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. What is the first thing you should do before sharing information with a patient?

Correct answer: B

Rationale: Before sharing information with a patient, it is essential to ask for their permission. This action respects the patient's autonomy and encourages their participation in the learning process. Asking for permission establishes a foundation of trust and partnership between the healthcare provider and the patient. Providing background knowledge (Choice A) is important, but it should come after receiving consent to share information. Removing personal protective equipment (Choice C) is not related to the communication process. Reminding the patient that you are the authority (Choice D) is inappropriate as it can undermine the patient's autonomy and hinder effective communication in a patient-centered care approach.

3. Before the nurse researcher starts her study, she analyzes how much time, money, materials and people she will need to complete the research project. This analysis prior to beginning the study is called:

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

4. The client is discussing sources of carbohydrates with a nurse recently diagnosed with diabetes. Which food(s) identified by the client indicate understanding? (SATA)

Correct answer: D

Rationale: The correct answer is D because starch, fiber, and sugar are all sources of carbohydrates. Starchy foods like bread, rice, and potatoes contain starch; fruits, vegetables, and whole grains provide fiber; and sugars are found in sweet foods like fruits, honey, and desserts. Fatty acids and amino acids are not sources of carbohydrates, so choices A, B, and C are correct while choices A and B are incorrect.

5. If it is determined that a child is being physically abused by a parent, what would be the most important goal for the nurse to establish with the family?

Correct answer: A

Rationale: The primary objective when dealing with cases of child abuse is to ensure the safety of the child and any siblings. This means creating a secure environment free from harm, which is why choice 'A' is the correct answer. While choices 'B', 'C', and 'D' might be subsequent steps in a comprehensive plan to deal with the situation, they are not the immediate priority. Understanding abusive behavioral patterns or improving the relationship with the counselor will not directly lead to the child's safety. Likewise, teaching the mother to apply verbal discipline doesn't guarantee the child's safety if the abusive behavior continues. Therefore, these options are not the most important initial goal.

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