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ATI PN Comprehensive Predictor 2023 with NGN
1. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following actions should the nurse take?
- A. Administer the TPN through a peripheral IV catheter.
- B. Check the client's capillary blood glucose level every 4 hours.
- C. Heat the TPN solution to room temperature before administering.
- D. Weigh the client every 3 days.
Correct answer: B
Rationale: The correct answer is to check the client's capillary blood glucose level every 4 hours. Clients receiving TPN are at risk for hyperglycemia, so regular monitoring of blood glucose levels is essential to detect and manage hyperglycemia promptly. Administering TPN through a peripheral IV catheter (Choice A) is incorrect as TPN should be given through a central venous catheter to prevent complications. Heating the TPN solution to room temperature (Choice C) is unnecessary and not a standard practice. Weighing the client every 3 days (Choice D) is important for monitoring fluid status but is not the priority action when caring for a client receiving TPN.
2. A client with multiple fractures following a motor-vehicle crash is struggling with opening a milk carton. Which of the following client statements should the nurse recommend a referral to an occupational therapist?
- A. I can't brush my teeth properly
- B. I am so frustrated I can't open my milk carton
- C. I can't hold a pencil
- D. I can't write anymore
Correct answer: B
Rationale: The correct answer is B. Struggling to open a milk carton indicates difficulty with fine motor skills and activities of daily living. This statement suggests a need for assistance from an occupational therapist to improve hand strength, coordination, and independence in performing essential tasks. Choices A, C, and D do not directly relate to the need for occupational therapy services in this context. In contrast, the inability to open a milk carton highlights specific challenges that occupational therapy can address effectively.
3. A nurse in a pediatric clinic is collecting data from a school-age child whose injuries are inconsistent with the parent's stated cause. Which of the following actions should the nurse take?
- A. Provide teaching to the parents
- B. Report suspected abuse to the appropriate agency
- C. Document the injuries and monitor the child
- D. Counsel the parents privately
Correct answer: B
Rationale: In cases where a child's injuries are inconsistent with the parent's stated cause, it raises concerns about possible abuse. The correct action for the nurse in this situation is to report suspected abuse to the appropriate agency. This is a legal and ethical obligation for healthcare professionals when they suspect child abuse. Providing teaching to the parents (Choice A) may not address the immediate safety concerns of the child. Documenting the injuries and monitoring the child (Choice C) is important but reporting suspected abuse takes precedence to ensure the child's safety. Counseling the parents privately (Choice D) may not be effective if abuse is suspected, as the primary focus should be on protecting the child.
4. What is the first nursing action when caring for a client with a wound infection?
- A. Change the dressing every 12 hours
- B. Perform a wound culture before applying antibiotics
- C. Cleanse the wound with normal saline
- D. Apply a wet-to-dry dressing to the wound
Correct answer: B
Rationale: The first nursing action when caring for a client with a wound infection is to perform a wound culture before applying antibiotics. This step is crucial to identify the specific infecting organism and determine the most effective antibiotic therapy. Choices A, C, and D are incorrect because changing the dressing, cleansing the wound, or applying a wet-to-dry dressing should only be done after obtaining the culture results and starting appropriate antibiotic treatment.
5. What are the signs of an acute myocardial infarction?
- A. Chest pain radiating to the arm and shortness of breath
- B. Nausea, vomiting, and high fever
- C. Headache, confusion, and low blood pressure
- D. Increased heart rate and bradycardia
Correct answer: A
Rationale: The correct answer is A: Chest pain radiating to the arm and shortness of breath. These are classic signs of an acute myocardial infarction. Choice B is incorrect because nausea, vomiting, and high fever are not typical signs of a heart attack. Choice C is incorrect as headache, confusion, and low blood pressure are not specific to myocardial infarction. Choice D is incorrect because an acute myocardial infarction typically presents with an increased heart rate, not bradycardia.
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