ATI RN
ATI RN Exit Exam Test Bank
1. A nurse is caring for a client who is at risk for developing deep vein thrombosis (DVT). Which of the following interventions should the nurse implement?
- A. Massage the client's legs every 4 hours.
- B. Administer prophylactic antibiotics.
- C. Apply sequential compression devices to the client's legs.
- D. Encourage the client to remain on bed rest.
Correct answer: C
Rationale: Applying sequential compression devices is the appropriate intervention for a client at risk for developing deep vein thrombosis (DVT). This intervention helps prevent venous stasis by promoting circulation in the lower extremities, reducing the risk of DVT. Massaging the client's legs every 4 hours is contraindicated as it can dislodge a blood clot and increase the risk of embolism. Administering prophylactic antibiotics is not indicated for preventing DVT. Encouraging the client to remain on bed rest can contribute to venous stasis and increase the risk of developing DVT.
2. A nurse is assessing a client who has increased intracranial pressure (ICP). Which of the following findings should the nurse expect?
- A. Bradycardia.
- B. Increased level of consciousness.
- C. Tachycardia.
- D. Hyperactive bowel sounds.
Correct answer: C
Rationale: The correct answer is C: Tachycardia. In a client with increased intracranial pressure (ICP), tachycardia is a common finding. This is due to the body's compensatory mechanisms in response to the increased pressure. Bradycardia (choice A) is not typically associated with increased ICP and may indicate a different issue. Increased level of consciousness (choice B) is unlikely with increased ICP, as it often leads to altered mental status. Hyperactive bowel sounds (choice D) are not directly related to increased ICP and are more indicative of gastrointestinal issues.
3. A nurse is providing teaching to a client who has heart failure and a new prescription for furosemide. Which of the following statements should the nurse make?
- A. Taking furosemide can cause your potassium levels to be high
- B. Eat foods that are high in sodium
- C. Rise slowly when getting out of bed
- D. Taking furosemide can cause you to be overhydrated
Correct answer: C
Rationale: Furosemide can cause low potassium levels, and clients should be advised to rise slowly to prevent dizziness.
4. A nurse is reviewing the laboratory results of a client who is at 28 weeks of gestation. Which of the following laboratory values should the nurse report to the provider?
- A. Hgb 10 g/dL
- B. Platelets 300,000/mm³
- C. WBC count 12,000/mm³
- D. BUN 18 mg/dL
Correct answer: A
Rationale: The correct answer is A: Hgb 10 g/dL. A hemoglobin level of 10 g/dL is below the normal range for a pregnant client, indicating possible anemia, which is crucial to report during pregnancy to prevent complications for both the mother and the baby. Platelets, WBC count, and BUN levels within the listed values are generally within normal ranges for a pregnant individual at 28 weeks of gestation. Platelets play a role in blood clotting, WBC count helps in fighting infections, and BUN measures kidney function, all of which are typically expected to be within normal limits during pregnancy.
5. A healthcare provider is reviewing the laboratory data of a client who is receiving total parenteral nutrition. Which of the following findings should the healthcare provider report?
- A. Serum calcium 8.5 mg/dL
- B. Blood glucose level 120 mg/dL
- C. Serum sodium 138 mEq/L
- D. Serum albumin 3.5 g/dL
Correct answer: D
Rationale: The correct answer is D: Serum albumin 3.5 g/dL. A low serum albumin level indicates protein deficiency, which can be a complication of TPN therapy and requires prompt intervention. The other laboratory findings provided (serum calcium 8.5 mg/dL, blood glucose level 120 mg/dL, and serum sodium 138 mEq/L) are within normal ranges and do not specifically indicate complications related to TPN therapy.
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