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ATI Nutrition
1. A client with cirrhosis and ascites is being cared for by a nurse. Which of the following interventions should the nurse include in the plan of care?
- A. Decrease the client’s fluid intake.
- B. Increase the client’s saturated fat intake.
- C. Increase the client’s sodium intake.
- D. Decrease the client’s carbohydrate intake.
Correct answer: Decrease the client’s carbohydrate intake.
Rationale: In a client with cirrhosis and ascites, decreasing carbohydrate intake is essential as it helps reduce the production of ascitic fluid. Excess carbohydrates can lead to fluid retention. Choices A, B, and C are incorrect. Decreasing fluid intake can worsen dehydration, increasing saturated fat intake is not recommended due to its impact on liver health, and increasing sodium intake can worsen fluid retention and exacerbate ascites in these clients.
2. A nurse is providing teaching to a client who is postoperative following a cataract extraction. Which of the following statements should the nurse include?
- A. You should expect to have eye pain for the first 2 days after surgery.
- B. You should bend at the waist to pick up objects from the floor.
- C. You should avoid sleeping on the side of the body that was operated on.
- D. You should wear an eye shield at night for 2 weeks.
Correct answer: D
Rationale: The correct answer is D. After cataract surgery, wearing an eye shield at night for 2 weeks is essential to protect the eye during the initial healing period. Choice A is incorrect because significant eye pain should not be expected for the first 2 days after surgery. Choice B is incorrect as bending at the waist can increase intraocular pressure, which should be avoided postoperatively. Choice C is incorrect as there is no need to avoid sleeping on the side of the body that was operated on after cataract surgery.
3. A client with asthma presents with bilateral wheezing, decreased pulse oxygen saturation, and suprasternal retraction on inhalation. Which actions should the nurse take? (SATA)
- A. Administer prescribed salmeterol (Serevent) inhaler.
- B. Assess the client for a tracheal deviation.
- C. Administer oxygen to maintain saturations above 94%.
- D. Perform peak expiratory flow measurements.
Correct answer: C
Rationale: Suprasternal retraction during inhalation suggests the client is using accessory muscles due to difficulty in moving air into the respiratory passages caused by airway narrowing. The presence of bilateral wheezing and decreased pulse oxygen saturation further support airway narrowing. In this situation, immediate intervention is necessary to improve oxygenation. Administering oxygen to maintain saturations above 94% is crucial to support oxygenation. While administering a rescue inhaler may be warranted, the priority in this scenario is ensuring adequate oxygenation to address the respiratory distress.
4. After administering 40 mEq of potassium chloride, a nurse evaluates the clients response. Which manifestations indicate that treatment is improving the clients hypokalemia? (Select all tha do not t apply.)
- A. Strong productive cough
- B. Active bowel sounds
- C. U waves present on the electrocardiogram (ECG)
- D.
Correct answer: U waves present on the electrocardiogram (ECG)
Rationale:
5. A school-age child has a new prescription for Atomoxetine. The nurse should monitor the client for which of the following adverse effects of this medication?
- A. Kidney toxicity
- B. Liver damage
- C. Seizure activity
- D. Adrenal insufficiency
Correct answer: B
Rationale: Liver damage is an adverse effect of Atomoxetine. The nurse should monitor for manifestations such as jaundice, upper abdominal tenderness, darkening of urine, and elevated liver enzymes. It is crucial to be vigilant for signs of liver damage to ensure early detection and intervention to prevent further complications. Kidney toxicity is not a common adverse effect of Atomoxetine. Seizure activity and adrenal insufficiency are also not typically associated with this medication.
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