a nurse is caring for a client who has a sodium level of 125 meql which of the following actions should the nurse take
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Nursing Elites

ATI RN

ATI Comprehensive Exit Exam 2023 With NGN Quizlet

1. A nurse is caring for a client who has a sodium level of 125 mEq/L. Which of the following actions should the nurse take?

Correct answer: A

Rationale: In a client with a sodium level of 125 mEq/L (hyponatremia), the nurse should administer 0.9% sodium chloride IV to help increase sodium levels. Choice B, administering a hypotonic IV solution, would further decrease the sodium level. Choice C, encouraging oral fluid intake, is contraindicated as it can dilute the sodium concentration further. Choice D, restricting oral fluid intake, could worsen the client's condition by leading to dehydration and further electrolyte imbalances.

2. A nurse is caring for a client who is scheduled for a colonoscopy. Which of the following findings should the nurse report to the provider?

Correct answer: A

Rationale: The correct answer is A. Ibuprofen is an NSAID that can increase the risk of bleeding during a colonoscopy due to its effects on platelet function. It is important to report this finding to the provider to consider alternative pain management options. Choices B, C, and D are not the most pertinent to report for a colonoscopy. Asthma and a history of diverticulitis are relevant medical history but do not directly impact the colonoscopy procedure. Drinking one glass of wine daily is not a concern specifically related to the colonoscopy procedure.

3. A nurse in an emergency department is assessing a newly admitted client who is experiencing drooling and hoarseness following a burn injury. Which of the following actions should the nurse take first?

Correct answer: D

Rationale: In a client experiencing drooling and hoarseness following a burn injury, the priority action for the nurse is to administer 100% humidified oxygen. This is crucial to maintain the airway and address respiratory distress, which takes precedence over obtaining an ECG, collecting blood for ABG analysis, or inserting an IV catheter. Providing oxygen therapy is essential in ensuring the client's oxygenation and respiratory function are optimized in this emergency situation.

4. A nurse is caring for a client who is 1 day postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?

Correct answer: D

Rationale: A temperature of 38.8°C (101.8°F) is above the normal range and may indicate infection, which should be reported. Elevated temperature postoperatively can be a sign of infection, especially in the early postoperative period. Serosanguineous drainage on the surgical dressing is expected in the early postoperative period. A heart rate of 88/min and a blood pressure of 118/76 mm Hg are within normal ranges and do not necessarily indicate a complication postoperatively.

5. A client is receiving furosemide for heart failure. Which of the following findings should the nurse report to the provider?

Correct answer: B

Rationale: The correct answer is B. A heart rate of 68/min is lower than expected and should be reported as it may indicate digoxin toxicity. Choices A, C, and D are within normal limits for a client receiving furosemide for heart failure and do not require immediate reporting. Weight loss may be expected due to diuretic therapy, a potassium level of 3.8 mEq/L is within the normal range, and a urine output of 60 mL/hr indicates adequate renal perfusion.

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