ATI LPN
LPN Fundamentals of Nursing
1. A healthcare professional is preparing to perform nasotracheal suctioning for a client. Which of the following actions should the healthcare professional take?
- A. Suction during inhalation.
- B. Apply intermittent suction during insertion.
- C. Place the client in a supine position.
- D. Insert the catheter while the client is inhaling.
Correct answer: D
Rationale: Inserting the catheter while the client is inhaling helps to align the trachea and vocal cords, reducing the risk of trauma to the respiratory tract. This technique also facilitates easier passage of the catheter into the trachea, enhancing the effectiveness of the suctioning procedure.
2. A healthcare provider is caring for a client who is receiving IV therapy via a peripheral catheter. The healthcare provider should identify that which of the following findings is an indication of infiltration?
- A. Redness at the infusion site
- B. Edema at the infusion site
- C. Warmth at the infusion site
- D. Oozing of blood at the infusion site
Correct answer: B
Rationale: Edema at the infusion site is an indication of infiltration, where fluid leaks into the surrounding tissues causing swelling. This can compromise the delivery of medication and fluids, potentially leading to complications. Redness, warmth, and oozing of blood are more suggestive of inflammation or infection rather than infiltration. Infiltration requires prompt recognition and intervention to prevent further issues with the IV therapy.
3. What action should be taken to prevent respiratory complications in a client who is postoperative?
- A. Encourage the use of an incentive spirometer.
- B. Restrict fluid intake.
- C. Place the client in a supine position.
- D. Administer a cough suppressant.
Correct answer: A
Rationale: Encouraging the use of an incentive spirometer is crucial in preventing respiratory complications postoperatively. The incentive spirometer helps the client perform deep breathing exercises, which can prevent atelectasis (lung collapse) and promote lung expansion. This, in turn, reduces the risk of respiratory complications such as pneumonia. Restricting fluid intake, placing the client in a supine position, and administering a cough suppressant are not appropriate actions for preventing respiratory complications in a postoperative client.
4. A client with peptic ulcer disease is being taught about dietary management. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should avoid drinking milk.
- B. I should avoid drinking coffee.
- C. I should avoid eating high-fiber foods.
- D. I should avoid eating low-fat foods.
Correct answer: B
Rationale: The correct answer is B. Avoiding coffee is important in managing peptic ulcer disease as it helps reduce acid production and alleviate symptoms. Coffee is known to stimulate acid secretion in the stomach, which can exacerbate ulcer symptoms. Therefore, instructing the client to avoid drinking coffee is essential in the dietary management of peptic ulcer disease. Choices A, C, and D are incorrect. Drinking milk is generally allowed and can even provide a protective effect against ulcers. High-fiber foods are beneficial for digestion and do not need to be avoided unless they cause discomfort. Low-fat foods are also typically recommended for individuals with peptic ulcer disease as they are easier on the digestive system.
5. During an admission interview, a nurse is assessing a client's personal identity. Which of the following questions should the nurse ask?
- A. What is your marital status?
- B. How would you describe yourself?
- C. Are you employed?
- D. Do you have any children?
Correct answer: B
Rationale: When assessing personal identity, it is important to ask questions that prompt clients to describe themselves. Question B, 'How would you describe yourself?' is the most appropriate as it allows the client to share their own perceptions and characteristics, aiding in understanding their personal identity. Choices A, C, and D are more focused on specific personal details such as marital status, employment status, and parental status, which do not directly contribute to understanding personal identity.
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