ATI RN
ATI Fundamentals Exam Special Unit ADN Questions
Extract:
Question 1 of 5
As part of an annual physical examination, a nurse is preparing a client to undergo a chest x-ray. Which of the following instructions should the nurse give the client prior to the procedure?
Correct Answer: A
Rationale: Remove all metal necklaces: Metal can obscure the x-ray image, so all metal jewelry, piercings, and clothing with metal components should be removed. Take several shallow breaths during the procedure: Patients should take a deep breath and hold it during the x-ray to expand the lungs fully for clearer imaging. Do not eat or drink anything the morning of the test: Fasting is not needed for a chest x-ray; it is typically required for procedures like CT scans with contrast or abdominal ultrasounds. Expect minor discomfort after the procedure: A chest x-ray is non-invasive and painless. There is no expected discomfort afterward.
Question 2 of 5
While performing an assessment, the nurse hears crackles in the patient's lung fields. The nurse also learns that the patient is sleeping on three pillows to help with the difficulty breathing during the night. Which condition will the nurse most likely observe written in the patient's medical record?
Correct Answer: A
Rationale: Left-sided heart failure: Left-sided heart failure causes pulmonary congestion leading to crackles, orthopnea (difficulty breathing while lying flat), and paroxysmal nocturnal dyspnea (waking up gasping for air). Myocardial ischemia: Myocardial ischemia causes chest pain, shortness of breath, and fatigue, but it does not cause crackles in the lungs or fluid overload symptoms. Right-sided heart failure: Right-sided heart failure results in systemic congestion (peripheral edema, weight gain, and jugular vein distention), not pulmonary symptoms like crackles. Atrial fibrillation: Atrial fibrillation causes irregular heartbeats, palpitations, and fatigue, but it is not the primary cause of crackles or orthopnea.
Question 3 of 5
A nurse is teaching a client about taking diphenhydramine. The nurse should explain to the client that which of the following is an adverse effect of this medication?
Correct Answer: D
Rationale: Sedation: Diphenhydramine is a first-generation antihistamine that crosses the blood-brain barrier and has a sedative effect by blocking histamine receptors in the central nervous system. It is commonly used as a sleep aid for this reason. Hypertension: Diphenhydramine (Benadryl) is an antihistamine that typically causes hypotension, not hypertension. It can have a mild vasodilatory effect, leading to a drop in blood pressure in some patients. Constipation: While some antihistamines can cause mild gastrointestinal effects, constipation is not a primary adverse effect of diphenhydramine. Dry mouth and urinary retention are more common due to its anticholinergic properties. Bradycardia: Diphenhydramine can sometimes cause tachycardia (increased heart rate), especially in elderly patients or those prone to cardiovascular effects. Bradycardia (slow heart rate) is not a usual adverse effect.
Question 4 of 5
A nurse caring for a child who has asthma and a prescription for montelukast granules. Which of the following instructions should the nurse provide to the client's parents on administering the medication?
Correct Answer: A
Rationale: Give the medication in the morning daily: Montelukast (a leukotriene receptor antagonist) is given once daily in the evening for long-term asthma control. If prescribed for allergic rhinitis, it can be given in the morning. Administer the medication 2 hours before exercise: Montelukast is not a rescue medication but a maintenance drug. However, it can be prescribed for exercise-induced bronchospasm and is taken at least 2 hours before exercise when used for that purpose. Administer the granules mixed with 20 ounces of water: Montelukast granules should be mixed with a small amount of soft food (e.g., applesauce, mashed carrots) or breast milk/formula but not a large volume of liquid. Give the medication at the onset of wheezing: Montelukast is not a quick-relief medication and does not work immediately. Short-acting bronchodilators (e.g., albuterol) should be used for acute wheezing.
Question 5 of 5
A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: C
Rationale: I will be sure to take the albuterol before taking the cromolyn': Albuterol (a bronchodilator) should be taken first to open the airways, allowing better absorption of cromolyn (an anti-inflammatory medication). 'I will administer the medications 10 minutes apart': Timing is important, but this option does not specify which medication should be taken first. The correct sequence is albuterol first, followed by cromolyn. 'I will use both medications immediately after exercising': Cromolyn is a mast cell stabilizer used for prevention, not acute symptoms. It should be taken 15-30 minutes before exercise to prevent exercise-induced bronchospasm, not after. 'If my breathing begins to feel tight, I will use the cromolyn immediately': Cromolyn is not a rescue medication. Albuterol should be used for acute bronchospasm, while cromolyn is for long-term asthma control.