a nurse is assessing a client who is 30 minutes postoperative following an arterial thrombectomy what should the nurse report a nurse is assessing a client who is 30 minutes postoperative following an arterial thrombectomy what should the nurse report
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Nursing Elites

ATI RN

ATI Comprehensive Exit Exam 2023 With NGN

1. A nurse is assessing a client who is 30 minutes postoperative following an arterial thrombectomy. What should the nurse report?

Correct answer: A

Rationale: In this scenario, postoperative chest pain is a critical finding that must be reported promptly. Chest pain after an arterial thrombectomy could indicate serious complications such as myocardial infarction or pulmonary embolism. Muscle spasms and cool, moist skin are not the priority assessments in this situation. Incisional pain is common after surgery and is not typically a cause for immediate concern unless it is severe and accompanied by other symptoms.

2. When educating a client starting Simvastatin, which instruction should the nurse provide?

Correct answer: A

Rationale: The correct answer is to take Simvastatin in the evening. This timing is important because the body synthesizes the most cholesterol at night. By taking the medication in the evening, its effectiveness is increased, leading to better outcomes for the client.

3. A woman is being treated with clomiphene citrate for the treatment of infertility. She states to the nurse that she has seen an increase in vaginal discharge. The nurse knows that this effect is related to:

Correct answer: C

Rationale: The correct answer is C: 'Increased production of vaginal secretions.' Clomiphene citrate affects cervical mucus production, leading to an increase in vaginal secretions. This effect is beneficial for fertility as it helps create a more hospitable environment for sperm transport. Choice A, 'Increased blood flow to the vaginal area,' is incorrect as the increase in vaginal discharge is primarily due to changes in cervical mucus. Choice B, 'Increased cervical mucus production,' is partially correct but does not fully explain the increase in vaginal secretions. Choice D, 'Increased lubrication in the vaginal canal,' is not directly related to the effect seen with clomiphene citrate treatment for infertility.

4. A nurse is assessing a client who has a history of seizure disorder and is receiving phenytoin. Which of the following findings should the nurse identify as an adverse effect of the medication?

Correct answer: B

Rationale: The correct answer is B: Ataxia. Ataxia, which refers to uncoordinated movements, is a common adverse effect of phenytoin, a medication used to manage seizure disorders. Bradycardia (Choice A) is not typically associated with phenytoin; instead, it may cause tachycardia (Choice C) as a side effect. Insomnia (Choice D) is not a common adverse effect of phenytoin.

5. A client needs to increase his protein intake and enjoys certain foods. Which of the following foods should the nurse recommend as the best source of protein among these suggestions?

Correct answer: C: Chicken

Rationale: Chicken is the best source of protein among the options provided. It is a lean source of protein and contains essential amino acids needed for the body. Eggs are also a good source of protein, but chicken typically contains more protein per serving compared to eggs. Peanuts are a good source of plant-based protein, but chicken provides a higher amount of protein and is usually leaner. Yams, while nutritious, are not a significant source of protein compared to chicken, eggs, or peanuts.

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