a nurse is caring for a client who is receiving positive pressure mechanical ventilation which of the following interventions should the nurse impleme a nurse is caring for a client who is receiving positive pressure mechanical ventilation which of the following interventions should the nurse impleme
Logo

Nursing Elites

ATI RN

ATI Maternal Newborn Proctored Exam

1. A client is receiving positive-pressure mechanical ventilation. Which of the following interventions should the nurse implement to prevent complications? (Select one that doesn't apply.)

Correct answer: Reposition the endotracheal tube to the opposite side of the mouth daily.

Rationale: Repositioning the endotracheal tube to the opposite side of the mouth daily is not a standard practice in preventing complications in a client receiving positive-pressure mechanical ventilation. This action may disrupt the secure placement of the endotracheal tube and increase the risk of complications. Elevating the head of the bed to at least 30° helps prevent aspiration and ventilator-associated pneumonia. Applying restraints if the client becomes agitated helps maintain the safety of the client by preventing self-extubation or accidental dislodgement of tubes. Administering pantoprazole as prescribed helps prevent stress ulcers, a common complication in critically ill patients on mechanical ventilation.

2. Which of the following statements is least likely to be made by a humanist?

Correct answer: B

Rationale: The corrected question assesses the least likely statement made by a humanist. Choice B, 'The behavior of humans tends to be influenced by environmental circumstances,' is least likely to be made by a humanist. Humanists believe that human behavior is not simply dictated by environmental circumstances but is influenced by a combination of factors, including personal experiences, emotions, and conscious decisions. Choices A, C, and D are more aligned with humanist perspectives. Choice A acknowledges the uniqueness of humans, which is a common theme in humanistic psychology. Choice C reflects the humanistic belief that individuals strive to reach their full potential and self-actualization. Choice D contrasts with humanist views as humanists often consider research on animals to be relevant in understanding human behavior due to shared basic psychological processes.

3. During the 2-month well-child checkup, the nurse expects the infant to respond to sound in which manner?

Correct answer: B

Rationale: At 2 months, infants typically react to loud noises with the Moro reflex, a startle response that is normal at this stage of development.

4. A nurse is caring for a client who has heart failure and is receiving furosemide. Which of the following findings should the nurse identify as an adverse effect of the medication?

Correct answer: C

Rationale: The correct answer is C: 'Hypokalemia.' Furosemide is a loop diuretic that can lead to potassium depletion (hypokalemia) due to increased urinary excretion of potassium. This can result in adverse effects such as muscle weakness, cardiac dysrhythmias, and other complications. Hyperkalemia (choice A) is not an adverse effect of furosemide but rather an elevated potassium level. Hyperglycemia (choice B) and hyponatremia (choice D) are not typically associated with furosemide use. Therefore, monitoring potassium levels and addressing hypokalemia is crucial in clients taking furosemide.

5. A school-age child with cancer is being prepared for a procedure. The child says, “I have had one of these before. They hurt.” The nurse bases her response on what knowledge related to pain in this patient?

Correct answer: D

Rationale: The correct answer is D. Pain is frequently reported by children with cancer, with around 84% experiencing it. Most children report moderate to severe pain, with about half finding it highly distressing. There is no evidence to suggest that children often misrepresent their pain experiences. Pain tolerance is not solely based on age but is a complex phenomenon. Children do not become accustomed to painful procedures, as each experience of pain is unique.

Similar Questions

Which lab value is most critical to monitor in a patient receiving insulin therapy?
A healthcare professional is caring for a client who has a new prescription for metformin. Which of the following laboratory results should the healthcare professional review before administering the medication?
A client has been diagnosed with depersonalization/derealization disorder. Which of the following behaviors should the nurse expect?
A client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?
Which term best describes the sharing of common characteristics that differentiate one group from other groups in a society?

Access More Features

ATI Basic

  • 50,000 Questions with answers
  • All ATI courses Coverage
    • 30 days access @ $69.99

ATI Basic

  • 50,000 Questions with answers
  • All ATI courses Coverage
    • 90 days access @ $149.99