a nurse is preparing to administer a dose of naloxone which of the following should the nurse assess
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Nursing Elites

ATI LPN

PN ATI Capstone Proctored Comprehensive Assessment 2020 A with NGN

1. A healthcare professional is preparing to administer a dose of naloxone. Which of the following should the healthcare professional assess?

Correct answer: B

Rationale: Correct. Naloxone is used to reverse opioid overdose, which can cause respiratory depression. Assessing the respiratory rate before administering naloxone is crucial to monitor the patient's breathing. Choices A, C, and D are important assessments in general patient care but are not specifically crucial before administering naloxone for opioid overdose.

2. A nurse is caring for a client who is 36 weeks pregnant and reports leaking fluid. Which of the following tests should the nurse use to confirm that the client's membranes have ruptured?

Correct answer: C

Rationale: The correct answer is the Fern test. The Fern test is specifically used to confirm the rupture of membranes. A sample of vaginal fluid is examined under a microscope, and the presence of a fern-like pattern indicates the presence of amniotic fluid. The Nonstress test (Choice A) is used to monitor fetal heart rate and movement, not to confirm ruptured membranes. The Biophysical profile (Choice B) is a prenatal ultrasound evaluation to assess fetal well-being, not to confirm ruptured membranes. Amniocentesis (Choice D) involves the aspiration of amniotic fluid for various diagnostic purposes, not specifically to confirm ruptured membranes.

3. A healthcare professional is preparing to administer a dose of potassium chloride. Which of the following should the professional do?

Correct answer: B

Rationale: Correct Answer: Dilute the medication. Potassium chloride should always be diluted before administration to avoid irritation and complications. Choice A is incorrect because administering it as a bolus can lead to adverse effects. Choice C is incorrect as giving it rapidly can be dangerous. Choice D is incorrect as monitoring the respiratory rate is not directly related to administering potassium chloride.

4. A client with lactose intolerance needs to increase calcium intake. Which food should the nurse recommend?

Correct answer: A

Rationale: Spinach is a suitable choice to recommend for increasing calcium intake to a client with lactose intolerance. Spinach is a good non-dairy source of calcium. Peanut butter, ground beef, and carrots are not significant sources of calcium. Peanut butter is high in protein and fats, ground beef is a source of protein and iron, and carrots are rich in vitamin A and fiber, but none of these choices provide a substantial amount of calcium.

5. A nurse is caring for a client with hepatic encephalopathy. Which food selection indicates an understanding of dietary teaching?

Correct answer: C

Rationale: The correct answer is C: 'Rice with black beans.' Clients with hepatic encephalopathy should limit animal proteins due to their high ammonia content, which can exacerbate symptoms. Plant-based proteins like beans are preferred as they help reduce ammonia levels. Choices A, B, and D contain animal proteins that are not ideal for clients with hepatic encephalopathy.

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