what should a nurse prioritize when managing a client with delirium
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ATI PN Comprehensive Predictor 2023 Quizlet

1. What should a healthcare professional prioritize when managing a client with delirium?

Correct answer: C

Rationale: When managing a client with delirium, the priority should be to identify the underlying cause of the delirium. Delirium can result from various triggers such as infections, medication side effects, or metabolic imbalances. By determining the root cause, healthcare professionals can provide targeted treatment and improve outcomes. Administering sedative medication (Choice A) could exacerbate delirium as these drugs can worsen confusion. While providing a low-stimulation environment (Choice B) is beneficial, it is not as critical as identifying the cause. Controlling behavioral symptoms with medication (Choice D) should only be considered after identifying and addressing the underlying cause of delirium.

2. What are the primary goals of post-operative care for a patient who has undergone abdominal surgery?

Correct answer: A

Rationale: The correct answer is A: Pain Management. After abdominal surgery, one of the primary goals of post-operative care is to manage the patient's pain effectively to ensure their comfort and promote recovery. While wound care, prevention of complications, and ensuring digestive function are also important aspects of post-operative care, pain management takes precedence as it directly impacts the patient's well-being and recovery process.

3. A nurse is reviewing the medical record of a client who is taking enalapril for hypertension. Which of the following findings should the nurse report to the provider?

Correct answer: C

Rationale: The correct answer is C: Persistent cough. Enalapril is known to cause a persistent dry cough as a side effect. This adverse reaction is due to the accumulation of bradykinin in the lungs, leading to irritation and cough. The nurse should report this symptom to the provider for further evaluation and possible medication adjustment. Choices A, B, and D are not directly associated with enalapril use. While a blood pressure of 150/80 mm Hg is elevated and should be monitored, it is not a direct side effect of enalapril. Swelling in the legs and a heart rate of 72 beats per minute are also not typically related to enalapril use and should be assessed but are not the priority findings to report in this scenario.

4. A nurse is reviewing the laboratory results of a client who is undergoing screening for prostate cancer. The nurse should expect an elevation in which of the following laboratory values?

Correct answer: A

Rationale: The correct answer is A: Prostate-specific antigen (PSA). PSA is a marker specifically used for prostate cancer screening. Elevated levels of PSA can indicate prostate cancer or other prostate-related issues, prompting the need for further diagnostic investigations. Choices B, C, and D are not typically associated with prostate cancer screening. Human chorionic gonadotropin (hCG) is related to pregnancy, alpha-fetoprotein (AFP) is associated with liver and germ cell tumors, and carcinoembryonic antigen (CEA) is linked to colorectal cancer.

5. What are the key nursing interventions for a patient receiving diuretic therapy?

Correct answer: A

Rationale: The correct answer is A: Monitor electrolyte levels and administer potassium as needed. Patients on diuretic therapy are at risk of electrolyte imbalances, particularly low potassium levels. Monitoring electrolytes and administering potassium as needed are crucial nursing interventions to prevent imbalances. Choice B is incorrect because restricting fluid intake and providing a low-sodium diet are not typically indicated for patients on diuretic therapy. Choice C is incorrect as encouraging oral fluids and increasing dietary potassium can exacerbate electrolyte imbalances in patients on diuretics. Choice D is incorrect as providing high-sodium foods would worsen electrolyte balance issues in patients on diuretic therapy.

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