ATI RN
ATI RN Comprehensive Exit Exam
1. A nurse is assessing a client who has a new prescription for enoxaparin. Which of the following findings is a priority for the nurse to report?
- A. Platelet count of 200,000/mm³
- B. Hemoglobin level of 15 g/dL
- C. Respiratory rate of 22/min
- D. Dark, tarry stools
Correct answer: D
Rationale: The correct answer is D. Dark, tarry stools indicate gastrointestinal bleeding, which is a serious side effect of enoxaparin that requires immediate medical attention. Reporting this finding promptly is crucial to prevent further complications. Choices A, B, and C are within normal ranges and are not directly related to the adverse effects of enoxaparin, so they do not take precedence over the urgent concern of gastrointestinal bleeding.
2. A nurse is assessing a client who has left-sided heart failure. Which of the following should the nurse identify as a manifestation of pulmonary congestion?
- A. Frothy, pink sputum
- B. Jugular vein distention
- C. Weight gain
- D. Bradypnea
Correct answer: A
Rationale: Correct! Frothy, pink sputum is a classic sign of pulmonary congestion in left-sided heart failure. This occurs due to the accumulation of fluid in the lungs, leading to the coughing up of frothy, pink-tinged sputum. Jugular vein distention (choice B) is more indicative of right-sided heart failure, where fluid backs up into the systemic circulation. Weight gain (choice C) may occur due to fluid retention, but it is not a direct manifestation of pulmonary congestion. Bradypnea (choice D) refers to abnormally slow breathing and is not specifically associated with pulmonary congestion.
3. A healthcare provider is preparing to administer an intramuscular injection to a client. Which of the following actions should the provider take?
- A. Insert the needle at a 90-degree angle
- B. Insert the needle at a 45-degree angle
- C. Inject the medication slowly after aspiration
- D. Massage the site after injection
Correct answer: A
Rationale: Correct answer: When administering an intramuscular injection, the needle should be inserted at a 90-degree angle to ensure proper delivery of the medication into the muscle tissue. Option B is incorrect because a 45-degree angle is typically used for subcutaneous injections, not intramuscular. Option C is incorrect as aspiration is not recommended for intramuscular injections. Option D is incorrect as massaging the site after an intramuscular injection can cause tissue damage or interfere with the absorption of the medication.
4. A client who has a prescription for insulin glargine is talking to a nurse. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will mix this insulin with my regular insulin before injecting it.
- B. I will store this insulin in the refrigerator after opening it.
- C. I will take this insulin twice a day.
- D. I will inject this insulin when my blood glucose is above 200 mg/dL.
Correct answer: B
Rationale: The correct answer is B because insulin glargine should be stored in the refrigerator after opening to maintain its potency. Choice A is incorrect as insulin glargine should not be mixed with other insulins. Choice C is incorrect because insulin glargine is typically taken once a day. Choice D is incorrect because insulin glargine is usually taken regardless of blood glucose levels.
5. A nurse is caring for a client who has a prescription for digoxin. Which of the following laboratory values should the nurse monitor to identify an adverse effect of this medication?
- A. Potassium 3.5 mEq/L
- B. Sodium 140 mEq/L
- C. Calcium 9.5 mg/dL
- D. Magnesium 2.0 mEq/L
Correct answer: A
Rationale: The correct answer is A: Potassium 3.5 mEq/L. Digoxin can cause hypokalemia as an adverse effect. Monitoring potassium levels is crucial because low potassium levels can increase the risk of digoxin toxicity. Choices B, C, and D are incorrect as they are not directly associated with potential adverse effects of digoxin. Sodium levels are not typically affected by digoxin, calcium levels are not a primary concern with digoxin therapy, and magnesium levels are not the most important to monitor for digoxin adverse effects.
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