ATI LPN
ATI NCLEX PN Predictor Test
1. A nurse manager is discussing the responsibility of nurses caring for clients who have Clostridium difficile. Which of the following information should the nurse include in the teaching?
- A. Assign the client to a room with a negative air-flow system
- B. Use alcohol-based hand sanitizer when leaving the client's room
- C. Clean contaminated surfaces in the client's room with a phenol solution
- D. Have family members wear a gown and gloves when visiting
Correct answer: D
Rationale: The correct answer is D because having family members wear a gown and gloves when visiting a client with Clostridium difficile is essential to prevent the spread of infection. Options A, B, and C are incorrect. Negative air-flow systems are not necessary for preventing the spread of C. difficile. While alcohol-based hand sanitizers are effective for routine hand hygiene, they may not be sufficient for C. difficile. Cleaning contaminated surfaces with a phenol solution is not the most effective method for preventing the spread of C. difficile, as spores can be resistant to many disinfectants.
2. A nurse is preparing to apply a transdermal nicotine patch for a client. Which of the following actions should the nurse take?
- A. Shave hairy areas of skin prior to application.
- B. Wear gloves to apply the patch to the client's skin.
- C. Apply the patch within 1 hr of removing it from the protective pouch.
- D. Remove the previous patch and place it in a tissue.
Correct answer: B
Rationale: The correct answer is to wear gloves when applying the transdermal nicotine patch to prevent the nurse from absorbing nicotine through the skin. Choice A is incorrect because shaving hairy areas of skin is not necessary for applying a transdermal patch. Choice C is incorrect as transdermal patches should be applied immediately after removal from the protective pouch, not necessarily within 1 hour. Choice D is incorrect because the previous patch should be disposed of properly following institutional guidelines, not placed in a tissue.
3. What is the proper technique for measuring a patient's blood pressure?
- A. Place the cuff at heart level and listen for Korotkoff sounds
- B. Ensure the patient is in a seated position and inflate the cuff to 180 mmHg
- C. Use a manual sphygmomanometer and measure blood pressure on both arms
- D. Monitor pulse rate and apply pressure to the brachial artery
Correct answer: A
Rationale: The correct technique for measuring blood pressure involves placing the cuff at heart level to ensure accurate readings. Listening for Korotkoff sounds helps determine the systolic and diastolic pressures. Choice B is incorrect as inflating the cuff to 180 mmHg is excessive and can lead to inaccurate readings. Choice C is incorrect as it is unnecessary to measure blood pressure on both arms unless there is a specific medical reason to do so. Choice D is incorrect as monitoring pulse rate and applying pressure to the brachial artery are not part of the standard blood pressure measurement technique.
4. What are the key components of a respiratory assessment?
- A. Inspection, Palpation, Percussion, Auscultation
- B. Inspection, Observation, Auscultation, Percussion
- C. Auscultation, Palpation, Observation, Percussion
- D. Observation, Palpation, Percussion, Auscultation
Correct answer: A
Rationale: The correct answer is A: Inspection, Palpation, Percussion, Auscultation. A focused respiratory assessment involves inspecting the chest for symmetry and signs of distress, palpating for tenderness or abnormal masses, performing percussion to assess underlying tissues, and auscultating lung sounds. Choice B is incorrect as observation is a broad term that can encompass both inspection and palpation. Choice C is incorrect as auscultation is usually performed after inspection and palpation. Choice D is incorrect as observation should be more specific, and auscultation is a key component that is typically done last in a respiratory assessment.
5. How should a healthcare professional assess and manage a patient with acute renal failure?
- A. Monitor urine output and administer diuretics
- B. Administer IV fluids and restrict potassium intake
- C. Monitor electrolyte levels and provide dietary education
- D. Administer potassium and restrict fluids
Correct answer: A
Rationale: In acute renal failure, it is crucial to monitor urine output to assess kidney function and fluid balance. Administering diuretics helps manage fluid levels by promoting urine production. Choice B is incorrect because administering IV fluids can worsen fluid overload in renal failure patients, and restricting potassium intake is not typically the initial approach. Choice C is not the primary intervention but is important for long-term management. Choice D is incorrect as administering potassium can be dangerous in renal failure, and restricting fluids can lead to dehydration.
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