ATI LPN
LPN Nursing Fundamentals
1. A client with a new diagnosis of anemia is being taught about dietary management. Which of the following statements should be included in the teaching?
- A. You should increase your intake of foods high in iron.
- B. You should decrease your intake of foods high in calcium.
- C. You should avoid foods that contain gluten.
- D. You should increase your intake of high-fat foods.
Correct answer: A
Rationale: The correct answer is A: 'You should increase your intake of foods high in iron.' This statement should be included in the teaching because increasing intake of foods high in iron is essential for managing anemia. Iron is a key component for producing hemoglobin, which carries oxygen in the blood. By increasing iron-rich foods like leafy greens, red meat, and fortified cereals, the client can help improve their hemoglobin levels and overall health. Choices B, C, and D are incorrect. Decreasing intake of foods high in calcium is not necessary for anemia management; avoiding foods that contain gluten is relevant for individuals with gluten sensitivity or celiac disease, not anemia; and increasing intake of high-fat foods is not recommended for managing anemia.
2. When caring for a client with a hearing impairment, which of the following actions should the nurse take when speaking with the client?
- A. Speak in a high-pitched voice.
- B. Exaggerate lip movements.
- C. Face the client when speaking.
- D. Use a monotone voice.
Correct answer: C
Rationale: When caring for a client with a hearing impairment, it is essential for the nurse to face the client when speaking. By facing the client, the nurse allows the individual to read lips and see facial expressions, which can significantly improve communication effectiveness. This approach facilitates better understanding and helps the client feel more connected during interactions. Speaking in a high-pitched voice (Choice A) is not recommended as it may distort speech sounds. Exaggerating lip movements (Choice B) can be patronizing and ineffective. Using a monotone voice (Choice D) lacks intonation that helps convey meaning and emotions in speech, making it harder for the client to understand.
3. 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.
4. A client has a new prescription for a potassium-sparing diuretic. Which of the following foods should the nurse recommend?
- A. Bananas
- B. Oranges
- C. Spinach
- D. Apples
Correct answer: D
Rationale: Clients on potassium-sparing diuretics need to avoid high-potassium foods to prevent hyperkalemia. Apples are a low-potassium fruit, making them a suitable recommendation for clients on this type of diuretic. Bananas, oranges, and spinach are high-potassium foods that should be avoided by clients taking potassium-sparing diuretics to prevent complications such as hyperkalemia.
5. 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.
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