ATI LPN
ATI PN Comprehensive Predictor 2023
1. A healthcare provider is reviewing the medical record of a client who has coronary artery disease (CAD) and a prescription for aspirin. Which of the following findings should the healthcare provider report to the provider?
- A. History of gastrointestinal bleeding
- B. History of asthma
- C. History of liver disease
- D. History of hypertension
Correct answer: A
Rationale: A history of gastrointestinal bleeding is a critical finding to report to the healthcare provider because it is a contraindication for aspirin use in individuals with CAD. Aspirin can further increase the risk of bleeding in individuals with a history of gastrointestinal bleeding. Choices B, C, and D are not directly contraindications for aspirin use in this scenario. Asthma, liver disease, and hypertension are not typically contraindications for prescribing aspirin to patients with CAD.
2. A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD). Which of the following interventions should the nurse include in the plan of care?
- A. Administer oxygen at 2L/min via nasal cannula
- B. Encourage pursed-lip breathing
- C. Position the client in high Fowler's position
- D. Encourage deep breathing and coughing
Correct answer: B
Rationale: The correct intervention for a client with COPD is to encourage pursed-lip breathing. Pursed-lip breathing helps improve oxygenation by preventing airway collapse, slowing down the breathing rate, and promoting better gas exchange. Administering oxygen at 2L/min via nasal cannula is not the first-line intervention as it can cause oxygen toxicity in COPD patients. Positioning the client in high Fowler's position may improve ventilation but does not specifically address the breathing technique required for COPD. Encouraging deep breathing and coughing is generally not recommended for clients with COPD as it can lead to air trapping and increased work of breathing.
3. A nurse is caring for a client who is postoperative following a thyroidectomy. The nurse should monitor for which of the following findings as a sign of hypocalcemia?
- A. Nausea
- B. Tingling in the fingers
- C. Numbness in the toes
- D. Sweating
Correct answer: B
Rationale: Tingling in the fingers is a classic sign of hypocalcemia. Following a thyroidectomy, hypocalcemia can occur due to damage to the parathyroid glands, which regulate calcium levels in the body. Nausea, numbness in the toes, and sweating are not specific signs of hypocalcemia. Numbness and tingling usually start in the hands and feet due to their increased nerve sensitivity to low calcium levels.
4. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following findings should the nurse report to the provider?
- A. Blood glucose level of 120 mg/dL
- B. White blood cell count of 8,000/mm³
- C. Temperature of 37.2°C (99°F)
- D. Daily weight increase of 0.45 kg (1 lb)
Correct answer: D
Rationale: The correct answer is D. A sudden weight increase may indicate fluid retention, a complication of TPN therapy that should be reported. Options A, B, and C are within normal ranges and do not directly relate to TPN therapy complications. A blood glucose level of 120 mg/dL is normal, a white blood cell count of 8,000/mm³ is within the normal range, and a temperature of 37.2°C (99°F) is also normal.
5. A nurse is reinforcing discharge teaching with a client who has dependent personality disorder. Which of the following instructions should the nurse include in the discharge teaching?
- A. Limit social interactions
- B. Demonstrate assertiveness
- C. Follow a rigid schedule
- D. Perform deep breathing exercises
Correct answer: B
Rationale: The correct answer is B: 'Demonstrate assertiveness.' For clients with dependent personality disorder, assertiveness training is crucial as it helps them become more independent and develop the skills to express their own needs and preferences effectively. Choice A ('Limit social interactions') is incorrect because promoting healthy social interactions is important for individuals with this disorder to build confidence and reduce dependency. Choice C ('Follow a rigid schedule') is incorrect as overly rigid schedules may exacerbate feelings of helplessness and dependence. Choice D ('Perform deep breathing exercises') is not directly related to addressing the core issues of dependent personality disorder, which primarily involve developing self-reliance and assertiveness.
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