ATI LPN
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1. A client undergoing radiation therapy is being taught about skin care by a nurse. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will use a heating pad to soothe the skin
- B. I will avoid using perfumed lotions on the treated area
- C. I will apply cold compresses to the area
- D. I will scrub the area daily with soap and water
Correct answer: B
Rationale: The correct answer is B because avoiding perfumed lotions is important to prevent skin irritation after radiation therapy. Using a heating pad (A) can further damage the skin, applying cold compresses (C) may not be recommended, and scrubbing the area daily with soap and water (D) can be too harsh on the skin, leading to further irritation and damage.
2. When instructing a client with tuberculosis on home care, what is the priority teaching point?
- A. Wear a surgical mask at all times
- B. Limit visitors to two-hour increments
- C. Take medication for 6-9 months
- D. Take breaks during meals
Correct answer: C
Rationale: The correct answer is C: 'Take medication for 6-9 months.' The priority teaching point for a client with tuberculosis is to ensure they understand the importance of completing the entire course of medication. This is crucial to effectively treat and cure tuberculosis, prevent the development of drug-resistant strains, and reduce the risk of transmission to others. Choice A is incorrect as wearing a surgical mask at all times is not the priority teaching point for tuberculosis home care. Choice B is not the priority teaching point; while limiting visitors can help reduce exposure to others, completing the medication course is more critical. Choice D is not relevant to tuberculosis home care instructions.
3. A client with type 2 diabetes mellitus is concerned about weight gain during pregnancy. Which of the following responses should the nurse make?
- A. You should not gain more than 10 lbs
- B. Your weight gain should be the same as for someone without diabetes
- C. Avoid gaining more than 15 lbs
- D. You should gain more weight because of your condition
Correct answer: B
Rationale: The correct answer is B. Clients with type 2 diabetes should aim for the same pregnancy weight gain as those without diabetes. Option A is too restrictive and may not be appropriate for a healthy pregnancy. Option C also imposes a specific limit without considering individual needs. Option D is incorrect as excessive weight gain can lead to complications in pregnancy, especially for individuals with diabetes.
4. What are the signs of opioid withdrawal, and how should it be managed?
- A. Sweating, nausea; administer methadone
- B. Muscle cramps, vomiting; administer naloxone
- C. Tremors, sweating; administer buprenorphine
- D. Fever, agitation; provide sedatives
Correct answer: A
Rationale: The signs of opioid withdrawal typically include sweating and nausea. The correct management approach involves administering methadone to alleviate the symptoms. Choice B is incorrect because naloxone is used to reverse opioid overdose, not for managing withdrawal symptoms. Choice C is incorrect as buprenorphine is typically used to treat opioid addiction, not just withdrawal symptoms. Choice D is incorrect as sedatives are not the primary treatment for opioid withdrawal.
5. How should a healthcare provider manage a patient with hyperkalemia?
- A. Administer insulin and glucose
- B. Restrict potassium intake
- C. Monitor ECG
- D. All of the above
Correct answer: D
Rationale: In managing hyperkalemia, it is essential to administer insulin and glucose to shift potassium into the cells, restrict potassium intake to prevent further elevation of serum levels, and monitor the ECG for signs of potassium-induced cardiac effects. Therefore, the correct answer is D, as all of the provided actions are important in the management of hyperkalemia. Choice A alone is not sufficient as it only addresses shifting potassium intracellularly without preventing further elevation. Choice B alone is not enough as it does not address the immediate need to lower serum potassium levels. Choice C alone is insufficient as it only monitors for cardiac effects without addressing potassium levels or shifting mechanisms.
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