient to address the current issue and could delay the improvement of fetal well-being.
5. A nurse is caring for a client who is experiencing acute alcohol withdrawal. Which of the following actions should the nurse take?
- A. Administer haloperidol as prescribed.
- B. Keep the client in a supine position.
- C. Administer lorazepam as prescribed.
- D. Encourage the client to drink fluids with meals.
Correct answer: C
Rationale: The correct action the nurse should take when caring for a client experiencing acute alcohol withdrawal is to administer lorazepam as prescribed. Lorazepam is a benzodiazepine used to prevent seizures and manage agitation in clients undergoing alcohol withdrawal. Administering haloperidol (Choice A) is not recommended in alcohol withdrawal as it may lower the seizure threshold. Keeping the client in a supine position (Choice B) is not specifically indicated in managing alcohol withdrawal. Encouraging the client to drink fluids with meals (Choice D) is important for hydration but does not address the acute symptoms of alcohol withdrawal.
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