ATI RN
ATI RN Fundamental Proctored Exam With NGN Graded Questions
Extract:
Question 1 of 5
A nurse is assessing a client who takes haloperidol (Haldol) for the treatment of schizophrenia. Which of the following findings should the nurse document as extrapyramidal symptoms (EPS)? Select all.
Correct Answer: B, C, E
Rationale: The correct findings to document as EPS for a client taking haloperidol are B, C, and E. Fine motor tremors are a common EPS manifestation, indicating potential Parkinsonism. Acute dystonias are sudden, involuntary muscle contractions, a characteristic EPS symptom. Uncontrollable restlessness, known as akathisia, is another EPS effect. Orthostatic hypotension (
A) is not typically associated with EPS but rather with antipsychotic-induced orthostatic hypotension. Decreased level of consciousness (
D) is not a typical EPS manifestation but may indicate sedation.
Question 2 of 5
A nurse is preparing to administer a med to a client. The med was scheduled for administration at 0900. Which of the following are acceptable administration times for this med? Select all.
Correct Answer: A,D
Rationale: The correct answers are A (905) and D (840) because they fall within the acceptable timeframe for administering the medication. The general rule for medication administration is usually within 30 minutes before or after the scheduled time.
Choice A (905) is within this range as it is 5 minutes after 0900, and choice D (840) is also within this range as it is 20 minutes before 0900.
Choices B (825) and E (935) are outside the 30-minute window.
Choice C (1,000) is significantly delayed and could potentially affect the medication's effectiveness.
Therefore, choices B, C, and E are incorrect due to being outside the acceptable administration times.
Question 3 of 5
A nurse is providing teaching about managing anticholinergic effects for a client who has a new prescription for oxybutynin (Ditropan XL). Which of the following are appropriate to include in the teaching? Select all.
Correct Answer: A, B, E
Rationale:
Correct Answer: A, B, E
Rationale:
A: Taking frequent sips of water helps combat dry mouth, a common anticholinergic effect of oxybutynin.
B: Wearing sunglasses protects against photophobia, another potential anticholinergic effect.
E: Urinating prior to taking the medication can help reduce urinary retention, a side effect of oxybutynin.
Incorrect
Choices:
C: Using a soft toothbrush is not directly related to managing anticholinergic effects.
D: Taking the medication with an antacid may interfere with its absorption and is not recommended.
Question 4 of 5
A nurse is preparing to administer a cleansing enema to an adult client in preparation for a diagnostic procedure. Which of the following are appropriate steps for the nurse to take? Select all.
Correct Answer: A, B, C
Rationale:
Correct Answer: A, B, C
Rationale:
A: Warming the enema helps prevent cramping and discomfort during instillation.
B: Positioning the client on the left side with the right leg flexed forward helps facilitate easier insertion of the enema.
C: Lubricating the rectal tube or nozzle helps prevent injury and discomfort during insertion.
Incorrect
Choices:
D: Slowly inserting the rectal tube about 2 inches is incorrect as it may not be deep enough to reach the sigmoid colon.
E: Hanging the enema container 24 inches above the client's anus is incorrect as it may cause rapid flow leading to discomfort and cramping.
Question 5 of 5
A nurse is teaching a young adult client about health promotion & illness prevention. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: B
Rationale: The correct answer is B: It is important to schedule routine health care visits even if I'm feeling well. This statement indicates an understanding of health promotion and illness prevention as it emphasizes the importance of preventive care to maintain overall health. Regular health check-ups can help detect early signs of illness and address any potential health concerns before they become serious.
Incorrect choices:
A: I already had my immunizations as a child, so I'm protected in that area. This choice shows a misunderstanding as immunizations may need to be updated throughout adulthood.
C: If I'm having any discomfort, I'll just go to an urgent care center. This choice focuses on reactive care rather than preventive measures.
D: If I am feeling stressed, I will remind myself that this is something I should expect. This choice does not address health promotion or illness prevention strategies.
Summary:
Choice B is correct as it highlights the importance of proactive health maintenance through routine check-ups, while the other choices lack a focus on preventive