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ATI PN Comprehensive Predictor 2023 with NGN
1. A client is receiving phenytoin for management of grand mal seizures and has a new prescription for isoniazid and rifampin. Which of the following should the nurse conclude if the client develops ataxia and incoordination?
- A. The client is experiencing an adverse reaction to rifampin.
- B. The client's seizure disorder is no longer under control.
- C. The client is showing evidence of phenytoin toxicity.
- D. The client is having adverse effects due to combination antimicrobial therapy.
Correct answer: C
Rationale: Ataxia and incoordination are signs of phenytoin toxicity rather than adverse reactions to rifampin or isoniazid. These symptoms indicate that the client is experiencing an adverse effect of phenytoin, requiring a dose adjustment. Choice A is incorrect because rifampin is not typically associated with ataxia and incoordination. Choice B is incorrect as the development of ataxia and incoordination does not necessarily mean the seizure disorder is no longer under control. Choice D is incorrect as the symptoms are more indicative of phenytoin toxicity rather than adverse effects of combination antimicrobial therapy.
2. Which nursing intervention is best for a client with constipation?
- A. Encourage the client to remain in bed to avoid straining
- B. Administer a stool softener as prescribed
- C. Increase fiber intake through dietary changes
- D. Encourage regular exercise to promote bowel movement
Correct answer: C
Rationale: Increasing fiber intake is the most appropriate nursing intervention for a client experiencing constipation. Fiber helps add bulk to the stool, making it easier to pass and promoting regular bowel movements. Encouraging the client to remain in bed may exacerbate constipation by reducing movement and promoting inactivity. While stool softeners can be beneficial, they are typically used as a short-term solution and may not address the underlying issue of low fiber intake. Regular exercise is important for overall bowel health; however, in the immediate management of constipation, increasing fiber intake is the most effective intervention.
3. A nurse is reviewing the medical record of a client who is taking furosemide. Which of the following findings should the nurse report to the provider?
- A. Potassium level of 3.8 mEq/L
- B. Sodium level of 135 mEq/L
- C. Magnesium level of 1.6 mEq/L
- D. Calcium level of 8.5 mg/dL
Correct answer: C
Rationale: The correct answer is C. A magnesium level of 1.6 mEq/L is within the normal range, but monitoring potassium levels is crucial for clients taking furosemide. Furosemide can cause hypokalemia (low potassium levels), which can lead to adverse effects such as cardiac dysrhythmias. Sodium and calcium levels are not typically affected by furosemide, so they are not the priority findings to report to the provider in this case.
4. What is the main symptom of left-sided heart failure?
- A. Shortness of breath
- B. Edema
- C. Increased heart rate
- D. Decreased urine output
Correct answer: A
Rationale: Shortness of breath is the main symptom of left-sided heart failure because it results from pulmonary congestion due to fluid buildup in the lungs. Edema, increased heart rate, and decreased urine output are associated with right-sided heart failure rather than left-sided heart failure.
5. How should a healthcare professional manage a patient with suspected infection?
- A. Monitor vital signs and administer antibiotics
- B. Check for fever and monitor white blood cell count
- C. Assess for pain and check for localized swelling
- D. Monitor for chills and administer fluids
Correct answer: A
Rationale: Correct answer: When managing a patient with suspected infection, it is crucial to monitor vital signs like temperature, heart rate, blood pressure, and respiratory rate to assess the severity of the infection. Administering antibiotics is also essential to treat the infection. Choice B is incorrect because while checking for fever and monitoring white blood cell count are important, they alone are not sufficient to manage the patient. Choice C focuses on assessing pain and localized swelling, which are important but not primary in managing suspected infection. Choice D mentions monitoring for chills and administering fluids, which are not the primary interventions for managing a suspected infection.
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