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 client with a new diagnosis of systemic lupus erythematosus (SLE) is being cared for by a nurse. Which of the following findings should the nurse expect?
- A. Joint pain.
- B. Weight gain.
- C. Butterfly-shaped rash on the face.
- D. Increased appetite.
Correct answer: B
Rationale: The correct answer is B: Weight gain. Weight gain is a common finding in clients with systemic lupus erythematosus due to fluid retention. Joint pain (choice A) is also common in SLE but is not specific to fluid retention. A butterfly-shaped rash on the face (choice C) is a classic symptom of SLE but is not related to fluid retention. Increased appetite (choice D) is less likely in SLE compared to weight gain.
3. A client has a new prescription for hydrochlorothiazide. Which of the following instructions should the nurse include?
- A. Take this medication at bedtime to prevent dizziness.
- B. Increase your intake of potassium-rich foods.
- C. Take this medication with food to prevent gastrointestinal upset.
- D. This medication can increase your blood pressure.
Correct answer: B
Rationale: The correct instruction that the nurse should include for a client prescribed hydrochlorothiazide is to increase their intake of potassium-rich foods. Hydrochlorothiazide is a diuretic that can lead to potassium depletion, so increasing potassium-rich foods helps prevent hypokalemia. Option A is incorrect because hydrochlorothiazide is usually taken in the morning to prevent diuresis at night. Option C is not necessary as hydrochlorothiazide can be taken with or without food. Option D is incorrect because hydrochlorothiazide is used to lower blood pressure, not increase it.
4. A nurse is caring for a client who has Cushing's syndrome. Which of the following findings should the nurse expect?
- A. Hypotension.
- B. Weight loss.
- C. Hyperkalemia.
- D. Hypercalcemia.
Correct answer: C
Rationale: In clients with Cushing's syndrome, the nurse should expect hyperkalemia. Cushing's syndrome is characterized by excess cortisol levels, which can lead to potassium retention and result in hyperkalemia. Choices A, B, and D are incorrect. Hypotension is not typically associated with Cushing's syndrome; instead, hypertension is more common due to the effects of cortisol. Weight gain, rather than weight loss, is a common symptom of Cushing's syndrome. Hypercalcemia is not a typical finding in Cushing's syndrome; instead, hypocalcemia may occur due to increased urinary calcium excretion.
5. A nurse is providing discharge instructions to a client who has a new prescription for warfarin. Which of the following statements indicates a need for further teaching?
- A. I will avoid leafy green vegetables while taking warfarin.
- B. I will have my INR checked regularly while taking warfarin.
- C. I will use a soft toothbrush while taking warfarin.
- D. I will take this medication at the same time each day.
Correct answer: A
Rationale: The correct answer is A. Clients taking warfarin should avoid leafy green vegetables because they are high in vitamin K, which can interfere with the effectiveness of warfarin by counteracting its anticoagulant effects. Choices B, C, and D are all correct statements related to taking warfarin. Regular INR monitoring is necessary to ensure the medication is within the therapeutic range, using a soft toothbrush reduces the risk of bleeding gums, and taking the medication at the same time daily helps maintain consistent blood levels.
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