a nurse is planning care for a client who has a latex allergy and is scheduled for surgery which of the following actions should the nurse take
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Nursing Elites

ATI LPN

PN ATI Capstone Proctored Comprehensive Assessment B Quizlet

1. A nurse is planning care for a client who has a latex allergy and is scheduled for surgery. Which of the following actions should the nurse take?

Correct answer: C

Rationale: The correct action the nurse should take is to wrap monitoring cords with stockinette. This measure ensures that the latex in the cords does not come into contact with the client’s skin, reducing the risk of an allergic reaction. Applying tape to the client’s skin before surgery (Choice A) may expose the client to latex if the tape contains latex. Ensuring the surgical suite is well-ventilated (Choice B) is important for overall safety but does not specifically address the client's latex allergy. Scheduling the surgery at the end of the day (Choice D) is not directly related to preventing latex exposure and allergic reactions.

2. A client is being treated with thiazide diuretics. What should the nurse monitor regularly?

Correct answer: B

Rationale: Thiazide diuretics are known to cause hypokalemia by increasing potassium excretion in the urine. Therefore, the nurse should monitor the client for low potassium levels. Hyperkalemia (Choice A) is not typically associated with thiazide diuretics. Hyponatremia (Choice C) is more commonly linked with thiazide diuretics due to increased sodium excretion. Hypoglycemia (Choice D) is not a usual concern when a client is receiving thiazide diuretics.

3. A nurse is providing education to a client about a new prescription for digoxin. Which of the following should be included?

Correct answer: B

Rationale: The correct answer is B: 'Take the medication at the same time every day.' Clients should take digoxin at the same time each day to maintain consistent therapeutic levels, enhancing the drug's effectiveness and minimizing fluctuations in blood concentration. Choice A is incorrect because digoxin, as a medication, may actually help in controlling the heart rate. Choice C is incorrect as digoxin should never be stopped abruptly due to the risk of rebound effects and worsening of the condition. Choice D is unrelated to digoxin therapy, as it is more relevant to medications like potassium-sparing diuretics.

4. A client in labor has an epidural for pain control. Which of the following clinical manifestations is an adverse effect of epidural anesthesia?

Correct answer: C

Rationale: Pruritus is a common adverse effect of epidural anesthesia, often due to the opioids administered with the epidural. It presents as itching on the skin and can cause significant discomfort to the client. Polyuria (excessive urination) and dry mouth are not typical adverse effects of epidural anesthesia. Hypertension is not commonly associated with epidural anesthesia; in fact, hypotension is a more frequent complication due to sympathetic blockade. Therefore, the correct answer is pruritus (choice C), as it is a known adverse effect of epidural anesthesia.

5. A nurse is assessing a 2-hour-old newborn for cold stress. Which of the following findings should the nurse expect?

Correct answer: B

Rationale: The correct answer is B: Jitteriness of the hands. Jitteriness is a key sign of cold stress in a newborn, indicating the need for immediate warming measures. A respiratory rate of 60/min may not be directly indicative of cold stress. Diaphoresis (excessive sweating) and bounding peripheral pulses are not typical findings associated with cold stress in newborns.

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