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. Which factor contributes to the development of bone diseases in patients with Chronic Kidney Disease (CKD) due to retention?

Correct answer: D

Rationale: The correct answer is phosphorus. Retention of phosphorus in patients with Chronic Kidney Disease (CKD) contributes to the development of bone disorders, including osteodystrophy, because it disrupts the balance of calcium and phosphorus in the body. This imbalance leads to a variety of bone diseases. The other options - iron, sodium, and potassium - while important in the overall metabolic function, are not directly linked to the development of bone diseases in CKD patients due to retention.

3. A nurse is providing teaching to a client with gastroesophageal reflux. Which of the following statements by the client indicates a need for further teaching?

Correct answer: B

Rationale: The correct answer is B: 'I drink no more than 4 cups of coffee a day.' Excessive coffee consumption can aggravate gastroesophageal reflux due to its acidic nature. Choices A, C, and D are all appropriate self-care measures for managing gastroesophageal reflux. Elevating the head of the bed while sleeping helps prevent acid reflux, eating slowly can reduce reflux episodes, and avoiding trigger foods like chocolate can help alleviate symptoms.

4. Approximately 70 to 80 percent of acute pancreatitis cases are caused by gallstones or _____.

Correct answer: B

Rationale: Alcohol abuse is indeed a major cause of acute pancreatitis, along with gallstones, accounting for the majority of cases. While infections, diabetes, and obesity can also contribute to pancreatitis, they are not as prevalent as alcohol abuse and gallstones in causing acute pancreatitis.

5. You would expect that after an abdominal perineal resection, the type of colostomy that will be use is?

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.

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