a nurse is assessing a client who has just received an opioid medication which of the following findings should the nurse monitor for first
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Nursing Elites

ATI RN

ATI Comprehensive Exit Exam 2023 With NGN

1. A nurse is assessing a client who has just received an opioid medication. Which of the following findings should the nurse monitor first?

Correct answer: D

Rationale: When a client receives an opioid medication, the nurse should first monitor for respiratory depression as it is a life-threatening adverse effect associated with opioids. This can lead to inadequate ventilation and hypoxia, requiring immediate intervention. Constipation, drowsiness, and orthostatic hypotension are also common side effects of opioids but are not as immediately life-threatening as respiratory depression.

2. Which electrolyte imbalance is most concerning in a patient on furosemide?

Correct answer: B

Rationale: The correct answer is Hypokalemia. Furosemide is a loop diuretic that can lead to potassium depletion by increasing its excretion in the urine. Hypokalemia is a common and concerning side effect of furosemide therapy. Hyperkalemia (Choice A) is less likely as furosemide tends to lower potassium levels. Hyponatremia (Choice C) is more commonly seen with thiazide diuretics. Hypercalcemia (Choice D) is not directly associated with furosemide use.

3. A nurse is providing dietary teaching to a client who has a new prescription for warfarin. Which of the following client statements indicates an understanding of the teaching?

Correct answer: C

Rationale: Clients taking warfarin should avoid foods high in vitamin K, as it can interfere with the effectiveness of the medication.

4. Nurses caring for four clients. Which of the following client data should the nurse report to the provider?

Correct answer: D

Rationale: The correct answer is D. The client with chemotherapy and a low neutrophil count is at risk for infection and requires prompt intervention. Reporting this information to the provider is crucial to ensure appropriate monitoring and management to prevent potential complications. Choices A, B, and C do not indicate an immediate risk that requires immediate provider notification. A client reporting pain with pleurisy, a client draining fluid post-surgery, or a client with a heart rate of 98 per minute postoperative are not urgent enough to warrant immediate reporting compared to the client at risk for infection.

5. A nurse is teaching at a community health fair about electrical fire prevention. Which of the following information should the nurse include in the teaching?

Correct answer: A

Rationale: The correct answer is A: 'Use three-pronged grounded plugs.' This is important in preventing electrical fires as it provides a grounded connection, reducing the risk of electrical malfunctions. Choice B is incorrect because covering extension cords with a rug can lead to overheating and increase the risk of fire. Choice C is also incorrect as tingling sensations around a cord indicate an electrical hazard, not proper functioning. Choice D is incorrect as pulling the cord to remove a plug can damage the cord, leading to potential electrical dangers.

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