a nurse is assessing a client for signs of hyperglycemia which of the following findings should the nurse look for
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Nursing Elites

ATI LPN

PN ATI Capstone Proctored Comprehensive Assessment 2020 B

1. A healthcare professional is assessing a client for signs of hyperglycemia. Which of the following findings should the healthcare professional look for?

Correct answer: A

Rationale: Increased thirst is a classic symptom of hyperglycemia due to the body trying to eliminate excess glucose through urine, leading to dehydration and increased thirst. Weight gain, decreased urination, and fatigue are not typical signs of hyperglycemia. Weight gain is more commonly associated with conditions like hypothyroidism or fluid retention. Decreased urination is not a typical symptom of hyperglycemia, as high blood sugar levels usually lead to increased urination. Fatigue can be a symptom of hyperglycemia, but it is not as specific or characteristic as increased thirst.

2. A nurse is preparing a client for a colonoscopy. Which of the following medications should the nurse anticipate the provider to prescribe as an anesthetic for the procedure?

Correct answer: A

Rationale: The correct answer is A, Propofol. Propofol is a short-acting anesthetic medication commonly used to induce moderate sedation for procedures like a colonoscopy. This medication provides rapid onset and recovery, making it an ideal choice for such procedures. Choice B, Pancuronium, is a neuromuscular blocking agent used for muscle relaxation during surgery and would not be appropriate for sedation during a colonoscopy. Choice C, Promethazine, is an antihistamine used for nausea and motion sickness, not for anesthesia. Choice D, Pentoxifylline, is a medication used to improve blood flow in patients with circulation problems and is not indicated for anesthesia during a colonoscopy.

3. When assessing a client with a small bowel obstruction, what finding should a nurse expect?

Correct answer: C

Rationale: High-pitched bowel sounds are often heard early in a small bowel obstruction due to increased peristalsis as the bowel tries to overcome the blockage. Choices A, B, and D are incorrect. Abdominal distention is more commonly associated with large bowel obstructions, while large bowel movements and copious vomiting are not typical findings in small bowel obstructions.

4. A nurse is providing teaching to a client who has mild persistent asthma and has been prescribed montelukast. Which of the following statements should the nurse include in the teaching?

Correct answer: D

Rationale: Montelukast works as a leukotriene receptor antagonist, reducing inflammation and mucus production, which helps prevent asthma attacks but is not used for acute treatment. It is important for the client to understand that montelukast should be taken regularly to manage asthma symptoms and should not be abruptly discontinued. Taking the medication before exercise is not a typical instruction for montelukast.

5. A client with preeclampsia is receiving magnesium sulfate. Which finding indicates magnesium toxicity?

Correct answer: A

Rationale: The correct answer is A: Decreased deep tendon reflexes. In a client receiving magnesium sulfate for preeclampsia, decreased deep tendon reflexes indicate magnesium toxicity. Magnesium toxicity can lead to respiratory depression and other serious complications, requiring immediate intervention. Choices B, C, and D are incorrect because increased blood pressure, tachypnea, and hyperreflexia are not typical findings associated with magnesium toxicity.

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