during the acute phase of burn the priority nursing intervention in caring for this client is
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Nursing Elites

ATI RN

ATI RN Nutrition Online Practice 2019

1. During the acute phase of a burn, the priority nursing intervention in caring for this client is:

Correct answer: D

Rationale: During the acute phase of a burn, fluid resuscitation is the priority nursing intervention. This phase is characterized by fluid loss and the risk of hypovolemic shock. Administering fluids is crucial to maintain perfusion and prevent complications such as organ failure. While prevention of infection, pain management, and prevention of bleeding are important aspects of burn care, fluid resuscitation takes precedence in the acute phase to stabilize the client's condition and prevent further damage.

2. In approximately what percentage of cases is the prevalence seen?

Correct answer: A

Rationale: The correct answer is A, Type 1 Diabetes. The prevalence of Type 1 Diabetes is seen in approximately 5% to 10% of cases. This statement highlights a key epidemiological characteristic of Type 1 Diabetes. Choice B, Type 2 Diabetes, is incorrect because the prevalence mentioned does not align with Type 2 Diabetes, which has a much higher prevalence in the general population. Choices C and D are not relevant to the question and can be disregarded.

3. Before and after the operation, the operating suite is managed by the:

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

4. Which enzyme is most essential for the digestion of triglycerides found in butterfat?

Correct answer: A

Rationale: The correct answer is A: Gastric lipase. Gastric lipase is crucial for the digestion of short- and medium-chain triglycerides, such as those found in butterfat. Pepsin is involved in protein digestion, not lipid digestion. Mucus acts as a protective barrier in the stomach and does not play a direct role in lipid digestion. Intrinsic factor is involved in the absorption of vitamin B12 and is not related to the digestion of triglycerides.

5. What special consideration should be taken into account when Mario prepares Richard for postural drainage and percussion?

Correct answer: A

Rationale: The correct answer is A, 'Monitoring a respiratory rate of 16 to 20 per minute'. When performing postural drainage and percussion, it is crucial to monitor the respiratory rate to ensure the safety and effectiveness of the procedure. Choice B, 'Assessing the client's ability to tolerate sitting and lying positions', while important, is not directly related to the specifics of postural drainage and percussion. Similarly, option C, 'Ensuring the client is free of signs of infection', although important, is not directly linked to the procedure. Option D, 'Knowing the time of the client's last food and fluid intake', might be relevant for other procedures, but it is not the primary consideration for postural drainage and percussion.

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