a nurse is planning care for a client who has a new diagnosis of heart failure which of the following interventions should the nurse include in the pl a nurse is planning care for a client who has a new diagnosis of heart failure which of the following interventions should the nurse include in the pl
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ATI RN

ATI RN Comprehensive Exit Exam

1. A nurse is planning care for a client who has a new diagnosis of heart failure. Which of the following interventions should the nurse include in the plan of care?

Correct answer: C

Rationale: The correct intervention the nurse should include in the plan of care for a client with heart failure is to monitor the client's weight daily. Daily weight monitoring is essential to assess fluid balance and detect any signs of worsening heart failure. Limiting fluid intake to 1,500 mL per day (Choice A) may be appropriate in some cases, but it is not the initial priority for this client. Encouraging the client to walk every 2 hours (Choice B) is generally beneficial for mobility but may not be directly related to managing heart failure. Administering oxygen via nasal cannula at 2 L/min (Choice D) is a supportive measure for hypoxia but does not directly address heart failure management.

2. What is the fundamental block or foundation of the field health service information system?

Correct answer: B

Rationale: In the field health service information system, the fundamental block is the Target Client List. This list serves as the foundation for organizing and managing health service information efficiently. It helps in identifying and tracking clients, ensuring that appropriate services are provided to them, and maintaining accurate records for effective service delivery.

3. What are signs and symptoms of a possible kidney transplant rejection in a child? (Select all that apply.)

Correct answer: B

Rationale: Signs of kidney transplant rejection include fever, diminished urinary output, and swelling/tenderness in the graft area. These symptoms indicate that the body may be rejecting the transplanted organ, requiring immediate medical attention.

4. What is the procedure where a small mesh tube is inserted into an artery to keep it open after angioplasty?

Correct answer: A

Rationale: The correct answer is A, stent placement. Stent placement involves inserting a small mesh tube into an artery to maintain its openness after angioplasty. This choice is correct because it directly describes the procedure mentioned in the question. Choices B, C, and D are incorrect. Bypass surgery involves rerouting blood flow around a blocked artery using a vessel from another part of the body. Angioplasty is the procedure of widening a narrowed or blocked blood vessel, often followed by stent placement. Valve replacement is a surgical procedure to replace a damaged or diseased heart valve with an artificial or biological valve.

5. Can a person with Celiac disease eat Poptarts that contain gluten?

Correct answer: B

Rationale: A person with Celiac disease cannot consume Poptarts that contain gluten because gluten is a protein found in wheat, barley, and rye, triggering an autoimmune response in individuals with Celiac disease and damaging their small intestine. Even small quantities of gluten can lead to this harmful response, making choices 'A' and 'C' incorrect. While gluten-free Poptarts may be suitable for individuals with Celiac disease, regular Poptarts containing gluten are not safe for consumption by them, rendering choice 'D' incorrect as well.

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