how should a nurse assess for fluid overload in a patient with heart failure how should a nurse assess for fluid overload in a patient with heart failure
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Nursing Elites

ATI RN

ATI RN Comprehensive Exit Exam 2023

1. How should a healthcare professional assess for fluid overload in a patient with heart failure?

Correct answer: A

Rationale: Monitoring daily weight is the most accurate way to assess fluid overload in patients with heart failure. In heart failure, the body retains excess fluid, leading to weight gain. Monitoring daily weight allows healthcare professionals to track fluid retention accurately. Checking for edema (Choice B) is a valuable assessment technique, but it may not be as sensitive as monitoring daily weight. Monitoring blood pressure (Choice C) is essential in managing heart failure, but it is not the most accurate way to assess fluid overload. Checking oxygen saturation (Choice D) is important to assess respiratory status but is not directly related to fluid overload in heart failure.

2. Conditions that promote disease or injury and prevent people from realizing their health potential are termed as:

Correct answer: B

Rationale: The correct term for conditions that promote disease or injury and hinder people from achieving their health potential is 'health threats.' These are factors that pose a risk to an individual or community's health, such as environmental hazards, lifestyle choices, or infectious diseases.

3. A nurse is caring for a client who is post-operative following an open reduction internal fixation (ORIF) of a femur fracture. What is NOT included in the evaluation of the neurovascular status of the client’s affected extremity?

Correct answer: Skin integrity

Rationale:

4. A healthcare professional is reviewing the laboratory results of a client who is taking Lithium for Bipolar Disorder. Which of the following findings should the healthcare professional report to the provider immediately?

Correct answer: D

Rationale: A creatinine level of 1.0 mg/dL should be reported to the provider immediately. While a lithium level of 1.0 mEq/L falls within the therapeutic range, a creatinine level of 1.0 mg/dL could suggest early signs of kidney dysfunction, especially concerning in a client on long-term lithium therapy. It is crucial to monitor kidney function closely because lithium can be nephrotoxic over time. Elevated creatinine levels may indicate impaired kidney function and should prompt immediate reporting to the healthcare provider. Potassium and sodium levels within normal range are not immediate concerns when compared to potential kidney issues.

5. Who believed that complex mental activities have their origins in social interaction?

Correct answer: D

Rationale: The correct answer is Lev Vygotsky. Vygotsky emphasized the role of social interaction and cultural tools in the development of higher cognitive functions. Jean Piaget focused more on individual cognitive development stages, Renée Baillargeon is known for her work in infant cognition and object permanence, and Noam Chomsky is renowned for his theories in linguistics and the study of language.

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