a nurse is assessing a client who has cirrhosis which of the following findings should the nurse expect

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ATI Comprehensive Exit Exam 2023 With NGN

1. A nurse is assessing a client who has cirrhosis. Which of the following findings should the nurse expect?

A. Clay-colored stools.
B. Hypertension.
C. Stridor.
D. Elevated temperature.

Correct answer: A

Rationale: Clay-colored stools are a classic finding in a client with cirrhosis. Cirrhosis can lead to impaired bile flow, resulting in pale or clay-colored stools due to a lack of bilirubin in the stool. Hypertension, stridor, and elevated temperature are not typically associated with cirrhosis. Hypertension may occur in cirrhosis but is not a consistent finding, stridor is more commonly associated with upper airway obstruction, and elevated temperature may indicate an infection rather than a direct result of cirrhosis.

2. A nurse is preparing to administer potassium chloride IV to a client. Which of the following actions should the nurse take to prevent complications?

A. Administer the medication by IV bolus over 2 minutes
B. Infuse the medication slowly using an IV pump
C. Add the medication to an IV solution of D5W
D. Dilute the medication in 5 mL of sterile water

Correct answer: B

Rationale: The correct action to prevent complications when administering potassium chloride IV is to infuse the medication slowly using an IV pump. Rapid administration of potassium chloride can lead to complications such as hyperkalemia and cardiac arrest. Options A, C, and D are incorrect as they do not promote the safe administration of potassium chloride. Administering the medication by IV bolus over 2 minutes is too rapid and can cause adverse effects. Adding the medication to an IV solution of D5W or diluting it in sterile water may not control the rate of administration, increasing the risk of complications.

3. A nurse is teaching a client who has a new prescription for digoxin. Which of the following adverse effects should the nurse instruct the client to monitor and report to the provider?

A. Increased appetite
B. Rash on the face
C. Yellow-tinged vision
D. Weight gain

Correct answer: C

Rationale: The correct answer is C: 'Yellow-tinged vision.' Yellow-tinged vision is a characteristic sign of digoxin toxicity, indicating an overdose of the medication. This visual disturbance is a critical adverse effect that should be reported promptly to the healthcare provider to prevent serious complications.\n\nChoice A, 'Increased appetite,' is not typically associated with digoxin use and is not a common adverse effect.\n\nChoice B, 'Rash on the face,' is also not a common adverse effect of digoxin. Skin rash is not a typical manifestation of digoxin toxicity.\n\nChoice D, 'Weight gain,' is not a common adverse effect of digoxin. Weight gain is not a typical symptom of digoxin toxicity and is unlikely to be related to the medication.

4. A client has a new prescription for a combination of oral NRTIs (abacavir, lamivudine, and zidovudine) for the treatment of HIV. Which of the following statements should the nurse include in teaching the client?

A. These medications work by blocking HIV entry into cells.
B. These medications work by weakening the cell wall of the HIV virus.
C. These medications work by inhibiting enzymes to prevent HIV replication.
D. These medications work by preventing protein synthesis within the HIV cell.

Correct answer: C

Rationale: The NRTI antiretroviral medications this client is prescribed work by inhibiting the enzyme reverse transcriptase, thus preventing HIV replication. By inhibiting this crucial enzyme, the drug interferes with the virus's ability to replicate and spread in the body. Choice A is incorrect because NRTIs do not block HIV entry into cells. Choice B is incorrect as NRTIs do not weaken the cell wall of the virus. Choice D is incorrect as NRTIs do not prevent protein synthesis within the HIV cell.

5. Which term describes a situation in which there is a demonstrated health need combined with actual or potential resources to apply remedial measures and a commitment to act on the part of the provider or the client?

A. Health deficit
B. Health need
C. Health problem
D. Foreseeable crisis

Correct answer: C

Rationale: A health problem specifically refers to a situation where a health need is identified, resources are available or potentially available to address it, and there is a commitment from either the provider or the client to take action. This term encapsulates the combination of a demonstrated need for remedial measures with the readiness and commitment to act upon it.

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ATI RN

ATI Comprehensive Exit Exam 2023 With NGN

1. A nurse is assessing a client who has cirrhosis. Which of the following findings should the nurse expect?

2. A nurse is preparing to administer potassium chloride IV to a client. Which of the following actions should the nurse take to prevent complications?

3. A nurse is teaching a client who has a new prescription for digoxin. Which of the following adverse effects should the nurse instruct the client to monitor and report to the provider?

4. A client has a new prescription for a combination of oral NRTIs (abacavir, lamivudine, and zidovudine) for the treatment of HIV. Which of the following statements should the nurse include in teaching the client?

5. Which term describes a situation in which there is a demonstrated health need combined with actual or potential resources to apply remedial measures and a commitment to act on the part of the provider or the client?

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