the nurse is caring for a client who has just returned from a cardiac catheterization the nurse should prioritize which assessment
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Nursing Elites

ATI LPN

LPN Pharmacology Assessment A

1. The healthcare professional is caring for a client who has just returned from a cardiac catheterization. The healthcare professional should prioritize which assessment?

Correct answer: B

Rationale: Assessing the puncture site for bleeding is a critical assessment after a cardiac catheterization procedure. This is essential to detect and address any potential complications promptly, such as hemorrhage or hematoma formation. Monitoring vital signs, encouraging early ambulation, and providing fluids to flush out contrast dye are important aspects of post-cardiac catheterization care, but assessing the puncture site for bleeding takes precedence due to the immediate risk of complications such as severe bleeding that require immediate intervention.

2. The LPN/LVN is assisting in the care of a client with chronic heart failure who is receiving furosemide (Lasix). Which instruction should the nurse reinforce with the client?

Correct answer: B

Rationale: The correct instruction for the nurse to reinforce with the client is to increase potassium intake by eating bananas and oranges. Furosemide can lead to potassium loss, potentially causing hypokalemia. By increasing potassium intake through diet, the client can help prevent this electrolyte imbalance and maintain overall health. Choices A, C, and D are incorrect. Limiting fluid intake is not the appropriate instruction, as furosemide is a diuretic that already helps in fluid management. Weighing once a week is not as crucial as monitoring potassium levels, and taking the medication at night does not impact potassium levels.

3. A nurse is assessing a client who has been taking phenytoin for epilepsy. Which of the following findings should the nurse report to the provider?

Correct answer: B

Rationale: The correct answer is B: Gingival hyperplasia. Phenytoin is known to cause gingival hyperplasia, an overgrowth of gum tissue, which can lead to oral health issues and requires dental care. Choices A, C, and D are not directly associated with phenytoin use. Weight loss, increased thirst, and frequent urination are not typically reported findings related to phenytoin and should not be prioritized over gingival hyperplasia when assessing a client taking this medication.

4. The client admitted to the hospital with pulmonary edema is preparing for discharge. The client should be reminded of the importance of complying with which measure to prevent a recurrence?

Correct answer: A

Rationale: Monitoring weight daily, especially in the morning before breakfast, is crucial in detecting fluid retention early and preventing pulmonary edema. Sudden weight gain can indicate fluid accumulation, prompting timely intervention to prevent complications. Choice A is the correct answer because daily weight monitoring is a key component in managing heart failure and preventing pulmonary edema recurrence. Choices B and D are not directly related to preventing fluid retention or pulmonary edema recurrence. Choice C is unsafe as adjusting diuretic doses without healthcare provider guidance can lead to electrolyte imbalances and worsening of the condition.

5. An ambulatory clinic nurse is interviewing a client who is complaining of flu-like symptoms. The client suddenly develops chest pain. Which question best assists the nurse in discriminating pain caused by a non-cardiac problem?

Correct answer: C

Rationale: The correct answer is C. Pain that worsens with breathing in can indicate pleuritic chest pain, which is non-cardiac in nature. This specific question helps in differentiating non-cardiac causes from cardiac causes of chest pain, as cardiac pain typically does not worsen with breathing. Choices A, B, and D are less specific in discriminating between cardiac and non-cardiac chest pain.

Similar Questions

A client has a new prescription for metoprolol. Which of the following instructions should the nurse include?
A client has just completed an information session about measures to minimize the progression of coronary artery disease (CAD). Which statement indicates an initial understanding of lifestyle alterations?
The nurse is caring for a client who has returned to the unit after undergoing a cardiac catheterization. The nurse should monitor for which common complication following this procedure?
When assessing a client receiving total parenteral nutrition (TPN), which laboratory value is most important for the nurse to monitor regularly?
A client with heart failure is prescribed furosemide (Lasix). The nurse should monitor the client for which potential electrolyte imbalance?

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