ATI LPN
LPN Nursing Fundamentals
1. A client with a new diagnosis of cirrhosis is receiving dietary management education from a nurse. Which of the following statements should the nurse include in the teaching?
- A. You should increase your intake of sodium-rich foods.
- B. You should decrease your intake of sodium-rich foods.
- C. You should avoid foods that contain lactose.
- D. You should increase your intake of dairy products.
Correct answer: B
Rationale: Reducing the intake of sodium-rich foods is beneficial for managing fluid retention and symptoms of cirrhosis. Excessive sodium can lead to fluid buildup in the body, worsening edema and ascites commonly associated with cirrhosis. Therefore, advising the client to decrease their intake of sodium-rich foods is crucial in the dietary management of cirrhosis. Option A is incorrect as increasing sodium intake would exacerbate fluid retention. Option C is irrelevant to cirrhosis management unless the client has lactose intolerance. Option D is incorrect as increasing dairy product intake may not be suitable for all patients with cirrhosis, especially if they have complications like hepatic encephalopathy.
2. A client is receiving continuous enteral feedings. Which of the following interventions should the nurse implement?
- A. Monitor intake and output every 8 hours.
- B. Flush the feeding tube every 4 hours.
- C. Measure the client's temperature every 24 hours.
- D. Change the feeding bag and tubing every 72 hours.
Correct answer: B
Rationale: The correct answer is B: Flush the feeding tube every 4 hours. Flushing the feeding tube every 4 hours is essential to maintain patency and prevent clogging, ensuring the client receives the prescribed enteral nutrition without interruption. This intervention helps prevent complications such as tube occlusion. Monitoring intake and output is important for assessing the client's hydration status but does not directly address tube patency. Measuring the client's temperature is essential for monitoring for signs of infection but is not directly related to tube maintenance. Changing the feeding bag and tubing every 72 hours is important for infection control but does not address tube patency.
3. When assessing a client with chronic pain, which of the following is the most reliable indicator of the client's pain?
- A. The client's vital signs.
- B. The client's self-report of pain.
- C. The client's body language.
- D. The client's medical history.
Correct answer: B
Rationale: The client's self-report of pain is the most reliable indicator of pain. Pain is a subjective experience, and the client's self-report provides direct insight into their perception of pain intensity, quality, and impact on daily life. Vital signs, body language, and medical history can offer additional information but may not accurately reflect the client's actual pain experience. Therefore, relying on the client's self-report ensures a more accurate assessment of their pain and helps in tailoring appropriate interventions and treatment plans.
4. During an abdominal assessment, what is the correct sequence of steps for a healthcare provider to follow?
- A. Inspection, percussion, palpation, auscultation
- B. Percussion, auscultation, inspection, palpation
- C. Auscultation, palpation, inspection, percussion
- D. Inspection, auscultation, percussion, palpation
Correct answer: D
Rationale: During an abdominal assessment, the correct sequence of steps is inspection, auscultation, percussion, and palpation. This sequence is followed to prevent altering bowel sounds. Inspection allows for visual observation, followed by auscultation to listen for bowel sounds without causing disturbance, percussion to assess for tympany or dullness, and finally palpation to feel for any abnormalities or tenderness. Choice A is incorrect because palpation should come after percussion. Choice B is incorrect as auscultation should be performed after inspection. Choice C is incorrect because palpation should be the final step after percussion.
5. What is the primary benefit of using electronic health records (EHRs) in healthcare?
- A. EHRs eliminate the need for paper records.
- B. EHRs ensure complete patient confidentiality.
- C. EHRs improve the accuracy of patient information.
- D. EHRs reduce the time spent on documentation.
Correct answer: C
Rationale: The primary benefit of using electronic health records (EHRs) in healthcare is that they improve the accuracy and completeness of patient information. By utilizing EHRs, healthcare providers have access to more reliable and up-to-date patient data, which leads to better patient care outcomes. This improved accuracy enables healthcare professionals to make better-informed decisions and provide more effective treatments, ultimately enhancing patient safety and quality of care.
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