what is the priority nursing assessment for a patient who has just returned from surgery
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Nursing Elites

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ATI RN Exit Exam Test Bank

1. What is the priority nursing assessment for a patient who has just returned from surgery?

Correct answer: A

Rationale: The correct answer is to monitor the patient's respiratory rate. This assessment is essential as it ensures that the patient is breathing adequately post-surgery. Maintaining a patent airway and adequate oxygenation are the top priorities in the immediate postoperative period. Monitoring blood pressure, checking the surgical site, or monitoring heart rate are important assessments but are not the priority immediately upon the patient's return from surgery.

2. A nurse is assessing a client who has hypothyroidism. Which of the following findings should the nurse expect?

Correct answer: D

Rationale: Corrected Rationale: Decreased deep tendon reflexes are a common finding in clients with hypothyroidism due to slowed metabolic processes. The other choices, such as bradycardia (slow heart rate), weight gain, and hypertension (high blood pressure) are not typically associated with hypothyroidism. Bradycardia can occur due to the decreased metabolic rate, but it is not a consistent finding. Weight gain is common but not universal, and hypertension is more commonly associated with hyperthyroidism.

3. A client who has a new prescription for levothyroxine is being taught by a nurse. Which of the following client statements indicates an understanding of the teaching?

Correct answer: A

Rationale: The correct answer is A: ''I will need to take this medication for the rest of my life.'' Levothyroxine is a lifelong medication for clients with hypothyroidism and should be taken as prescribed. Choice B is incorrect because levothyroxine should not be taken with antacids as they can interfere with its absorption. Choice C is incorrect as iodine-containing foods do not need to be avoided with levothyroxine. Choice D is incorrect because levothyroxine should be stored at room temperature, not in the refrigerator.

4. What is the priority intervention for a patient with dehydration?

Correct answer: A

Rationale: The correct answer is to administer IV fluids. This intervention is the priority as it helps rapidly restore hydration in patients with dehydration by delivering fluids directly into the bloodstream. Monitoring intake and output (choice B) is important but comes after providing immediate fluid resuscitation. Administering oral fluids (choice C) may not be sufficient for a patient with dehydration who requires rapid rehydration. Providing electrolyte replacement (choice D) is essential but often follows fluid resuscitation to correct any electrolyte imbalances resulting from dehydration.

5. What is the first intervention for a patient experiencing anaphylactic shock?

Correct answer: A

Rationale: The correct answer is to administer epinephrine. Epinephrine is the first-line treatment for anaphylactic shock as it helps reverse the severe allergic reaction by constricting blood vessels, increasing heart rate, and opening airways for improved breathing. Oxygen (Choice B) can be administered after epinephrine to support oxygenation. Corticosteroids (Choice C) may be used to prevent a biphasic reaction but are not the initial intervention. Antihistamines (Choice D) can help with itching and hives but do not address the life-threatening symptoms of anaphylaxis.

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