ATI RN
ATI RN Fundamentals 2023 II Questions
Extract:
Exibit 1
Provider Prescriptions
Day 4, 1500:
Discharge prescriptions:
Cephalexin 500 mg PO every 6 hr for 5 days Prednisone 40 mg PO daily for 5 days Home oxygen 3 L/min via nasal cannula
Exibit 2
Vital Signs
Day 1, 1100:
Temperature 39.1° C (102.4° F) Pulse rate 102/min Respiratory rate 26/min
Blood pressure 122/80 mm Hg Oxygen saturation 86% on room air Weight 90.7 kg (200 lb)
Day 2, 1200:
Temperature 38° C (100.4° F) Pulse rate 100/min Respiratory rate 22/min
Blood pressure 120/74 mm Hg
Oxygen saturation 88% on nasal cannula at 2 L/min Day 3, 1200:
Température 37.2° C (98.9" F) Pulse rate 90/min
Respiratory rate 20/min
Blood pressure 120/72 mm Hg
Exibit 3
Medication Administration Record
Day 1, 1500:
Cefazolin 500 mg every 12 hr IV Dexamethasone 15 mg every 6 hr IV Day 3, 1200:
Discontinue dexamethasone 15 mg every 6 hr IV Prednisone 40 mg PO daily
Day 4, 1500:
Discontinue cefazolin 500 mg every 12 hr IV
Question 1 of 5
A nurse is caring for a client who has pneumonia. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)
Correct Answer: D,E,F
Rationale:
Correct Answer: D, E, F
Rationale:
D: Steroid medication should be taken in the morning - Steroid medication is typically taken in the morning to align with the body's natural cortisol production.
E: The steroid dose will decrease each day - Steroid therapy is usually tapered off gradually to prevent withdrawal symptoms.
F: Ensure the oxygen delivery system is at least 8 feet from any heat source - This is important to prevent the risk of fire or explosion.
Incorrect
Choices:
A: Store the oxygen cylinder wrench with the oxygen tank - This is incorrect as the wrench should be stored separately for easy access during emergencies.
B: Antibiotic therapy should be taken for 10 days - The duration of antibiotic therapy may vary depending on the specific antibiotic and the severity of the infection. It is not always 10 days.
C: Adjust the oxygen flow rate as needed to ease breathing - The oxygen flow rate should be set according to the healthcare provider's instructions and not adjusted arbitrarily.
G
Extract:
Question 2 of 5
A nurse is assessing a client who received an IM antibiotic injection 15 min ago. Which of the following findings should the nurse identify as an indication of a possible anaphylactic reaction to the medication?
Correct Answer: B
Rationale: The correct answer is B: A sharp decrease in blood pressure. An anaphylactic reaction is a severe allergic reaction that can lead to a sudden drop in blood pressure, known as anaphylactic shock. This is a life-threatening emergency that requires immediate intervention. A sudden decrease in heart rate (
A) is not typically associated with an anaphylactic reaction. A feeling of swelling in the feet (
C) could indicate a localized reaction but is not specific to anaphylaxis. Pain at the injection site (
D) is a common side effect of IM injections but not a sign of anaphylactic reaction.
Question 3 of 5
A nurse is planning care for a client who is immobile. Which of the following actions should the nurse include in the plan of care?
Correct Answer: B
Rationale: The correct answer is B: Use trochanter rolls beside the client's legs. This action helps prevent external rotation of the hips, which can lead to hip dislocation in immobile clients. Trochanter rolls provide support and maintain proper alignment of the legs, reducing the risk of pressure injuries and contractures.
Choice A is incorrect because crossing the client's ankles can cause pressure ulcers and restrict blood flow.
Choice C is incorrect as placing the client's arms at their side can lead to shoulder and elbow contractures.
Choice D is incorrect because logrolling every 4 hours is not necessary for all immobile clients and may cause unnecessary disruption and discomfort.
Question 4 of 5
A nurse is caring for a client who is anxious about being admitted to a health care facility for the first time. Which of the following statements should the nurse make?
Correct Answer: D
Rationale: The correct answer is D: "We can discuss what you can expect during your stay." This statement acknowledges the client's feelings of anxiety and offers support by providing information to help alleviate their fears. It promotes open communication, builds trust, and empowers the client by involving them in the care process. It also addresses the client's need for information and helps them feel more prepared for their stay.
Choice A is incorrect as it focuses on the client's fear rather than providing reassurance or support.
Choice B is incorrect as it generalizes the client's feelings without addressing their specific concerns.
Choice C is incorrect as it dismisses the client's anxiety without offering any information or support.
Question 5 of 5
A home health nurse is assessing the home environment of an older adult client who has osteoporosis. For which of the following findings should the nurse intervene?
Correct Answer: B
Rationale: The correct answer is B because having an area rug covering a tile floor poses a significant fall risk for an older adult with osteoporosis, as it increases the chances of tripping and falling. The other choices (A, C,
D) are all appropriate measures to promote safety. Storing prescriptions in a medication organizer promotes medication adherence and prevents errors. Installing grab bars in the shower enhances stability and reduces the risk of falls. Setting the hot water heater to 47°C (117°F) is within the safe range to prevent scalding injuries.