ATI LPN
ATI PN Comprehensive Predictor 2024
1. A client has developed phlebitis at the IV site. What should the nurse do first?
- A. Apply a warm compress to the IV site
- B. Discontinue the IV and notify the provider
- C. Monitor the IV site for signs of infection
- D. Administer an anti-inflammatory medication
Correct answer: B
Rationale: When a client develops phlebitis at the IV site, the priority action for the nurse is to discontinue the IV and notify the provider. Phlebitis is inflammation of the vein, and removing the IV can help prevent further complications. Applying a warm compress may provide symptomatic relief but does not address the root cause. Monitoring for infection is important, but immediate action to remove the source of inflammation is crucial. Administering an anti-inflammatory medication is not the first-line intervention for phlebitis; removal of the IV is necessary.
2. A nurse is caring for a client who is in Buck's traction. Which of the following actions should the nurse take?
- A. Remove the weights
- B. Ensure the weights hang freely
- C. Increase the traction force
- D. Loosen the ropes
Correct answer: B
Rationale: The correct action the nurse should take when caring for a client in Buck's traction is to ensure the weights hang freely. This is essential to maintain proper alignment and ensure the effectiveness of Buck's traction. Removing the weights (Choice A) would be incorrect and could compromise the treatment. Increasing the traction force (Choice C) can lead to excessive pressure and potential harm to the client. Loosening the ropes (Choice D) would also be inappropriate as it can disrupt the traction's effectiveness and alignment.
3. A client with peripheral arterial disease (PAD) is being taught about foot care by a nurse. Which of the following instructions should the nurse include?
- A. Apply lotion between the toes
- B. Wear shoes that fit properly
- C. Walk barefoot at home
- D. Apply ice to the feet daily
Correct answer: B
Rationale: The correct answer is B: 'Wear shoes that fit properly.' In peripheral arterial disease (PAD), it is crucial to wear shoes that fit well to prevent foot injuries. Choice A is incorrect because applying lotion between the toes can increase the risk of infection. Choice C is incorrect since walking barefoot at home can lead to injuries, especially in individuals with PAD. Choice D is incorrect as applying ice to the feet daily can further reduce blood flow to the extremities, worsening the condition in PAD.
4. What are the major risk factors for stroke?
- A. Hypertension, high cholesterol, and smoking
- B. Obesity and lack of exercise
- C. Family history of cardiovascular disease
- D. Age and gender
Correct answer: A
Rationale: The correct answer is A: Hypertension, high cholesterol, and smoking are major risk factors for stroke. These factors contribute to the development of atherosclerosis, which can lead to a stroke. While obesity and lack of exercise are risk factors for cardiovascular diseases, they are not as directly linked to stroke as hypertension, high cholesterol, and smoking. Family history of cardiovascular disease may increase the overall risk of heart problems, but it is not as specific to stroke as the factors listed in option A. Age and gender can influence the risk of stroke, but they are not modifiable risk factors like hypertension, high cholesterol, and smoking, which can be reduced through lifestyle changes.
5. A client with a tracheostomy is exhibiting signs of respiratory distress. What is the nurse's immediate priority?
- A. Increase the oxygen flow rate
- B. Suction the tracheostomy
- C. Notify the physician immediately
- D. Administer a bronchodilator
Correct answer: B
Rationale: When a client with a tracheostomy is experiencing respiratory distress, the immediate priority for the nurse is to suction the tracheostomy. This action helps clear the airway of secretions and ensures that the client can breathe effectively. Increasing the oxygen flow rate may be necessary but addressing the airway obstruction is more critical. Notifying the physician immediately is important but may cause a delay in addressing the immediate need for airway clearance. Administering a bronchodilator may help with bronchospasm but should not take precedence over ensuring a clear airway in a client with respiratory distress.
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