a nurse is caring for a client who has heart failure and is receiving digoxin which of the following findings should the nurse report to the provider a nurse is caring for a client who has heart failure and is receiving digoxin which of the following findings should the nurse report to the provider
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Nursing Elites

ATI RN

ATI Comprehensive Exit Exam

1. A nurse is caring for a client with heart failure receiving digoxin. Which of the following findings should the nurse report to the provider?

Correct answer: B

Rationale: The correct answer is B. A blood pressure of 110/70 mm Hg is a finding that the nurse should report to the provider when caring for a client with heart failure receiving digoxin. Digoxin can cause hypotension, so a low blood pressure reading should be reported promptly to the provider for further evaluation and management. Choices A, C, and D are within normal ranges and would not require immediate reporting. A heart rate of 60/min is considered normal, but any further decrease should be monitored. A serum potassium level of 4 mEq/L is also within the normal range. A blood pressure of 120/80 mm Hg is typically considered normal as well.

2. Which nursing instruction should the nurse discuss with the client who is receiving glucocorticoids for Addison’s disease?

Correct answer: A

Rationale: The correct answer is to discuss the importance of tapering medications when discontinuing medication. Tapering glucocorticoids is crucial to prevent adrenal insufficiency, which can occur if the medication is stopped abruptly. Choice B is incorrect because it focuses on adjustments during stress or infection, not discontinuation. Choice C is unrelated to the management of glucocorticoids. Choice D is important for emergency identification but is not directly related to medication management.

3. A client complains of pain in their leg, and the nurse notes swelling and pallor. What is the priority nursing action?

Correct answer: D

Rationale: The correct answer is D: Notify the provider immediately about the symptoms. Swelling and pallor in a limb can be indicative of serious circulatory issues or compartment syndrome. It is crucial to inform the healthcare provider promptly to assess and address the situation. Administering pain medication (choice A) may temporarily alleviate the symptoms but does not address the underlying cause. Elevating the limb and monitoring closely (choice B) can be beneficial but does not replace the need for immediate professional evaluation. Encouraging movement to reduce swelling (choice C) is contraindicated in this scenario as it may worsen the condition if a circulatory issue or compartment syndrome is present.

4. What are influences that are unusual events with a major impact on individual lives because they disrupt the expected sequence of the life cycle?

Correct answer: A

Rationale: Nonnormative influences refer to unusual events that have a significant impact on individuals' lives by disrupting the typical life cycle. They are events that are not typical for a specific age or cohort. Normative history-graded influences (choice B) are common influences shared by a specific generation due to historical circumstances. Normative age-graded influences (choice C) are typical events that occur at a particular age for most people. A sensitive period (choice D) is a biologically determined time during which specific experiences have a lasting impact on development.

5. A client has diaper dermatitis. Which of the following actions should the nurse take?

Correct answer: Apply zinc oxide ointment to the irritated area.

Rationale: Diaper dermatitis, also known as diaper rash, is a common condition in babies or clients who wear diapers. The primary intervention for diaper dermatitis is to apply a protective barrier cream, such as zinc oxide ointment, to the irritated area. This helps to protect the skin from irritants and promotes healing. Wiping stool from the skin using baby wipes may further irritate the skin, and talcum powder is no longer recommended due to potential respiratory risks when inhaled. Therefore, the correct action for the nurse in this scenario is to apply zinc oxide ointment to the irritated area.

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