ATI RN
ATI Comprehensive Exit Exam
1. A healthcare professional is reviewing the medication history of a client who has a new prescription for warfarin. Which of the following medications should the healthcare professional identify as a contraindication for this client?
- A. Acetaminophen
- B. Ibuprofen
- C. Clopidogrel
- D. Metoprolol
Correct answer: C
Rationale: The correct answer is C, Clopidogrel. Clopidogrel is an antiplatelet medication that increases the risk of bleeding when taken with warfarin. Acetaminophen (choice A) and metoprolol (choice D) do not have significant interactions with warfarin. Ibuprofen (choice B) is an NSAID that can also increase the risk of bleeding when taken with warfarin, but clopidogrel is a more significant contraindication due to its antiplatelet effects. Therefore, healthcare professionals should be cautious when combining warfarin with clopidogrel due to the increased risk of bleeding compared to other options.
2. A nurse is providing teaching to a client who has a new prescription for ferrous sulfate. Which of the following instructions should the nurse include?
- A. Take this medication with orange juice to increase absorption.
- B. Take this medication on an empty stomach.
- C. Take this medication with milk if it causes stomach upset.
- D. Take this medication at bedtime.
Correct answer: A
Rationale: The correct instruction for a client prescribed ferrous sulfate is to take the medication with orange juice to enhance absorption. Orange juice is recommended because of its vitamin C content, which aids in the absorption of iron. Choice B, taking the medication on an empty stomach, is incorrect because ferrous sulfate is better absorbed with food. Choice C, taking the medication with milk if it causes stomach upset, is incorrect as calcium in milk can interfere with iron absorption. Choice D, taking the medication at bedtime, is incorrect as it is usually recommended to take iron supplements between meals or with food to enhance absorption.
3. What is the appropriate nursing action for a patient experiencing an acute allergic reaction?
- A. Administer antihistamines
- B. Administer corticosteroids
- C. Administer oxygen
- D. Administer bronchodilators
Correct answer: A
Rationale: The appropriate nursing action for a patient experiencing an acute allergic reaction is to administer antihistamines. Antihistamines work by blocking the action of histamine, a chemical released during an allergic reaction, and can help relieve symptoms such as itching, swelling, and hives. Corticosteroids are used for severe allergic reactions not responding to antihistamines, as they have anti-inflammatory properties. Oxygen is administered in cases of respiratory distress, while bronchodilators are used for bronchospasms. However, the first-line intervention for an acute allergic reaction is antihistamines.
4. A nurse is caring for a client who has a chest tube. Which of the following actions should the nurse take?
- A. Clamp the chest tube for 15 minutes every 2 hours.
- B. Empty the drainage collection chamber when it is half full.
- C. Keep the drainage system below the level of the client's chest.
- D. Strip the chest tube every 2 hours to maintain patency.
Correct answer: C
Rationale: The correct action the nurse should take when caring for a client with a chest tube is to keep the drainage system below the level of the client's chest. This positioning helps prevent fluid from flowing back into the pleural space, ensuring proper drainage and effective functioning of the chest tube. Clamping the chest tube intermittently or stripping it frequently can lead to complications and should be avoided. Emptying the drainage collection chamber at specific intervals may vary based on institutional protocols, but it should be done when it is no more than two-thirds full to prevent backflow and maintain accurate monitoring of drainage output.
5. A nurse is preparing to administer an IV bolus of 0.9% sodium chloride to a client who is dehydrated. Which of the following actions should the nurse take?
- A. Administer the solution slowly over 24 hours
- B. Assess the client's lung sounds before administration
- C. Change the IV tubing every 12 hours
- D. Flush the IV line with 2 mL of heparin every 4 hours
Correct answer: B
Rationale: The correct action for the nurse to take is to assess the client's lung sounds before administering IV fluids. This is crucial to identify any signs of fluid overload, such as crackles or wheezes. Administering the solution slowly over 24 hours (choice A) is not appropriate for an IV bolus, which is a rapid infusion. Changing the IV tubing every 12 hours (choice C) is a standard practice for preventing infection but is not directly related to administering an IV bolus. Flushing the IV line with heparin every 4 hours (choice D) is a maintenance practice to prevent clot formation in the line, not specifically related to administering an IV bolus.
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