ATI RN
ATI Exit Exam RN
1. What is the best method to monitor fluid balance in a patient receiving diuretics?
- A. Monitor daily weight
- B. Monitor intake and output
- C. Monitor blood pressure
- D. Monitor edema
Correct answer: A
Rationale: The best method to monitor fluid balance in a patient receiving diuretics is to monitor daily weight. Daily weighing is a precise way to assess changes in fluid status as it reflects variations in total body water. Monitoring intake and output (choice B) is also important but may not provide as accurate a measurement as daily weight. Monitoring blood pressure (choice C) is essential but does not directly measure fluid balance. Monitoring edema (choice D) is helpful to assess fluid status visually but may not be as sensitive as daily weight measurements in detecting subtle changes in fluid balance.
2. When caring for a client with a new prescription for enoxaparin for the prevention of DVT, what is an appropriate action by the nurse?
- A. Expel any air bubbles at the top of the prefilled syringe
- B. Massage the injection site to evenly distribute the medication
- C. Inject the medication into the lateral abdominal wall
- D. Administer an NSAID for injection site discomfort
Correct answer: C
Rationale: When administering enoxaparin for the prevention of DVT, the nurse should inject the medication into the lateral abdominal wall. This site is preferred for subcutaneous injections of enoxaparin to reduce the risk of bleeding or injury. Expelling air bubbles, massaging the injection site, or administering an NSAID for discomfort are not appropriate actions and could lead to complications or ineffective medication delivery.
3. A nurse in an emergency department is caring for a client who reports cocaine use 1hr ago. Which of the following findings should the nurse expect?
- A. Hypotension
- B. Memory loss
- C. Slurred speech
- D. Elevated temperature
Correct answer: D
Rationale: The correct answer is D: Elevated temperature. Cocaine is a stimulant drug that can lead to an increase in body temperature. Hypotension (choice A) is less likely as cocaine tends to increase blood pressure. Memory loss (choice B) and slurred speech (choice C) are not typically immediate effects of recent cocaine use.
4. A nurse is caring for a client who is receiving a blood transfusion. Which of the following findings is a priority for the nurse to report?
- A. Low back pain
- B. Tachycardia
- C. Flushed skin
- D. Headache
Correct answer: B
Rationale: The correct answer is B: Tachycardia. Tachycardia can indicate a hemolytic transfusion reaction, a severe and life-threatening complication of blood transfusion. The nurse should report tachycardia immediately to prevent further complications. Low back pain, flushed skin, and headache are also important to monitor during a blood transfusion, but they are not as indicative of a severe transfusion reaction as tachycardia.
5. How should a healthcare provider monitor a patient who has been prescribed digoxin?
- A. Monitor potassium levels
- B. Monitor heart rate
- C. Check digoxin levels
- D. Check blood glucose levels
Correct answer: C
Rationale: The correct way to monitor a patient who has been prescribed digoxin is by checking digoxin levels. Digoxin is a medication used to treat various heart conditions, and monitoring its levels in the blood is crucial to prevent toxicity. Monitoring potassium levels (Choice A) is important as well, as digoxin can affect potassium levels, but checking digoxin levels is more specific to monitoring the medication itself. Monitoring heart rate (Choice B) is relevant but does not directly assess the medication levels. Checking blood glucose levels (Choice D) is not typically indicated specifically for patients prescribed digoxin.
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