ATI RN
ATI Fundamentals Proctored Exam 2024
1. Why is a precise amount of oxygen necessary for a patient with COPD to prevent which complication?
- A. Cardiac arrest related to increased partial pressure of carbon dioxide in arterial blood (PaCO2)
- B. Circulatory overload due to hypervolemia
- C. Respiratory excitement
- D. Inhibition of the respiratory hypoxic stimulus
Correct answer: D
Rationale: In patients with COPD, the respiratory drive is often stimulated by low oxygen levels. Administering too much oxygen can inhibit this hypoxic drive, leading to respiratory depression and potential respiratory failure. Therefore, it is crucial to carefully regulate the oxygen therapy to prevent the inhibition of the respiratory hypoxic stimulus in COPD patients.
2. When caring for a client who is to have a line placed for hemodynamic monitoring, which statement by the newly licensed nurse indicates effectiveness of the teaching?
- A. Air should be instilled into the monitoring system after the procedure.
- B. The client should be positioned on the left side after the procedure.
- C. The transducer should be level with the second intercostal space after the line is placed.
- D. A chest x-ray is needed to verify placement after the procedure.
Correct answer: D
Rationale: After a line is placed for hemodynamic monitoring, it is crucial to confirm its correct placement. The definitive way to verify the placement is through a chest x-ray. This ensures that the line is appropriately positioned without complications. Options A, B, and C do not address the essential step of confirming the line's placement, making them incorrect choices.
3. A client is being educated by a healthcare provider on the purpose of taking a bronchodilator. Which of the following client statements indicates an understanding of the teaching?
- A. ''This medication can decrease my immune response.''
- B. ''I take this medication to prevent asthma attacks.''
- C. ''I need to take this medication with food.''
- D. ''This medication has a slow onset to treat my symptoms.''
Correct answer: B
Rationale: The correct answer is, 'I take this medication to prevent asthma attacks.' Bronchodilators are commonly used to relieve bronchospasm in conditions such as asthma. This medication helps to dilate the airways, making it easier to breathe and preventing asthma attacks. The other options are incorrect: option A is inaccurate as bronchodilators do not decrease immune responses, option C is incorrect as bronchodilators are typically taken on an empty stomach for better absorption, and option D is false as bronchodilators have a rapid onset to provide quick relief of symptoms.
4. A patient with no known allergies is to receive penicillin every 6 hours. When administering the medication, the nurse observes a fine rash on the patient’s skin. The most appropriate nursing action would be to:
- A. Withhold the medication and notify the physician
- B. Administer the medication and notify the physician
- C. Administer the medication with an antihistamine
- D. Apply corn starch soaks to the rash
Correct answer: A
Rationale: In this scenario, the appearance of a rash after administering penicillin, even in a patient with no known allergies, is concerning for a potential allergic reaction. The appropriate action for the nurse to take is to withhold the medication and notify the physician. This precaution is necessary to prevent further administration of a medication that may be causing an adverse reaction, as allergic reactions can range from mild to severe and require immediate intervention.
5. The physician orders the administration of high-humidity oxygen by face mask and placement of the patient in a high Fowler’s position. After assessing Mrs. Paul, the nurse writes the following nursing diagnosis: Impaired gas exchange related to increased secretions. Which of the following nursing interventions has the greatest potential for improving this situation?
- A. Encourage the patient to increase her fluid intake to 200 ml every 2 hours
- B. Place a humidifier in the patient’s room
- C. Continue administering oxygen by high humidity face mask
- D. Perform chest physiotherapy on a regular schedule
Correct answer: D
Rationale: Chest physiotherapy is the most effective intervention in cases of impaired gas exchange related to increased secretions. This technique helps mobilize and clear secretions from the airways, thereby improving gas exchange in the lungs. Placing a humidifier or administering oxygen by high humidity face mask may provide moisture but may not directly address the clearance of secretions. Encouraging increased fluid intake can help with hydration but may not address the underlying issue of impaired gas exchange due to secretions.
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