the nurse is caring for clients on a cardiac floor which client should the nurse assess first
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Nursing Elites

ATI RN

ATI RN Custom Exams Set 2

1. The nurse is caring for clients on a cardiac floor. Which client should the nurse assess first?

Correct answer: C

Rationale: The correct answer is C because an audible S3 in a client with mitral valve prolapse could indicate heart failure, which requires immediate assessment. Choice A is less urgent as occasional unifocal PVCs are common. Choice B is important but can be addressed after the client with an audible S3. Choice D, a client with pericarditis in normal sinus rhythm, is stable compared to a client with potential heart failure symptoms.

2. Which potential complication should the nurse assess for in the client with infective endocarditis who has embolization of vegetative lesions from the mitral valve?

Correct answer: B

Rationale: The correct answer is 'Decreased urine output.' Embolization of vegetative lesions from the mitral valve can cause renal infarction, leading to a decrease in urine output. This complication is due to the obstruction of blood flow to the kidneys. Choices A, C, and D are incorrect because embolization from the mitral valve typically does not directly cause pulmonary embolism, hemoptysis, or deep vein thrombosis.

3. The nurse is caring for the client recovering from intestinal surgery. Which assessment finding would require immediate intervention?

Correct answer: D

Rationale: Complaints of chills and feeling feverish may indicate infection, which requires immediate intervention. This finding suggests a systemic response to infection, which can be life-threatening if not promptly addressed. Options A, B, and C are common postoperative findings and may not necessarily require immediate intervention unless accompanied by other concerning signs or symptoms.

4. A patient on long-term steroid therapy should be monitored for which condition?

Correct answer: D

Rationale: Corrected Rationale: Patients on long-term steroid therapy should be monitored for osteoporosis due to the medication's potential to decrease bone density. Choices A, B, and C are incorrect. While long-term steroid therapy can also lead to hyperglycemia, hypothyroidism, and hypertension, the primary concern and most common risk associated with prolonged steroid use is osteoporosis.

5. Which vitamin deficiency is commonly associated with prolonged antibiotic use?

Correct answer: D

Rationale: The correct answer is Vitamin K. Prolonged antibiotic use can disrupt the gut flora, leading to Vitamin K deficiency and an increased risk of bleeding. Vitamin A deficiency is not commonly associated with antibiotic use. Similarly, Vitamin B6 and Vitamin C deficiencies are not typically linked to prolonged antibiotic use.

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