ATI LPN
LPN Fundamentals of Nursing
1. Prior to administering a blood transfusion, what should the healthcare professional do first?
- A. Prime the IV tubing with normal saline.
- B. Verify the client's identity.
- C. Obtain the blood product from the blood bank.
- D. Check the client's vital signs.
Correct answer: B
Rationale: Verifying the client's identity is the essential initial step before administering a blood transfusion. This action is crucial to confirm that the correct blood product is being administered to the right client, thereby preventing any potential errors or adverse reactions. Ensuring patient safety is paramount in healthcare, and verifying the client's identity is a fundamental safety measure that should always be prioritized.
2. What is the primary purpose of therapeutic communication in healthcare?
- A. To gather client information.
- B. To provide client education.
- C. To establish a therapeutic relationship.
- D. To document client care.
Correct answer: C
Rationale: The primary purpose of therapeutic communication in healthcare is to establish a therapeutic relationship between the healthcare provider and the client. Through effective communication, trust, empathy, and understanding can be fostered, which are essential for providing quality care and promoting positive health outcomes. Building a therapeutic relationship enhances patient satisfaction, improves adherence to treatment plans, and increases the likelihood of successful health outcomes.
3. When teaching a client with a new diagnosis of diabetes mellitus about foot care, which of the following instructions should the nurse include?
- A. Soak your feet in hot water every day.
- B. Apply lotion between your toes.
- C. Inspect your feet daily.
- D. Use over-the-counter products to remove corns.
Correct answer: C
Rationale: Inspecting the feet daily is crucial for clients with diabetes mellitus to detect early signs of injury or infection promptly. This practice helps prevent serious complications such as diabetic foot ulcers. Soaking feet in hot water daily can lead to skin dryness and increase the risk of injury. Applying lotion between toes can cause moisture buildup, leading to fungal infections. Using over-the-counter products to remove corns can result in skin damage and should be done under healthcare provider supervision.
4. A healthcare professional is preparing to administer a cleansing enema to a client. Which of the following actions should the healthcare professional plan to take?
- A. Insert the rectal tube 15.2 cm (6 inches) into the client's rectum
- B. Wear clean gloves before inserting the tubing
- C. Position the client on their left side
- D. Hold the solution bag 91 cm (36 inches) above the client's rectum
Correct answer: C
Rationale: Positioning the client on their left side is crucial when administering an enema as it helps facilitate the flow of the solution into the sigmoid and descending colon. This position allows gravity to assist in the process. Placing the client on the left side is a standard practice to promote optimal outcomes during the procedure. Choices A, B, and D are incorrect. Choice A provides a specific measurement for the insertion depth of the rectal tube, which is not typically necessary to include in the plan of action. Choice B is essential but not specific to enema administration. Choice D mentions holding the solution bag without specifying the correct height, which should typically be around 18-24 inches above the rectum for a cleansing enema.
5. A client with a new diagnosis of type 2 diabetes mellitus is being taught about dietary management. Which of the following statements should the nurse include in the teaching?
- A. You should avoid foods that contain carbohydrates.
- B. You should decrease your intake of high-fiber foods.
- C. You should increase your intake of high-protein foods.
- D. You should monitor your carbohydrate intake.
Correct answer: D
Rationale: The correct answer is D: 'You should monitor your carbohydrate intake.' Monitoring carbohydrate intake is essential for managing blood glucose levels in clients with type 2 diabetes mellitus. By monitoring carbohydrate intake, individuals can make informed decisions about their dietary choices and better control their blood sugar levels. Avoiding foods that contain carbohydrates (choice A) is not advisable as carbohydrates are an essential nutrient that can be consumed in moderation. Decreasing intake of high-fiber foods (choice B) is not recommended as fiber is beneficial for glycemic control and overall health. Increasing intake of high-protein foods (choice C) is not the primary focus of dietary management for type 2 diabetes; while protein is important, it is more crucial to monitor carbohydrate intake for effective blood sugar management.
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