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. What is the priority nursing intervention for a patient with chest pain?
- A. Administer nitroglycerin
- B. Assess pain level
- C. Monitor vital signs
- D. Provide oxygen therapy
Correct answer: A
Rationale: The correct answer is to administer nitroglycerin. Nitroglycerin is the priority intervention for a patient with chest pain because it helps relieve chest pain by dilating coronary arteries, improving blood flow to the heart muscle. Assessing pain level, monitoring vital signs, and providing oxygen therapy are important interventions as well, but administering nitroglycerin takes precedence in addressing the immediate symptom of chest pain and potential cardiac ischemia.
3. A nurse is collecting data from a postpartum client who had a vaginal birth 2 days ago. Which of the following findings is the nurse's priority to report to the provider?
- A. Bright red bleeding
- B. Burning with urination
- C. Headache
- D. Heavy lochia flow
Correct answer: B
Rationale: The correct answer is B: 'Burning with urination.' Burning with urination can indicate a urinary tract infection postpartum, which requires immediate attention to prevent complications. Bright red bleeding and heavy lochia flow are expected findings in the early postpartum period as the uterus continues to contract and expel lochia. A headache alone is not uncommon postpartum and is often attributed to hormonal changes, dehydration, or fatigue, and can be managed with adequate rest, hydration, and pain relief. Therefore, the priority here is to address the potential infection indicated by burning with urination.
4. Which of the following interventions is most appropriate for a client with a pressure ulcer who has a low albumin level?
- A. Increase protein intake to improve healing
- B. Consult with a dietitian to create a high-protein diet
- C. Provide nutritional supplements
- D. Increase IV fluid intake to improve hydration
Correct answer: B
Rationale: Consulting with a dietitian to create a high-protein diet is the most appropriate intervention for a client with a pressure ulcer and low albumin level. This intervention can help address the client's poor nutritional status, support wound healing, and specifically target the low albumin level. Increasing protein intake alone (Choice A) may not be sufficient without proper guidance. Providing nutritional supplements (Choice C) can be beneficial but consulting with a dietitian for a personalized plan is more effective in this case. Increasing IV fluid intake (Choice D) primarily targets hydration and may not directly address the underlying issue of low albumin and poor nutritional status.
5. A nurse is reinforcing teaching to a client with hypertension. What lifestyle change should be emphasized?
- A. Increase intake of sodium-rich foods
- B. Limit intake of high-fat foods
- C. Reduce intake of caffeinated beverages
- D. Eat high-protein foods to lower blood pressure
Correct answer: B
Rationale: The correct lifestyle change that should be emphasized for a client with hypertension is to limit the intake of high-fat foods. High-fat foods can contribute to high blood pressure, so reducing their consumption is important in managing hypertension. Choice A is incorrect because increasing intake of sodium-rich foods can worsen hypertension due to their effect on blood pressure. Choice C is incorrect as caffeinated beverages can also elevate blood pressure. Choice D is incorrect because while high-protein foods can be beneficial, they do not directly lower blood pressure like reducing high-fat foods would.
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