ATI RN Adult Medical Surgical Practice with NGN

ATI RN Adult Medical Surgical Practice with NGN A nurse is assessing a client who has acute cholecystitis. Which of the following findings is the nurse's priority? Anorexia Abdominal pain radiating to the right shoulder Tachycardia Rebound abdominal tenderness Tachycardia -Tachycardia is a manifestation of biliary colic, which can lead to shock. The nurse should position the head of the client's bed flat and report this finding immediately A nurse is caring for a client who is undergoing hemodialysis to treat end-stage kidney disease (ESKD). The client reports muscle cramps and tingling sensation in their hands. Which of the following medications should the nurse plan to administer? Epoetin alfa Furosemide Captopril Calcium carbonate Calcium carbonate A nurse is providing teaching to a client who is receiving chemotherapy and has a new prescription for epoetin alfa. Which of the following client statements indicates an understanding of the teaching? "I will monitor my blood pressure while taking this medication" "I should take a vitamin D supplement to increase the effectiveness of the medication." "I should inform the provider if I experience an increased appetite while taking this medication" "I will decrease the amount of protein in my diet while taking this medication." "I will monitor my blood pressure while taking this medication" -monitor their blood pressure while taking this medication because hypertension is a common adverse effect and can lead to hypertensive encephalopathy. Rationale -client requires an adequate intake of iron, folic acid, and vitamin B12 while taking this medication because they are essential to the production of erythrocytes. -increase the amount of protein in their diet while receiving chemotherapy to decrease the risk for infection. The nurse is caring for a group of clients. The nurse should plan to make a referral to physical therapy for which of the following clients? -A client who is receiving preoperative teaching for a right knee arthroplasty. -A client who states they will have difficulty obtaining a walker for home use. -A client who reports an increase in pain following a left hip arthroplasty. -A client who is having emotional difficulty accepting that they have a prosthetic leg. A client who is receiving preoperative teaching for a right knee arthroplasty. -should make a referral to physical therapy for a client who is receiving preoperative teaching for a knee arthroplasty so the client can begin understanding postoperative exercises and physical restrictions. Rationale -should make a referral to a social worker for walker -should contact the provider for a client who is experiencing increased pain following a left hip arthroplasty. -should refer the client to a counselor to assist with coping with the adjustment to the need of a prosthetic leg. A nurse is providing teaching to a female client who has a history of urinary tract infections (UTIs). Which of the following information should the nurse include in the teaching? Avoid foods that are high in ascorbic acid. Add oatmeal to the water when taking a tub bath. Urinate every 6 hr. Take daily cranberry supplements. Take daily cranberry supplements -.take cranberry supplements or drink low-fructose cranberry juice because it contains compounds that adhere to the urinary tract wall, decreasing the risk for developing a UTI Rationale -risk for developing UTIs should urinate every 2 to 4 hr. -take showers rather than tub baths because bacteria in the bath water can enter the urethra. -increase intake of ascorbic acid to acidify the urine. A nurse is providing instructions to a client who has type 2 diabetes mellitus and a new prescription for metformin. Which of the following statements by the client indicates an understanding of the teaching? "I will monitor my blood sugar carefully because the medication increases the secretion of insulin." "I should take this medication with a meal." "I can expect to gain weight while taking this medication." "While taking this medication, I will experience flushing of my skin." "I should take this medication with a meal." -take metformin with or immediately following meals to improve absorption and to minimize gastrointestinal distress. Rationale -Metformin decreases the amount of glucose produced in the liver and increases tissue sensitivity to insulin -Typically, clients lose weight when beginning to take metformin due to nausea and vomiting. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). A new bag is not available when the current infusion is nearly completed. Which of the following actions should the nurse take? Keep the line open with 0.9% sodium chloride until the new bag arrives. Administer dextrose 10% in water until the new bag arrives. Flush the line and cap the port until the new bag arrives. Decrease the infusion rate until the new bag arrives. Administer dextrose 10% in water until the new bag arrives. -TPN solutions have a high concentration of dextrose. Therefore, if a TPN solution is temporarily unavailable, the nurse should administer dextrose 10% or 20% in water to avoid a precipitous drop in the client's blood glucose level. A nurse in a community clinic is caring for a client who reports an increase in the frequency of migraine headaches. To help reduce the risk for migraine headaches, which of the following foods should the nurse recommend the client avoid? Shellfish Aged cheese Peppermint candy Enriched pasta Aged cheese A nurse is preparing a client who has supraventricular tachycardia for elective cardioversion. Which of the following prescribed medications should the nurse instruct the client to withhold for 48 hr prior to cardioversion?