ATI RN
ATI Exit Exam RN
1. How should a healthcare professional monitor for infection in a patient with a central line?
- A. Check the central line dressing daily
- B. Monitor for signs of redness
- C. Check for abnormal breath sounds
- D. Monitor temperature
Correct answer: A
Rationale: Correct answer: A. Checking the central line dressing daily is crucial to monitor for signs of infection around the insertion site. This practice helps in early detection of any changes such as redness, swelling, or discharge, which are indicators of a potential infection. Monitoring for signs of redness (choice B) is limited as redness alone may not always indicate an infection; other symptoms like discharge and tenderness should also be observed. Checking for abnormal breath sounds (choice C) is not directly related to monitoring central line infections. Monitoring temperature (choice D) is important for detecting systemic signs of infection but may not specifically indicate an infection related to the central line site.
2. A nurse is providing dietary teaching to a client who has a new prescription for warfarin. Which of the following client statements indicates an understanding of the teaching?
- A. I will avoid eating leafy green vegetables while taking this medication.
- B. I will increase my intake of calcium-rich foods.
- C. I will avoid foods high in vitamin K while taking this medication.
- D. I will take this medication at bedtime to avoid dizziness.
Correct answer: C
Rationale: Clients taking warfarin should avoid foods high in vitamin K, as it can interfere with the effectiveness of the medication.
3. A nurse is caring for a client who is receiving TPN. Which of the following actions should the nurse take to prevent infection?
- A. Change the TPN tubing every 72 hours.
- B. Monitor the client's blood glucose every 4 hours.
- C. Monitor the client's urine output every 8 hours.
- D. Use sterile technique when changing the central line dressing.
Correct answer: D
Rationale: The correct answer is D: 'Use sterile technique when changing the central line dressing.' When caring for a client receiving TPN, it is crucial to maintain aseptic technique to prevent infections. Changing the central line dressing with sterile technique helps reduce the risk of introducing pathogens into the client's system. Choices A, B, and C are incorrect because changing the TPN tubing every 72 hours, monitoring blood glucose, and monitoring urine output are important aspects of care but are not directly related to preventing infection in clients receiving TPN.
4. A nurse is caring for a client who has a prescription for furosemide. The nurse should monitor the client for which of the following electrolyte imbalances?
- A. Hypernatremia
- B. Hypokalemia
- C. Hypercalcemia
- D. Hypomagnesemia
Correct answer: B
Rationale: The correct answer is B: Hypokalemia. Furosemide, a loop diuretic, can cause potassium loss leading to hypokalemia. Monitoring potassium levels is crucial as low potassium can result in various complications like cardiac dysrhythmias. Choices A, C, and D are incorrect. Hypernatremia is high sodium levels, which are not typically associated with furosemide use. Hypercalcemia is elevated calcium levels and hypomagnesemia is low magnesium levels, which are not the primary electrolyte imbalances associated with furosemide.
5. A nurse is caring for a client who has a sodium level of 125 mEq/L. Which of the following actions should the nurse take?
- A. Administer 0.9% sodium chloride IV
- B. Administer a hypotonic IV solution
- C. Encourage oral fluid intake
- D. Restrict oral fluid intake
Correct answer: A
Rationale: In a client with a sodium level of 125 mEq/L (hyponatremia), the nurse should administer 0.9% sodium chloride IV to help increase sodium levels. Choice B, administering a hypotonic IV solution, would further decrease the sodium level. Choice C, encouraging oral fluid intake, is contraindicated as it can dilute the sodium concentration further. Choice D, restricting oral fluid intake, could worsen the client's condition by leading to dehydration and further electrolyte imbalances.
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