ATI LPN
ATI PN Comprehensive Predictor 2020
1. A nurse is caring for a client who is scheduled for surgery in the morning. The nurse learns that the client has decided not to have surgery even though they have already signed the informed consent form. Which of the following actions should the nurse take?
- A. Ignore the client's decision and proceed
- B. Report the situation to the provider
- C. Ask the family to convince the client
- D. Reassess the need for surgery with the client
Correct answer: B
Rationale: The correct action for the nurse to take is to report the client's decision to the provider who obtained informed consent. This ensures that the provider is informed of the client's change in decision and can discuss the situation further with the client. Choice A is incorrect as ignoring the client's decision is not appropriate and goes against the principles of patient autonomy. Choice C is incorrect because involving the family in convincing the client can be coercive and may not respect the client's autonomy. Choice D is incorrect because the nurse should not re-sign the informed consent form without the client's consent and a discussion with the provider.
2. A nurse is teaching a client who has Parkinson's disease about dietary modifications. Which of the following instructions should the nurse include?
- A. Eat high-protein, high-calorie meals
- B. Drink milk with every meal
- C. Avoid foods high in carbohydrates
- D. Drink carbonated beverages with meals
Correct answer: A
Rationale: The correct answer is A: 'Eat high-protein, high-calorie meals.' Individuals with Parkinson's disease benefit from consuming high-protein, high-calorie meals to help maintain muscle mass and energy levels. This dietary modification is important in managing the symptoms of Parkinson's disease. Choice B is incorrect because there is no specific requirement for drinking milk with every meal for individuals with Parkinson's disease. Choice C is incorrect as carbohydrates are also essential for a balanced diet and should not be completely avoided. Choice D is incorrect as carbonated beverages may interfere with the absorption of nutrients from food and are not recommended for individuals with Parkinson's disease.
3. A nurse is preparing to administer a medication to a client. The client states, 'I'm sick of all these medications, and I'm not taking any more today!' Which of the following actions should the nurse take?
- A. Ask the client to discuss their feelings
- B. Explain the importance of the medications
- C. Document the refusal and withhold the medication
- D. Inform the client of the possible consequences of refusal
Correct answer: D
Rationale: When a client refuses medication, the nurse should inform the client of the possible consequences of refusal. This action helps the client understand the risks associated with not taking the medication. Asking the client to discuss their feelings (choice A) is important but should follow after informing them of the consequences. Explaining the importance of the medications (choice B) might not address the immediate concern of the client. Documenting the refusal and withholding the medication (choice C) should be done after informing the client of the consequences and attempting to address their concerns.
4. A nurse is caring for a client who has a chest tube following a thoracotomy. Which of the following findings should the nurse report to the provider?
- A. Drainage of 75 mL in the first hour after surgery.
- B. Constant bubbling in the water seal chamber.
- C. Tidaling in the water seal chamber.
- D. Client report of pain at the chest tube insertion site.
Correct answer: B
Rationale: Constant bubbling in the water seal chamber indicates an air leak, which should be reported to the provider. This finding suggests that the chest tube system is not functioning properly, leading to potential complications such as pneumothorax. Drainage of 75 mL in the first hour after surgery is within the expected range for a chest tube. Tidaling in the water seal chamber is a normal fluctuation and indicates proper functioning of the system. Client report of pain at the chest tube insertion site is expected after surgery and can be managed with appropriate pain management measures.
5. A client takes prednisone daily for the treatment of chronic asthma. The nurse should plan to monitor the client for which of the following adverse effects?
- A. Hyperglycemia
- B. Hypertension
- C. Gastric ulcer formation
- D. Diarrhea
Correct answer: C
Rationale: The correct answer is C: Gastric ulcer formation. Prednisone, a corticosteroid, increases the risk of gastric ulcer formation, especially with long-term use. While prednisone can also lead to hyperglycemia (choice A) and hypertension (choice B) as adverse effects, monitoring for gastric ulcer formation is a priority due to its association with corticosteroid therapy. Diarrhea (choice D) is not a common adverse effect of prednisone and is less likely compared to gastric ulcers.
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