the nurse is caring for a client in a sickle cell crisis which is the pain regimen of choice to relieve the pain

ATI RN

ATI RN Custom Exams Set 1

1. The nurse is caring for a client in a sickle cell crisis. Which is the pain regimen of choice to relieve the pain?

A. Frequent aspirin (acetylsalicylic acid) and a non-narcotic analgesic
B. Motrin (ibuprofen), an NSAID, PRN
C. Demerol (meperidine), a narcotic analgesic, every four (4) hours
D. Morphine, a narcotic analgesic, every two (2) to three (3) hours PRN

Correct answer: D

Rationale: In a sickle cell crisis, morphine is the preferred analgesic due to its potency and effectiveness in managing severe pain. Choice A is incorrect because aspirin is contraindicated in sickle cell disease due to its potential to cause a further decrease in blood flow. Choice B, Motrin (ibuprofen), is also not the ideal choice as NSAIDs can exacerbate renal complications in sickle cell patients. Choice C, Demerol (meperidine), is not recommended for sickle cell pain management due to its toxic metabolite accumulation which can cause seizures and other complications.

2. What is the initial step in providing healthcare for a patient?

A. Obtain and interpret vital signs
B. Determine the needs of the patient
C. Develop a plan of care
D. Obtain lab work and x-rays

Correct answer: B

Rationale: The initial step in providing healthcare for a patient is to determine the needs of the patient. This step involves assessing the patient's condition, listening to their concerns, and understanding what care or treatment they require. Obtaining and interpreting vital signs (Choice A) is a crucial step but typically follows the assessment of the patient's needs. Developing a plan of care (Choice C) and obtaining lab work and x-rays (Choice D) come after understanding the patient's needs and assessing their condition.

3. The client diagnosed with diabetes mellitus type 2 is admitted to the hospital with cellulitis of the right foot secondary to an insect bite. Which intervention should the nurse implement first?

A. Administer intravenous antibiotics
B. Apply warm moist packs every two hours
C. Elevate the right foot on two pillows
D. Teach the client about skin and foot care

Correct answer: A

Rationale: Administering intravenous antibiotics is the priority intervention in this situation. Cellulitis is a bacterial infection that can spread rapidly, especially in individuals with diabetes. Immediate antibiotic therapy is crucial to prevent the infection from worsening and causing serious complications. Applying warm moist packs, elevating the foot, and teaching the client about skin and foot care are important interventions but should come after initiating antibiotic treatment to address the underlying infection.

4. Enteral feedings may be appropriate for patients with:

A. Acute cholecystitis
B. Hepatic encephalopathy
C. Ulcerative colitis in remission
D. Acute exacerbation of Crohn’s disease

Correct answer: D

Rationale: Enteral feedings are commonly utilized for patients experiencing acute exacerbations of Crohn’s disease to provide necessary nutrition and rest the bowel. Choices A, B, and C are incorrect because enteral feedings are not typically indicated for acute cholecystitis, hepatic encephalopathy, or ulcerative colitis in remission.

5. A client is admitted to the hospital with the diagnosis of a right-sided brain attack (CVA). The client is right-handed. Which task will be most difficult for this client?

A. Eating meals
B. Writing letters
C. Combing the hair
D. Dressing every morning

Correct answer: B

Rationale: The correct answer is B: Writing letters. Writing requires fine motor skills, which are often impaired in a right-handed person with a right-sided CVA. Eating meals (choice A), combing the hair (choice C), and dressing every morning (choice D) involve gross motor skills and may not be as challenging for a right-handed individual with a right-sided CVA compared to the fine motor skill required for writing.