ATI RN
Pediatric Nursing Practice Questions Questions
Question 1 of 5
A client with advanced breast cancer is prescribed tamoxifen (Nolvadex). When teaching the client about this drug, the nurse should emphasize the importance of reporting which adverse reaction immediately?
Correct Answer: A
Rationale: Tamoxifen (Nolvadex) is associated with the potential side effect of retinopathy, which can present as changes in vision. Retinopathy is a serious condition that can lead to vision loss. Therefore, it is crucial for the client to report any vision changes immediately to their healthcare provider for further evaluation and management. Reporting this adverse reaction promptly can help prevent serious complications and ensure the client's safety and well-being.
Question 2 of 5
The patient develops a low-grade fever 18 hours post-operatively and has diminished breath sounds. Which of the following actions is most appropriate for the nurse to take to prevent complications? i.Administer antibiotics iv.Decrease fluid intake ii.Encourage coughing and deepbreathing v.Ambulate patient as ordered iii.Administer acetaminophen (Tylenol)
Correct Answer: A
Rationale: In this scenario, the patient developing a low-grade fever post-operatively along with diminished breath sounds could indicate the possibility of atelectasis or pneumonia. The most appropriate actions for the nurse to take to prevent complications in this situation would be to encourage coughing and deep breathing (to help clear secretions and improve lung expansion) and ambulate the patient as ordered (to promote lung ventilation and prevent further complications). Administering antibiotics, acetaminophen for fever management, and decreasing fluid intake may be considered based on the healthcare provider's assessment and orders, but the immediate nursing interventions to address the presenting symptoms are encouraging coughing and deep breathing and ambulating the patient.
Question 3 of 5
When the nurse is reviewing a patient's daily laboratory test results, which of the ff. electrolyte imbalances should the nurse recognize as predisposing the patient to digoxin toxicity?
Correct Answer: A
Rationale: Hypokalemia, or low potassium levels, predisposes the patient to digoxin toxicity because potassium is essential for proper digoxin metabolism. Potassium competes with digoxin for binding sites on sodium-potassium ATPase pumps in the myocardial cells. When potassium levels are low, digoxin binding is increased, leading to an increased risk of digoxin toxicity. Monitoring and correcting hypokalemia are important in patients taking digoxin to reduce the risk of toxicity. Hyperkalemia, on the other hand, can increase the risk of digoxin toxicity by affecting electrophysiological properties of the heart, but hypokalemia is the most significant imbalance predisposing to digoxin toxicity.
Question 4 of 5
If the systolic BP is elevated and the diastolic BP is normal, the nurse recognizes that a patient is most likely to have which type of hypertension?
Correct Answer: B
Rationale: Isolated systolic hypertension is characterized by elevated systolic blood pressure (SBP) with normal diastolic blood pressure (DBP). In this case, if the systolic BP is elevated and the diastolic BP is normal, the nurse would recognize this pattern as indicative of isolated systolic hypertension. This condition is more common in older adults and is associated with aging and stiffening of the arteries. Patients with isolated systolic hypertension are at an increased risk of cardiovascular events, so it is important to monitor and manage their blood pressure appropriately.
Question 5 of 5
Why should the nurse monitor angiotensin converting enzyme inhibitors cautiously in clients with renal or hepatic impairment and in older adults?
Correct Answer: B
Rationale: Angiotensin converting enzyme (ACE) inhibitors are commonly used to manage hypertension and heart failure by blocking the conversion of angiotensin I to angiotensin II. In clients with renal or hepatic impairment, as well as in older adults, the metabolism and excretion of ACE inhibitors may be altered, leading to an increased risk of drug accumulation and potential hypotension. Monitoring these clients cautiously for a sudden drop in blood pressure, especially during the first 1-3 hours after the initial dose, is crucial to prevent complications such as dizziness, lightheadedness, and falls. Adjustments in dosage or frequency may be necessary to ensure the safe and effective use of ACE inhibitors in these populations.