what is the priority action if a patient experiences abdominal cramping during enema administration
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Nursing Elites

ATI RN

ATI Capstone Medical Surgical Assessment 1 Quizlet

1. What is the priority action if a patient experiences abdominal cramping during enema administration?

Correct answer: A

Rationale: During enema administration, if a patient experiences abdominal cramping, the priority action is to lower the height of the solution container. This adjustment can help relieve abdominal cramping by reducing the flow rate of the enema, making it more comfortable for the patient. Increasing the flow of the enema solution (Choice B) can exacerbate the cramping. Stopping the procedure and removing the tubing (Choice C) may be necessary in some cases of severe discomfort or complications, but adjusting the height of the solution container should be the initial response. Continuing the enema at a slower rate (Choice D) may not address the immediate need to alleviate the cramping.

2. What is the first medication to give to a patient with an allergic reaction causing wheezing?

Correct answer: A

Rationale: The correct answer is A, Albuterol 3 ml via nebulizer. Albuterol is a fast-acting bronchodilator that helps relieve wheezing by relaxing the muscles in the airways, making it the first-line treatment for wheezing caused by bronchospasms in allergic reactions. Methylprednisolone (Choice B) is a corticosteroid used for its anti-inflammatory properties and is typically given after bronchodilators. Cromolyn (Choice C) is a mast cell stabilizer that is used for the prevention of asthma symptoms, not for immediate relief. Aminophylline (Choice D) is a bronchodilator that is less commonly used nowadays due to its narrow therapeutic window and potential for toxicity.

3. A patient with pre-dialysis end-stage kidney disease is asking for dietary recommendations. What should the nurse suggest?

Correct answer: D

Rationale: In patients with pre-dialysis end-stage kidney disease, it is crucial to limit phosphorus intake to 700mg/day to manage their condition. High phosphorus levels can lead to complications such as bone and heart problems. Limiting protein intake is essential in later stages of kidney disease, particularly in dialysis patients to reduce the buildup of waste products. While limiting potassium and restricting sodium intake are also important in kidney disease management, the priority for a patient with pre-dialysis end-stage kidney disease is to control phosphorus levels.

4. What symptoms are expected in a patient with compartment syndrome?

Correct answer: A

Rationale: In a patient with compartment syndrome, the key symptoms include unrelieved pain, pallor, and pulselessness. These symptoms indicate reduced circulation in the affected compartment. Choice B is incorrect as localized swelling and numbness are not typically associated with compartment syndrome. Choice C is incorrect as fever and infection are not primary symptoms of compartment syndrome. Choice D is incorrect as weakness and fatigue are not typically seen in compartment syndrome.

5. A nurse is teaching a client who has type 1 DM about hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching?

Correct answer: C

Rationale: The client can correct any development of hypoglycemia with a quick intake of glucose. The client should have 15 g carbohydrates on hand to treat hypoglycemic episodes, like 4 oz of regular soda.

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