a nurse is developing a care plan for a client with alzheimers disease which of the following interventions should the nurse include
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Nursing Elites

ATI RN

ATI Exit Exam 2023

1. A nurse is developing a care plan for a client with Alzheimer's disease. Which of the following interventions should the nurse include?

Correct answer: A

Rationale: The correct intervention the nurse should include in the care plan for a client with Alzheimer's disease is to provide reality orientation throughout the day. Reality orientation involves helping clients with Alzheimer's disease stay connected to the present, reducing confusion and disorientation. This intervention can help the client maintain a sense of time, place, and person. Choices B, C, and D are incorrect because limiting choices may lead to frustration, group therapy may not always be suitable for clients with Alzheimer's disease, and sensory stimulation activities may not address the core issue of disorientation in Alzheimer's disease.

2. A nurse is reviewing admission prescriptions for a group of clients. Which prescription should the nurse identify as complete?

Correct answer: A

Rationale: The correct answer is A. A complete prescription should include the medication name (Furosemide), dosage (20 mg), and administration schedule (BID - twice daily). Choice B is missing the dosage of Aspirin, choice C lacks the dosage information for Nitroglycerin, and choice D does not specify the administration schedule for Metoprolol.

3. A nurse is caring for a client who is in labor and is receiving oxytocin. Which of the following findings indicates that the nurse should increase the rate of infusion?

Correct answer: D

Rationale: The correct answer is D because contractions every 5 minutes that last 30 seconds indicate that the rate of infusion should be increased. This pattern suggests weak contractions or intervals that are too far apart, requiring an adjustment to improve labor progress. Option A is incorrect as a low urine output is not directly related to the need for an increase in the oxytocin infusion rate. Option B, Montevideo units consistently at 300 mm Hg, is incorrect because it is a measure of intrauterine pressure and does not determine the need for an increase in oxytocin infusion. Option C, FHR pattern with absent variability, is incorrect as it may indicate fetal distress but does not specifically relate to the need for adjusting the oxytocin infusion rate.

4. A nurse is preparing to administer a dose of amoxicillin to a client who has an allergy to penicillin. Which of the following actions should the nurse take?

Correct answer: C

Rationale: In this scenario, the nurse should ask the provider to prescribe a different antibiotic instead of administering amoxicillin to a client with a known penicillin allergy. Choice A is incorrect because administering amoxicillin to a client with a penicillin allergy can lead to an allergic reaction. Choice B is not the best option as simply verifying the client's allergy status does not address the potential harm of giving amoxicillin. Choice D is irrelevant as checking the client's skin for rashes does not address the issue of administering a potentially harmful medication. Therefore, the most appropriate action is to request a different antibiotic from the provider to ensure the safety of the client.

5. A nurse is assessing a client who is receiving continuous enteral feedings through a nasogastric tube. Which of the following findings should the nurse report to the provider?

Correct answer: D

Rationale: The correct answer is D. A blood glucose level of 180 mg/dL is higher than expected and should be reported to prevent hyperglycemia complications. High blood glucose levels can lead to hyperglycemia, causing various issues such as increased risk of infection and delayed wound healing. Choices A, B, and C are within normal limits for a client receiving continuous enteral feedings and do not require immediate reporting.

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