a nurse is assessing a client who is receiving opioid analgesics for pain management which of the following findings should the nurse report to the pr a nurse is assessing a client who is receiving opioid analgesics for pain management which of the following findings should the nurse report to the pr
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ATI RN Exit Exam Test Bank

1. A nurse is assessing a client who is receiving opioid analgesics for pain management. Which of the following findings should the nurse report to the provider?

Correct answer: C

Rationale: The correct answer is C. A heart rate of 88/min is a normal finding; therefore, it does not require immediate reporting to the provider. The respiratory rate of 20/min, blood pressure of 118/76 mm Hg, and oxygen saturation of 94% are also within normal ranges and do not indicate any immediate concerns. However, a serum potassium level of 3.0 mEq/L indicates hypokalemia, which can be a serious issue and should be reported to the provider for further evaluation and management.

2. A nurse is preparing discharge information for a client who has type 2 diabetes mellitus. Which of the following resources should the nurse provide to the client?

Correct answer: D

Rationale: The correct answer is D. Food exchange lists from the American Diabetes Association are valuable resources for individuals with diabetes as they provide specific guidance on meal planning and portion control, which are crucial for managing blood sugar levels. Choice A is incorrect because personal blogs may not always provide accurate or evidence-based information. Choice B is incorrect as food label recommendations, while important, may not offer the structured guidance needed for meal planning in diabetes. Choice C is also incorrect as medication information is different from dietary guidance needed for diabetes management.

3. A client has been prescribed Phenelzine for depression. Which of the following indicates that the client has developed an adverse effect of this medication?

Correct answer: A

Rationale: Orthostatic hypotension is a known adverse effect of Phenelzine, a monoamine oxidase inhibitor (MAOI) used for depression. It is caused by a sudden drop in blood pressure when changing positions, leading to symptoms like dizziness or fainting. Monitoring for orthostatic hypotension is crucial during Phenelzine therapy to prevent complications. Choices B, C, and D are incorrect because hearing loss, gastrointestinal bleeding, and weight loss are not typically associated with Phenelzine use.

4. A nearby community provides blood pressure screening, height and weight measurement, smoking cessation classes and aerobics class services. This type of program is referred to as

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

5. A client is being taught about following a low-cholesterol diet after coronary artery bypass grafting. Which of the following food choices reflects the client’s understanding of these dietary instructions?

Correct answer: C: BEANS

Rationale: Choosing beans as a food option indicates that the client understands the low-cholesterol diet instructions. Beans are a good source of fiber and plant-based protein, which can help lower cholesterol levels. On the other hand, liver and eggs are high in cholesterol and should be limited in a low-cholesterol diet. Milk, especially whole milk, can also be high in saturated fats and cholesterol, so it is not the best choice for a low-cholesterol diet.

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