the nurse supervises care of a client who is receiving enteral feeding via a nasogastric tube the nurse determines that care is appropriate if which o
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Nursing Elites

ATI RN

ATI RN Custom Exams Set 3

1. The nurse supervises care of a client who is receiving enteral feeding via a nasogastric tube. The nurse determines that care is appropriate if which of the following is observed? (Select all that apply)

Correct answer: D

Rationale: Elevating the head of the bed to 30 degrees reduces the risk of aspiration by promoting proper digestion and preventing reflux. Warming the formula to room temperature is essential to prevent discomfort and complications. Aspirating and measuring the gastric aspirate is not a recommended nursing action for monitoring enteral feeding via a nasogastric tube, as it can introduce the risk of introducing contaminants into the feeding tube. Therefore, choices A and B are incorrect, making choice D the correct answer.

2. A patient with hypothyroidism should be advised to consume more of which nutrient?

Correct answer: B

Rationale: The correct answer is B: Iodine. Iodine is crucial for the production of thyroid hormones. A deficiency in iodine can lead to hypothyroidism. Calcium (Choice A) is important for bone health but is not directly related to thyroid function. Vitamin C (Choice C) is essential for the immune system and skin health but does not play a significant role in thyroid function. Iron (Choice D) is vital for red blood cell production and oxygen transport but is not specifically relevant to hypothyroidism.

3. Why are hospital patients at greater risk for drug-nutrient interactions than they used to be?

Correct answer: A

Rationale: The correct answer is A. Hospitalized patients are at greater risk for drug-nutrient interactions because they are more acutely ill, often having multiple conditions and treatments that increase the risk of such interactions. Choice B is incorrect as hospital routines interfering with medication timing are not directly related to drug-nutrient interactions. Choice C is incorrect as the toxicity and side effects of drugs do not necessarily relate to interactions with nutrients. Choice D is incorrect as shared responsibility for monitoring does not directly contribute to the increased risk of drug-nutrient interactions in hospitalized patients.

4. The nurse prepares to administer digoxin (Lanoxin) to a newborn with a diagnosis of heart failure and notes that the apical rate is 140 beats per minute. Which nursing action is appropriate?

Correct answer: B

Rationale: An apical rate of 140 bpm is within the normal range for a newborn. Digoxin is commonly used to treat heart failure by increasing the strength and efficiency of the heart's contractions. Since the heart rate is within the normal range, there is no need to hold the medication or notify the healthcare provider. Rechecking the apical rate in an hour is unnecessary as the heart rate is not alarming. Therefore, the appropriate nursing action is to administer the digoxin.

5. The nurse on the medical/surgical unit cares for a client with a diagnosis of cerebrovascular accident (CVA). The nursing assessment of the client’s neurological status should include which of the following? (Select all that apply)

Correct answer: D

Rationale: The correct choices are B and C. Assessing grasp strength and orientation to person, place, and time are essential components of a neurological assessment after a CVA. Pulse assessment in all four extremities is more relevant to circulatory assessment rather than neurological status. Therefore, option A is incorrect.

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