ATI RN
Chapter 41 Oxygenation NCLEX Questions Questions
Question 1 of 5
A nurse is caring for a patient with acute pancreatitis. Which intervention should the nurse prioritize?
Correct Answer: A
Rationale: The correct answer is A: Administer intravenous fluids. In acute pancreatitis, fluid resuscitation is crucial to maintain circulation and prevent hypovolemic shock. It helps support organ perfusion and prevent complications like acute kidney injury. Providing a high-protein diet (B) is contraindicated as the pancreas needs to rest. Administering insulin (C) may be needed for hyperglycemia but is not the priority. Monitoring respiratory status (D) is important, but fluid resuscitation takes precedence to stabilize the patient's condition.
Question 2 of 5
A nurse is caring for a patient who is experiencing a myocardial infarction (MI). What is the priority nursing intervention?
Correct Answer: B
Rationale: The correct answer is B: Administer aspirin. Aspirin helps to reduce clot formation and minimize damage during a myocardial infarction (MI). This intervention is a priority because it can potentially save the patient's life by preventing further complications. Administering oxygen therapy (choice A) is important, but aspirin takes precedence due to its immediate impact on the outcome. Administering analgesics (choice C) can be considered after aspirin administration to address pain. Monitoring vital signs (choice D) is essential, but providing aspirin should be the initial priority to address the underlying cause of the MI.
Question 3 of 5
A nurse is caring for a patient with a history of diabetes who is experiencing dizziness and weakness. What is the priority action?
Correct Answer: B
Rationale: The correct answer is B: Administer glucagon. Glucagon is the hormone that raises blood glucose levels quickly in cases of hypoglycemia, which can cause dizziness and weakness in diabetic patients. Administering oral glucose (choice A) may take longer to raise blood sugar levels. Administering insulin (choices C and D) would lower blood glucose levels further, worsening the patient's symptoms. The priority is to quickly raise blood sugar levels to prevent further complications.
Question 4 of 5
A nurse is caring for a patient with a history of asthma who is experiencing an asthma attack. What is the priority intervention?
Correct Answer: A
Rationale: The correct answer is A: Administer a bronchodilator. During an asthma attack, the priority intervention is to open the airways quickly to improve breathing. Bronchodilators help to relax and widen the air passages, providing immediate relief. Corticosteroids may be used later to reduce inflammation. Reassurance is important but not the priority during an acute attack. Insulin therapy is not relevant to managing an asthma attack.
Question 5 of 5
A nurse is caring for a patient with a history of chronic kidney disease (CKD). The patient is experiencing fluid retention. What is the priority nursing action?
Correct Answer: A
Rationale: The correct answer is A: Administer albuterol. Albuterol is a bronchodilator that helps to relieve fluid retention by promoting diuresis through the dilation of blood vessels. Step 1: Assess the patient's condition and identify fluid retention as an issue. Step 2: Administer albuterol as it helps to reduce fluid volume by increasing urine output. Step 3: Monitor the patient for improvement in fluid status. Other choices are incorrect because B: Monitoring blood pressure is important but not the priority in this case. C: Administering IV fluids would worsen fluid retention. D: Administering antihypertensive medications may not directly address the fluid retention issue.