how should a nurse monitor for infection in a patient with a central line
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Nursing Elites

ATI RN

ATI Exit Exam RN

1. How should a healthcare professional monitor for infection in a patient with a central line?

Correct answer: A

Rationale: Correct answer: A. Checking the central line dressing daily is crucial to monitor for signs of infection around the insertion site. This practice helps in early detection of any changes such as redness, swelling, or discharge, which are indicators of a potential infection. Monitoring for signs of redness (choice B) is limited as redness alone may not always indicate an infection; other symptoms like discharge and tenderness should also be observed. Checking for abnormal breath sounds (choice C) is not directly related to monitoring central line infections. Monitoring temperature (choice D) is important for detecting systemic signs of infection but may not specifically indicate an infection related to the central line site.

2. What is the priority nursing action for a patient experiencing an acute asthma attack?

Correct answer: A

Rationale: The correct answer is to administer bronchodilators as the priority nursing action for a patient experiencing an acute asthma attack. Bronchodilators help open the airways and improve airflow, which is crucial in managing the acute respiratory distress in asthma. Corticosteroids may be used subsequently to reduce inflammation, but in the acute phase, bronchodilators take precedence. Providing supplemental oxygen is important but may not address the underlying bronchoconstriction characteristic of an asthma attack. Starting IV fluids is not a priority in managing an acute asthma attack unless indicated for specific reasons such as dehydration.

3. How should a healthcare professional prepare a patient for a colonoscopy?

Correct answer: D

Rationale: Giving a bowel prep solution is essential to clean out the colon thoroughly before a colonoscopy. This process is crucial as it helps to achieve a clear view of the colon during the procedure. Providing clear instructions on diet (Choice A) and ensuring the patient has an empty stomach (Choice C) are important steps in the preparation process but may not be sufficient on their own to adequately cleanse the colon. Explaining the procedure in detail (Choice B) is helpful for patient education but does not directly contribute to the physical preparation required for a successful colonoscopy.

4. What is the appropriate action for a healthcare provider to take when a patient has a high fever and is disoriented?

Correct answer: C

Rationale: Administering fluids is the appropriate action for a healthcare provider to take when a patient has a high fever and is disoriented. Dehydration can worsen confusion and other symptoms in such a situation. Administering acetaminophen or cooling the patient with cold compresses may help reduce the fever but does not address the underlying issue. Administering antibiotics is not indicated for a high fever and disorientation without knowing the cause.

5. The healthcare provider is reviewing the medical record of a client who is requesting combination oral contraceptives. Which of the following conditions in the client's history is a contraindication to the use of oral contraceptives?

Correct answer: B

Rationale: Thrombophlebitis is a condition characterized by inflammation of a vein, which increases the risk of blood clots. The use of oral contraceptives further elevates the risk of clot formation, making them contraindicated in individuals with thrombophlebitis. Hyperthyroidism (Choice A), diverticulosis (Choice C), and hypocalcemia (Choice D) are not contraindications to the use of oral contraceptives.

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