ATI RN
ATI RN Custom Exams Set 2
1. Which electrolyte imbalance is a potential side effect of diuretics?
- A. Hyperkalemia
- B. Hypercalcemia
- C. Hypomagnesemia
- D. Hypokalemia
Correct answer: D
Rationale: The correct answer is D, Hypokalemia. Diuretics commonly lead to hypokalemia, which is low potassium levels in the body. Hyperkalemia (choice A) is the opposite, indicating high potassium levels. Hypercalcemia (choice B) refers to elevated calcium levels, not typically associated with diuretics. Hypomagnesemia (choice C) is low magnesium levels and can also be a consequence of diuretic use, but potassium imbalance is more common.
2. During a physical assessment of a newborn, what finding should the nurse prioritize reporting?
- A. Head circumference of 40 cm
- B. Chest circumference of 32 cm
- C. Acrocyanosis and edema of the scalp
- D. Heart rate of 160 bpm and respirations of 40/min
Correct answer: A
Rationale: The correct answer is A because a head circumference of 40 cm is unusually large for a newborn, which may indicate hydrocephalus or other abnormalities. Reporting this finding is crucial for further evaluation and intervention. Choices B, C, and D are not as concerning during a newborn physical assessment. A chest circumference of 32 cm is within the normal range for a newborn. Acrocyanosis and edema of the scalp are common findings in newborns and usually resolve without intervention. While a heart rate of 160 bpm and respirations of 40/min should be monitored, they are not as critical as an unusually large head circumference.
3. When assessing a client for an endocrine dysfunction, which question should the nurse ask?
- A. “Have you noticed any pain in your legs when walking?”
- B. “Have you had any unexplained weight loss?”
- C. “Have you noticed any change in your bowel movements?”
- D. “Have you experienced any joint pain or discomfort?”
Correct answer: B
Rationale: The correct answer is B: “Have you had any unexplained weight loss?” Unexplained weight loss can be a common symptom of various endocrine disorders, such as hyperthyroidism and diabetes. This weight loss is often despite an adequate or increased appetite. Choices A, C, and D are less likely to be directly associated with endocrine dysfunction. Pain in the legs when walking could be related to musculoskeletal issues, changes in bowel movements may suggest gastrointestinal concerns, and joint pain is more commonly linked to rheumatologic conditions rather than primary endocrine disorders.
4. The nurse is caring for the client one day postoperative sigmoid colostomy operation. Which independent nursing intervention should the nurse implement?
- A. Change the infusion rate of the intravenous fluid
- B. Encourage the client to discuss his or her feelings
- C. Administer opioid narcotic medications for pain management
- D. Assist the client out of bed to sit in the chair twice daily
Correct answer: D
Rationale: Assisting the client to sit in a chair is an essential nursing intervention postoperatively as it helps promote circulation, prevent complications like blood clots, and aids in the recovery process. Changing the infusion rate of intravenous fluid (Choice A) requires a physician's order and is not an independent nursing intervention. Encouraging the client to discuss feelings (Choice B) is important for emotional support but not as crucial as physical care immediately postoperatively. Administering opioid narcotic medications (Choice C) for pain management should be based on a prescribed schedule and assessment rather than being an independent nursing action.
5. Enteral feedings may be appropriate for patients with:
- A. Acute cholecystitis
- B. Hepatic encephalopathy
- C. Ulcerative colitis in remission
- D. Acute exacerbation of Crohn’s disease
Correct answer: D
Rationale: Enteral feedings are commonly used in patients with Crohn’s disease during acute exacerbations to provide adequate nutrition while resting the bowel. Acute cholecystitis, hepatic encephalopathy, and ulcerative colitis in remission wouldn't typically require enteral feedings as the primary nutritional support. Acute cholecystitis may necessitate fasting and intravenous fluids, hepatic encephalopathy may require dietary modifications but not enteral feedings, and patients with ulcerative colitis in remission usually have their nutritional needs met through a regular diet.
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