a nurse is planning care for a client who has a new diagnosis of deep vein thrombosis dvt which of the following interventions should the nurse includ
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Nursing Elites

ATI RN

ATI RN Exit Exam

1. A nurse is planning care for a client who has a new diagnosis of deep vein thrombosis (DVT). Which of the following interventions should the nurse include in the plan of care?

Correct answer: C

Rationale: The correct intervention for a client with DVT is to apply cold packs to the affected extremity. Cold packs can help reduce swelling and pain by constricting blood vessels. Massaging the affected extremity can dislodge a clot and worsen the condition. Elevating the affected extremity helps with blood flow but is not the priority intervention for DVT. Performing range-of-motion exercises on the affected extremity can also dislodge a clot and is contraindicated.

2. A nurse is completing a dietary assessment for a client who is Jewish and observes kosher dietary practices. Which of the following behaviors should the nurse expect to find?

Correct answer: C

Rationale: The correct answer is C. Kosher dietary laws require the separation of meat and dairy products. Choice A is incorrect because leavened bread is not eaten during Passover in Jewish dietary practices. Choice B is incorrect as shellfish is not considered kosher and is not consumed in Jewish dietary practices. Choice D is incorrect as fasting from meat does not occur during Hanukkah.

3. A nurse is assessing a client who has a history of angina and reports chest pain. Which of the following actions should the nurse take first?

Correct answer: B

Rationale: The correct answer is to obtain a 12-lead ECG. In a client with a history of angina and reporting chest pain, the priority action is to assess for myocardial infarction, which is best done through an ECG. Administering oxygen, nitroglycerin, or notifying the provider can be important actions but obtaining an ECG takes precedence in evaluating the client's condition.

4. A nurse in an emergency department is assessing a newly admitted client who is experiencing drooling and hoarseness following a burn injury. Which of the following actions should the nurse take first?

Correct answer: D

Rationale: In a client experiencing drooling and hoarseness following a burn injury, the priority action for the nurse is to administer 100% humidified oxygen. This is crucial to maintain the airway and address respiratory distress, which takes precedence over obtaining an ECG, collecting blood for ABG analysis, or inserting an IV catheter. Providing oxygen therapy is essential in ensuring the client's oxygenation and respiratory function are optimized in this emergency situation.

5. A client with osteoporosis needs to increase calcium intake. Which of the following foods should be recommended by the nurse?

Correct answer: B

Rationale: The correct answer is B: Broccoli. Broccoli is rich in calcium and is a suitable food to recommend to clients with osteoporosis to increase their calcium intake. Carrots, chicken, and bananas are not as high in calcium content compared to broccoli and therefore not the most appropriate choices for increasing calcium intake in clients with osteoporosis.

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