a client is in the emergency room in critical condition and hypotensive her spouse is distraught what is the priority nursing action
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Nursing Elites

ATI RN

Multi Dimensional Care | Exam | Rasmusson

1. A client is in the emergency room in critical condition and hypotensive. Her spouse is distraught. What is the priority nursing action?

Correct answer: Maintain the client’s blood pressure

Rationale:

2. A nurse is teaching a client who has out about dietary recommendations. The nurse should teach the client which of the following beverages can trigger an attack?

Correct answer: Alcohol

Rationale:

3. A nurse is caring for a 25-year-old male quadriplegic client. Which of the following treatments would the nurse perform to decrease the risk of joint contracture and promote joint mobility?

Correct answer: D

Rationale: The correct answer is to provide passive range of motion (ROM). In quadriplegic clients, who have limited or no movement of their limbs, passive ROM exercises are crucial to maintain joint mobility and prevent joint contractures. Administering glucosamine supplements (choice A) is not directly related to promoting joint mobility. Turning the client every 2 hours (choice B) is essential for preventing pressure ulcers but does not directly address joint contracture and mobility. Providing active ROM exercises (choice C) may not be suitable for quadriplegic clients as they are unable to perform these movements on their own.

4. What is the best goal for pain control in a client with RA?

Correct answer: The client will have pain less than 3/10 for most of the day

Rationale:

5. What is accurate health promotion teaching to prevent ear infection or trauma? (Select all that apply)

Correct answer: D

Rationale: The correct health promotion teachings to prevent ear infection or trauma include blowing the nose gently without blocking nostrils, wearing hearing protection when exposed to loud noise, and avoiding the use of cotton-tipped applicators to clean the external ear. Blocking one nostril when blowing the nose is incorrect, as it can cause problems. Therefore, choice A is inaccurate. Additionally, using cotton-tipped applicators to clean the external ear can lead to trauma or infection, making choice C a correct preventive measure.

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