the nurse is monitoring a patient receiving a heparin infusion for the treatment of pulmonary embolism which assessment finding most likely related to
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Nursing Elites

ATI RN

ATI Pediatric Proctored Exam 2023

1. The patient is receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding is most likely related to an adverse effect of heparin?

Correct answer: C

Rationale: The primary and most serious adverse effect of heparin is bleeding. However, discolored urine can indicate bleeding into the urinary tract, which is a potential adverse effect of heparin therapy. While changes in heart rate (HR) and blood pressure (BP) can occur due to various reasons, discolored urine specifically points towards a potential adverse effect related to heparin therapy.

2. The healthcare provider is providing dietary teaching to the parent of a school-age child who has celiac disease. The healthcare provider should recommend that the parent offer which of the following foods to the child?

Correct answer: D

Rationale: Celiac disease requires a lifelong gluten-free diet. Foods containing gluten such as wheat, barley, and rye should be avoided. Rice pudding is a safe option as it does not contain gluten, making it a suitable choice for a child with celiac disease.

3. The nurse is preparing to administer a daily dose of digoxin. What is the priority nursing intervention?

Correct answer: A

Rationale: Before giving digoxin, the nurse will assess the HR and rhythm. The dosage will be held and the prescriber notified if the HR is below 60 bpm or if the cardiac rhythm has changes. Digoxin can cause bradycardia and electrical changes in the heart.

4. What is the next food texture after 'soft and bite-sized pieces of meltable and soft-solid foods'?

Correct answer: A

Rationale: After mastering soft and bite-sized pieces, children typically progress to regular table foods.

5. A nurse administers naloxone (Narcan) to a post-op patient experiencing respiratory sedation. What undesirable effect would the nurse anticipate after giving this medication?

Correct answer: C

Rationale: Naloxone reverses the effects of narcotics. Although the patient�s respiratory status will improve after administration of naloxone, the pain will be more acute.

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