ATI Learning System PN Medical Surgical Final Quizlet

Correct Answer: C

Rationale: The correct answer is C: Deep, rapid respirations (Kussmaul breathing). This is a sign of severe acidosis commonly seen in diabetic ketoacidosis (DKA) and requires immediate intervention. Kussmaul breathing helps to compensate for the metabolic acidosis by blowing off carbon dioxide. Prompt intervention is necessary to prevent further deterioration and potential respiratory failure.

Correct Answer: B

Rationale: Increasing sharp pain related to compartment syndrome necessitates immediate intervention as it may lead to permanent damage to muscles and nerves. Compartment syndrome is a serious condition that requires urgent medical attention to prevent further complications such as tissue necrosis and nerve injury.

Correct Answer: C

Rationale: The correct answer is C: Hemoglobin level. Erythropoietin therapy is used to stimulate red blood cell production in patients with chronic kidney disease who often develop anemia due to reduced erythropoietin production by the kidneys. Monitoring the hemoglobin level is essential to evaluate the effectiveness of erythropoietin therapy as an increase in hemoglobin indicates improved red blood cell production and better management of anemia in these patients. Serum creatinine, white blood cell count, and serum potassium levels are important parameters to monitor in CKD patients but are not specific indicators of the effectiveness of erythropoietin therapy for managing anemia.

Correct Answer: B

Rationale: Nausea and vomiting are common signs of digoxin toxicity, which can lead to serious complications like dysrhythmias. Prompt intervention is crucial to prevent further harm to the client.

Correct Answer: C

Rationale: The priority action for the nurse when time is limited is to focus on essential teaching. In this scenario, the patient should be educated on how to self-monitor glucose levels and administer medications to control glucose levels. While diet, exercise, medications, and potential complications are important topics for further education, these can be addressed through appropriate referrals and future teaching sessions.