ATI LPN
PN ATI Comprehensive Predictor
1. What are the key nursing considerations for a patient with a central venous catheter?
- A. Maintain sterility during dressing changes
- B. Change the dressing weekly
- C. Monitor blood pressure and fluid balance
- D. Monitor the catheter site for infection
Correct answer: A
Rationale: The correct answer is A: Maintain sterility during dressing changes. It is crucial to maintain sterility during dressing changes for patients with central venous catheters to prevent infections. Changing the dressing weekly (Choice B) is not frequent enough to prevent infections effectively. Monitoring blood pressure and fluid balance (Choice C) is important for overall patient care but not specific to central venous catheter management. While monitoring the catheter site for infection (Choice D) is important, the key consideration is to prevent infections through proper sterile techniques during dressing changes.
2. What are the key differences between hypoglycemia and hyperglycemia?
- A. Hypoglycemia: Sweating, trembling; Hyperglycemia: Frequent urination, thirst
- B. Hypoglycemia: Increased thirst; Hyperglycemia: Sweating, confusion
- C. Hypoglycemia: Increased appetite; Hyperglycemia: Blurred vision
- D. Hypoglycemia: Dizziness; Hyperglycemia: Low blood pressure
Correct answer: A
Rationale: Hypoglycemia typically presents with sweating and trembling, while hyperglycemia is characterized by frequent urination and thirst. Therefore, the correct key differences between hypoglycemia and hyperglycemia are that hypoglycemia includes symptoms like sweating and trembling, while hyperglycemia involves symptoms such as frequent urination and thirst. Choices B, C, and D are incorrect because they do not accurately represent the characteristic symptoms of hypoglycemia and hyperglycemia, as stated in the question.
3. A charge nurse is teaching new staff members about factors that increase a client's risk of becoming violent. Which of the following risk factors should the nurse include as the best predictor of future violence?
- A. Experiencing delusions.
- B. Male gender.
- C. Previous violent behavior.
- D. A history of being in prison.
Correct answer: C
Rationale: The correct answer is C: Previous violent behavior. This is considered the best predictor of future violent actions as individuals who have a history of violent behavior are more likely to engage in violent acts again. Option A, experiencing delusions, although it can impact behavior, is not as strong of a predictor as past violent behavior. Option B, male gender, is a demographic factor but not as specific or predictive as a history of violence. Option D, a history of being in prison, may indicate past behavior but is not directly linked to future violent actions as a known history of violence.
4. How should a healthcare professional assess a patient with dehydration?
- A. Monitor skin turgor and check urine output
- B. Assess for jugular venous distention
- C. Auscultate lung sounds and monitor for fever
- D. Monitor for cyanosis and increased respiratory rate
Correct answer: A
Rationale: Correct Answer: When assessing a patient for dehydration, healthcare professionals should monitor skin turgor, as it indicates the degree of dehydration, and check urine output, as decreased urine output can be a sign of dehydration. Choices B, C, and D are incorrect because they do not directly assess for dehydration. Assessing for jugular venous distention (B) is more relevant for heart failure, auscultating lung sounds and monitoring for fever (C) are more relevant for respiratory infections, and monitoring for cyanosis and increased respiratory rate (D) are more indicative of respiratory distress rather than dehydration.
5. A client is undergoing radiation therapy. Which of the following actions should the nurse take to prevent skin irritation?
- A. Apply heat packs to the area
- B. Use perfumed soap to cleanse the area
- C. Keep the area moist with lotion
- D. Avoid sun exposure to the treated area
Correct answer: D
Rationale: Avoiding sun exposure is crucial to prevent skin irritation and burns in clients undergoing radiation therapy. Radiation therapy makes the skin more sensitive to sunlight, increasing the risk of skin damage. Applying heat packs (choice A) can exacerbate skin irritation as heat can further irritate the skin that is already sensitive due to radiation. Using perfumed soap (choice B) can further irritate the skin due to its harsh chemicals, potentially worsening skin reactions. While keeping the area moist with lotion (choice C) may seem beneficial, some lotions contain ingredients that can worsen skin reactions during radiation therapy. Therefore, avoiding sun exposure to the treated area (choice D) is the most appropriate action to prevent skin irritation and damage during radiation therapy.
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