the client is four 4 hours post operative abdominal aortic aneurysm repair which nursing intervention should be implemented for this client
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Nursing Elites

ATI RN

ATI RN Custom Exams Set 4

1. The client is four hours post-operative abdominal aortic aneurysm repair. Which nursing intervention should be implemented for this client?

Correct answer: B

Rationale: Assessing the client's bilateral pedal pulses is essential in this situation as it helps in evaluating the peripheral perfusion and circulation in the lower extremities. This assessment is crucial to detect any signs of decreased blood flow or complications, such as arterial occlusion or thrombosis. Ambulating the client may be important in the postoperative period, but assessing pedal pulses takes priority to ensure adequate perfusion. Maintaining continuous IV heparin drip is not typically indicated immediately post-operatively for an abdominal aortic aneurysm repair, as the risk of bleeding complications may outweigh the benefits. Providing a clear liquid diet is not a priority nursing intervention at this stage, as the focus should be on vascular assessment and postoperative monitoring.

2. Whenever possible, patients evacuated from the theater of operations who are expected to return within 60 days are admitted to which of the following?

Correct answer: B

Rationale: Patients evacuated from the theater of operations who are expected to return within 60 days are admitted to DOD tri-service hospitals. These hospitals are equipped to provide specialized care tailored to military personnel. Choice A, civilian hospitals participating in the National Disaster Medical System, may not always have the necessary expertise and resources to cater specifically to military-related injuries. Choice C, Department of Veterans Affairs hospitals, primarily serve veterans and may not always accommodate short-term care for active-duty personnel. Choice D, field hospitals, are usually set up in temporary or emergency situations and are not designed for long-term care, making them less suitable for patients expected to return within 60 days.

3. Students in the resident M6 Practical Nurse Course are expected to achieve entry-level competencies for which of the following?

Correct answer: A

Rationale: The correct answer is A: Medical-surgical nursing. In the resident M6 Practical Nurse Course, students are expected to achieve entry-level competencies in medical-surgical nursing. This area of nursing focuses on caring for adult patients with a variety of medical conditions. Obstetric and newborn nursing (choice B), pediatric nursing (choice C), and trauma nursing (choice D) are specialized areas within nursing that are not typically covered in entry-level practical nurse courses, making them incorrect choices.

4. The nurse teaches the mother of an infant how to care for her infant following repair of a cleft lip. It is MOST important for the nurse to include which of the following instructions?

Correct answer: D

Rationale: The correct answer is D because feeding the infant with a rubber-tipped syringe reduces the risk of injury to the surgical site and prevents aspiration. Choice A is incorrect because feeding in the recumbent position can increase the risk of aspiration. Choice B is incorrect as Betadine is not recommended for wound care near the mouth due to its potential toxicity if ingested. Choice C is incorrect because placing the infant in the prone position after feeding can increase the risk of regurgitation and aspiration.

5. Enteral feedings may be appropriate for patients with:

Correct answer: D

Rationale: Enteral feedings are commonly utilized for patients experiencing acute exacerbations of Crohn’s disease to provide necessary nutrition and rest the bowel. Choices A, B, and C are incorrect because enteral feedings are not typically indicated for acute cholecystitis, hepatic encephalopathy, or ulcerative colitis in remission.

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