a nurse is caring for a client who is 1 day postoperative following a total knee replacement the client reports pain of 8 on a scale of 0 to 10 which a nurse is caring for a client who is 1 day postoperative following a total knee replacement the client reports pain of 8 on a scale of 0 to 10 which
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Nursing Elites

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ATI Exit Exam

1. A nurse is caring for a client who is 1 day postoperative following a total knee replacement. The client reports pain of 8 on a scale of 0 to 10. Which of the following actions should the nurse take?

Correct answer: B

Rationale: In this scenario, the appropriate action for the nurse to take when a client reports severe postoperative pain of 8 out of 10 is to administer oxycodone 10 mg PO. Oxycodone is a potent analgesic that is more effective in managing severe pain compared to ibuprofen, making choice A incorrect. Repositioning the client to the unaffected side or applying a cold compress may provide some comfort but are not the priority interventions for severe postoperative pain, making choices C and D less appropriate.

2. During the oliguric phase of acute kidney injury, what intervention should be included in the plan of care for a child?

Correct answer: A

Rationale: During the oliguric phase of acute kidney injury, the priority is managing fluid balance. Administering a loop diuretic is crucial to promote diuresis and reduce fluid retention, aiding in managing the condition effectively. Providing a low-sodium diet may be beneficial but is not the priority intervention during this phase. Weighing the child weekly is important for monitoring overall health but does not directly address the oliguric phase. Providing a high-protein diet is not typically recommended in acute kidney injury, especially during the oliguric phase, as it can put additional stress on the kidneys.

3. Elmer is scheduled for a proctoscopy and has an I.V. The doctor wrote an order for 5mg of I.V. diazepam(Valium). Which order is correct regarding diazepam?

Correct answer: A

Rationale: The correct method for administering I.V. diazepam is to give it in the I.V. port closest to the vein.

4. A patient is prescribed estradiol (Estrace) for hormone replacement therapy (HRT). What should the nurse monitor during this therapy?

Correct answer: B

Rationale: During estradiol therapy, monitoring liver function tests is essential due to the potential for liver dysfunction. Estradiol can affect liver function, making it crucial to monitor enzyme levels. Choice A, blood glucose levels, is not directly impacted by estradiol therapy, making it an incorrect choice. Choice C, kidney function tests, is not typically affected by estradiol therapy, so it is not the priority for monitoring. Choice D, blood pressure, is also not the primary parameter to monitor during estradiol therapy unless there are pre-existing conditions that warrant such monitoring.

5. Which characteristics are associated with adults fixated in the anal stage?

Correct answer: A

Rationale: The correct answer is A: 'Orderliness, obstinacy, or messiness.' According to Freud's psychosexual theory, fixation in the anal stage can lead to these characteristics in adulthood. Choice B is incorrect as fixation in the oral stage is associated with issues related to dependency and aggression. Choice C is incorrect as it refers to the Electra complex, which is not related to the anal stage fixation. Choice D is incorrect as it refers to penis envy and the female Oedipus complex, which are not directly related to characteristics of adults fixated in the anal stage.

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