ATI LPN
LPN Fundamentals of Nursing
1. A client has a pressure ulcer. Which of the following findings indicates healing of the ulcer?
- A. Increase in drainage.
- B. Decrease in size.
- C. Presence of foul odor.
- D. Reddened wound edges.
Correct answer: B
Rationale: When a pressure ulcer is healing, there is a decrease in its size as the tissue repair progresses. This reduction in size is a positive indication of the healing process. An increase in drainage, presence of foul odor, or reddened wound edges are typically signs of infection or lack of improvement. Therefore, the correct answer is a decrease in size.
2. During tracheostomy care, what action should a healthcare professional take?
- A. Use clean technique to remove the inner cannula.
- B. Remove the outer cannula for cleaning.
- C. Soak the inner cannula in normal saline.
- D. Change tracheostomy ties if they are wet.
Correct answer: D
Rationale: Changing tracheostomy ties if they are wet is essential to prevent infection and maintain skin integrity. Wet ties can harbor bacteria, increasing the risk of skin breakdown and other complications. Regularly changing wet ties promotes cleanliness, reduces the likelihood of complications, and ensures optimal care for the client with a tracheostomy.
3. A client has a new diagnosis of gout, and the nurse is providing dietary management education. Which of the following statements should the nurse include in the teaching?
- A. You should increase your intake of purine-rich foods.
- B. You should decrease your intake of purine-rich foods.
- C. You should avoid foods that contain lactose.
- D. You should increase your intake of dairy products.
Correct answer: B
Rationale: The correct answer is to decrease intake of purine-rich foods to manage uric acid levels and symptoms of gout. Purine-rich foods can exacerbate gout symptoms by increasing uric acid production, leading to flare-ups. Therefore, reducing purine intake is essential in the dietary management of gout. Option A is incorrect because increasing purine-rich foods can worsen gout symptoms. Option C is irrelevant as lactose is not directly related to gout. Option D is incorrect as increasing dairy products is not a recommended dietary modification for managing gout.
4. Which of the following dietary modifications should be recommended to a client with hypertension?
- A. Increase sodium intake.
- B. Reduce potassium intake.
- C. Increase fiber intake.
- D. Reduce calcium intake.
Correct answer: C
Rationale: Increasing fiber intake is a beneficial dietary modification for clients with hypertension. Fiber helps in reducing blood pressure and improving cardiovascular health by promoting better digestion and regulating cholesterol levels. Therefore, advising a client with hypertension to increase fiber intake can be beneficial for their overall health. In contrast, increasing sodium intake can lead to higher blood pressure, reducing potassium intake is not recommended as potassium helps in regulating blood pressure, and reducing calcium intake is not typically necessary for hypertension management.
5. What action is required by law when preparing to administer a controlled substance?
- A. Verify the client’s identification using two identifiers.
- B. Document the medication administration in the client’s chart immediately.
- C. Return any unused portion of the medication to the pharmacy.
- D. Have a second nurse witness the disposal of any unused portion.
Correct answer: D
Rationale: Having a second nurse witness the disposal of any unused portion of a controlled substance is a legal requirement to ensure proper disposal, prevent diversion, and maintain accountability. This practice helps in reducing the risk of misuse or unauthorized access to controlled substances, enhancing patient safety, and complying with legal regulations and standards.
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