ATI LPN
LPN Fundamentals of Nursing
1. A client with a seizure disorder is under the care of a nurse. Which of the following precautions should the nurse include in the plan?
- A. Place a padded tongue depressor at the bedside.
- B. Keep the bed in the lowest position.
- C. Restrain the client during a seizure.
- D. Keep the lights dim in the client's room.
Correct answer: B
Rationale: Keeping the bed in the lowest position is crucial for ensuring the safety of the client during a seizure. Lowering the bed reduces the risk of injury if the client falls during a seizure episode. It is important not to restrain the client during a seizure as it can lead to further injury. Placing a padded tongue depressor at the bedside is not appropriate and can pose a risk of injury if used incorrectly. Keeping the lights dim in the client's room is not directly related to safety during a seizure and is not a standard precaution.
2. A client has a new prescription for a low-fat diet. Which of the following foods should be recommended?
- A. Bacon
- B. Whole milk
- C. Chicken breast
- D. Cheese
Correct answer: C
Rationale: When following a low-fat diet, it is essential to choose foods that are low in fat. Chicken breast is a lean protein source that is low in fat, making it a suitable option for a low-fat diet. Bacon, whole milk, and cheese are higher in fat content and should be avoided or limited in a low-fat diet. Bacon is high in saturated fat, whole milk contains significant amounts of fat, including saturated fat, and cheese is also high in fat. Therefore, these options are not ideal for a low-fat diet.
3. A client has a stage 1 pressure ulcer on the right heel. Which of the following interventions should the nurse include in the plan?
- A. Apply a heat lamp to the area for 20 minutes each day.
- B. Change the dressing on the heel every 12 hours.
- C. Apply a transparent dressing over the heel.
- D. Use a water pressure mattress.
Correct answer: C
Rationale: Applying a transparent dressing over the heel is beneficial as it can protect the ulcer from friction and shear, and allow for continuous observation of the wound. This intervention promotes healing and prevents further damage to the skin. Choice A is incorrect because applying heat can increase the risk of tissue damage and should be avoided. Choice B is incorrect as changing the dressing every 12 hours may disrupt the wound healing process and is not necessary for a stage 1 pressure ulcer. Choice D is incorrect because using a water pressure mattress is not a specific intervention for a stage 1 pressure ulcer on the heel.
4. A client with chronic obstructive pulmonary disease (COPD) is being cared for by a nurse. Which of the following interventions should the nurse include in the plan of care?
- A. Encourage pursed-lip breathing.
- B. Administer oxygen at 6 L/min via nasal cannula.
- C. Place the client in a supine position.
- D. Restrict fluid intake to less than 1,500 mL/day.
Correct answer: A
Rationale: Encouraging pursed-lip breathing is essential for clients with COPD as it aids in improving ventilation and gas exchange. This technique helps keep the airways open longer during exhalation, preventing air trapping and promoting more effective breathing. Administering oxygen, placing the client in a supine position, or restricting fluid intake are not primary interventions for managing COPD and may not address the specific respiratory needs of the client.
5. A client has a new diagnosis of hypertension and is being taught about dietary management. Which of the following statements should be included by the healthcare provider?
- A. Increase your intake of sodium-rich foods.
- B. Decrease your intake of sodium-rich foods.
- C. Avoid foods that contain lactose.
- D. Increase your intake of dairy products.
Correct answer: B
Rationale: The correct answer is B: 'Decrease your intake of sodium-rich foods.' When managing hypertension, reducing the intake of sodium-rich foods is essential. Excessive sodium can contribute to increased blood pressure, which is why limiting its consumption is crucial to prevent complications. Choices A, C, and D are incorrect. Increasing sodium intake would exacerbate hypertension, avoiding lactose is unrelated to managing hypertension, and increasing dairy product intake does not specifically address the issue of sodium intake in hypertension management.
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