ATI LPN
ATI PN Comprehensive Predictor 2020
1. A nurse is teaching a client who has peripheral arterial disease (PAD) about exercise recommendations. Which of the following instructions should the nurse include?
- A. Exercise to the point of pain
- B. Stop exercising if pain occurs
- C. Exercise only once per week
- D. Avoid walking to prevent pain
Correct answer: B
Rationale: The correct instruction the nurse should include is to 'Stop exercising if pain occurs.' In peripheral arterial disease (PAD), it is crucial to avoid exercising to the point of pain as this may worsen the condition and lead to complications. Exercising to the point of pain can result in inadequate blood flow to the extremities, causing further damage. By stopping exercise if pain occurs, the client can prevent exacerbating their condition. Choices A, C, and D are incorrect because exercising to the point of pain, limiting exercise to once per week, and avoiding walking altogether are not recommended strategies for managing PAD and could potentially harm the client.
2. A nurse is performing postmortem care for a client prior to the arrival of the client's family for viewing of the body. Which of the following actions should the nurse take?
- A. Apply moisturizing lotion to the skin
- B. Turn off the lights
- C. Remove all jewelry
- D. Gently close the client's eyelids
Correct answer: D
Rationale: The correct action the nurse should take is to gently close the client's eyelids. This is a respectful and common practice in postmortem care before allowing the family to view the body. Applying moisturizing lotion to the skin is unnecessary and may not be appropriate at this time. Turning off the lights might not be necessary and could impact the viewing environment for the family. While removing all jewelry is generally a good practice, it is not as crucial as gently closing the client's eyelids for postmortem care.
3. A nurse is caring for a client who is taking digoxin. Which of the following findings should the nurse identify as a sign of digoxin toxicity?
- A. Bradycardia
- B. Tachycardia
- C. Hypotension
- D. Hyperkalemia
Correct answer: A
Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin, a cardiac glycoside, can lead to toxicity manifesting as bradycardia due to its effect on the heart's electrical conduction system. Tachycardia (choice B) is not typically associated with digoxin toxicity. Hypotension (choice C) and hyperkalemia (choice D) are not direct signs of digoxin toxicity. Therefore, the correct answer is bradycardia.
4. A nurse is caring for a client who has diabetes mellitus and is receiving insulin. Which of the following findings should the nurse report to the provider?
- A. A fasting blood glucose of 90 mg/dL
- B. A blood glucose level of 200 mg/dL
- C. A hemoglobin A1c of 6%
- D. A fasting blood glucose of 100 mg/dL
Correct answer: B
Rationale: The correct answer is B. A blood glucose level of 200 mg/dL indicates hyperglycemia, which may necessitate insulin adjustment to better control the client's blood sugar levels. A fasting blood glucose of 90 mg/dL (choice A) is within the normal range, a hemoglobin A1c of 6% (choice C) is indicative of good long-term blood sugar control, and a fasting blood glucose of 100 mg/dL (choice D) is also within the normal range. Therefore, these findings do not require immediate reporting to the provider.
5. What is the priority for a client with dehydration?
- A. Administer antiemetics to prevent nausea
- B. Monitor electrolyte levels to prevent imbalances
- C. Administer oral rehydration solutions
- D. Administer intravenous fluids
Correct answer: B
Rationale: The priority for a client with dehydration is to monitor electrolyte levels to prevent imbalances. Dehydration can lead to electrolyte disturbances, which can have serious consequences. Administering antiemetics (Choice A) may help with nausea but does not address the root cause of dehydration. Administering oral rehydration solutions (Choice C) can be beneficial, but monitoring electrolyte levels is crucial in managing dehydration. Administering intravenous fluids (Choice D) is important in severe cases of dehydration, but monitoring electrolytes should come first to assess the extent of the imbalance and guide fluid replacement therapy effectively.
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