ATI LPN
ATI PN Comprehensive Predictor 2020 Answers
1. A healthcare professional is managing a client with a wound infection. What is the priority action?
- A. Change the wound dressing every 12 hours
- B. Perform a wound culture before applying antibiotics
- C. Apply a wet-to-dry dressing to the wound
- D. Cleanse the wound with a solution of alcohol and water
Correct answer: B
Rationale: Performing a wound culture before applying antibiotics is crucial to identify the specific pathogen causing the infection. This helps in selecting the most effective antibiotics for treatment. Changing the wound dressing, applying a wet-to-dry dressing, or cleansing the wound are important interventions but should follow the assessment and identification of the infecting organism through a wound culture to guide appropriate treatment.
2. A nurse is caring for a client who has a prescription for wound irrigation. Which of the following actions should the nurse take?
- A. Wear sterile gloves when removing the old dressing
- B. Warm the irrigation solution to 40.5°C (105°F)
- C. Cleanse the wound from the center outwards
- D. Use a 20 mL syringe to irrigate the wound
Correct answer: C
Rationale: The correct action for the nurse to take when caring for a client with a prescription for wound irrigation is to cleanse the wound from the center outwards. This technique helps prevent contamination by pushing debris away from the wound rather than into it. Choice A is incorrect because wearing sterile gloves is important during wound care but not specifically mentioned for wound irrigation. Choice B is incorrect because warming the irrigation solution to a specific temperature is not a standard recommendation and can potentially harm the client. Choice D is incorrect because the size of the syringe may vary based on the wound size and depth, so using a 20 mL syringe is not a universal guideline.
3. A nurse is reinforcing teaching about using a cane with a client who has left-leg weakness. What instruction should the nurse give?
- A. Use the cane on the weaker side
- B. Advance the cane and the strong leg together
- C. Maintain two points of support on the floor at all times
- D. Advance the cane 30 to 45 cm with each step
Correct answer: C
Rationale: The correct instruction for a client with left-leg weakness using a cane is to maintain two points of support on the floor at all times. This technique provides stability and support while walking. Choice A is incorrect because the cane should be used on the stronger side to support the weaker leg. Choice B is incorrect as advancing the cane and the strong leg together may not provide adequate support and balance. Choice D is incorrect as the distance to advance the cane with each step can vary depending on the individual's needs and abilities.
4. What are the differences between viral and bacterial infections?
- A. Viral infections often cause fatigue and body aches
- B. Bacterial infections often cause high fever and localized pain
- C. Viral infections are treated with antibiotics
- D. Bacterial infections are usually self-limiting
Correct answer: A
Rationale: Corrected Rationale: Viral infections often cause fatigue and body aches, while bacterial infections are more likely to cause high fever and localized pain. Choice A is the correct answer as it accurately reflects the symptoms commonly associated with viral infections. Bacterial infections, on the other hand, typically present with fever and localized pain, as stated in choice B. Choice C is incorrect as viral infections do not respond to antibiotics, while choice D is inaccurate because bacterial infections may require antibiotic treatment and are not always self-limiting.
5. Which of the following actions should the nurse take for a client who has been diagnosed with dementia and is at risk for falls?
- A. Maintain the client's bed in the lowest position
- B. Use a bed exit alarm system
- C. Assist the client with ambulation every hour
- D. Raise all 4 side rails for safety
Correct answer: B
Rationale: The correct answer is B: "Use a bed exit alarm system." For a client with dementia at risk for falls, a bed exit alarm system is beneficial as it alerts staff when the client is trying to get up, helping to reduce fall risks. Choice A, maintaining the client's bed in the lowest position, may not prevent falls as effectively as an alarm system. Choice C, assisting the client with ambulation every hour, may not be feasible and could disrupt the client's rest. Choice D, raising all 4 side rails for safety, can lead to restraint issues and is not recommended as a routine fall prevention measure.
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