ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation
1. 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:
2. Which action exemplifies primary prevention in a community setting?
- A. Administering vaccines to children
- B. Screening for early signs of disease
- C. Offering support groups for chronic illness management
- D. Providing treatment for infectious diseases
Correct answer: A
Rationale: Administering vaccines to children is a primary prevention strategy that focuses on preventing the development of diseases before they occur. By administering vaccines, the aim is to protect individuals and the community from infectious diseases by building immunity against them. This proactive approach targets the root causes of illnesses, contributing to overall community health and well-being.
3. Which of the following is a sign of digoxin toxicity?
- A. Bradycardia
- B. Hypertension
- C. Tachycardia
- D. Tachypnea
Correct answer: A
Rationale: The correct answer is A, Bradycardia. Bradycardia, or a slower than normal heart rate, is a classic sign of digoxin toxicity. Digoxin is a medication commonly used to treat heart conditions, but an excess of digoxin in the body can lead to toxicity. This toxicity can manifest as various symptoms, with bradycardia being one of the most common ones. Hypertension (high blood pressure) and tachycardia (fast heart rate) are not typical signs of digoxin toxicity. Tachypnea, which refers to rapid breathing, is also not a common sign of digoxin toxicity.
4. A client is prescribed Propranolol for a dysrhythmia. Which of the following actions should the nurse plan to take?
- A. Hold Propranolol if the client's apical pulse is greater than 100/min.
- B. Administer Propranolol to decrease the client's blood pressure.
- C. Assist the client with sitting up or standing after taking this medication.
- D. Monitor the client for hypokalemia due to the risk of Propranolol toxicity.
Correct answer: C
Rationale: The correct action the nurse should plan to take when administering Propranolol is to assist the client when sitting up or standing after taking the medication. Propranolol can lead to orthostatic hypotension, causing dizziness upon sudden position changes. It is essential to help the client with position changes to prevent falls or injury. Holding Propranolol if the client's apical pulse is greater than 100/min (Choice A) is incorrect because Propranolol is often used to manage dysrhythmias and slowing down the heart rate. Administering Propranolol to decrease the client's blood pressure (Choice B) is not the primary indication for using this medication. Monitoring the client for hypokalemia due to the risk of Propranolol toxicity (Choice D) is not a direct effect of Propranolol; rather, it is more related to other medications like diuretics.
5. The nurse is caring for a patient with an incision. Which actions will best indicate an understanding of medical and surgical asepsis for a sterile dressing change?
- A. Donning sterile gown and gloves to remove the wound dressing
- B. Utilizing clean gloves to remove the dressing and clean supplies for the new dressing
- C. Utilizing clean gloves to remove the dressing and sterile supplies for the new dressing
- D. Donning clean goggles, gown, and gloves to dress the wound
Correct answer: C
Rationale: Choice C is the correct answer. When performing a sterile dressing change, it is essential to use clean gloves to remove soiled dressings and sterile gloves and supplies for applying the new dressing. This helps maintain aseptic technique and reduce the risk of introducing pathogens to the wound. Choices A, B, and D involve incorrect use of sterile and clean supplies, which can compromise the sterility of the procedure and increase the risk of infection.
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