ATI LPN
ATI PN Comprehensive Predictor 2020
1. What are the nursing interventions for a patient with hypertension?
- A. Monitor blood pressure and educate the patient about lifestyle changes
- B. Administer antihypertensive medications and provide dietary education
- C. Provide regular monitoring of blood pressure and administer diuretics
- D. Provide regular blood glucose monitoring
Correct answer: A
Rationale: The correct nursing interventions for a patient with hypertension involve monitoring blood pressure and educating the patient about lifestyle changes. These interventions help in managing hypertension by keeping track of the patient's blood pressure readings and empowering them with knowledge to make lifestyle modifications such as adopting a healthy diet, regular exercise, stress management, and avoiding smoking and excessive alcohol consumption. Administering antihypertensive medications (choice B) is typically done by a healthcare provider rather than a nurse. While regular monitoring of blood pressure (choice C) is important, administering diuretics is a specific medical intervention that should be prescribed by a healthcare provider. Monitoring blood glucose (choice D) is more relevant for patients with diabetes rather than hypertension.
2. A nurse is reviewing the plan of care for a client who is receiving chemotherapy for cancer. Which of the following interventions should the nurse include to prevent infection?
- A. Encourage the client to eat high-protein foods
- B. Encourage the client to drink 2 liters of fluid daily
- C. Instruct the client to use a soft toothbrush
- D. Instruct the client to use a mouthwash containing alcohol
Correct answer: C
Rationale: The correct answer is to instruct the client to use a soft toothbrush. Using a soft toothbrush helps prevent bleeding in clients receiving chemotherapy, who are at risk for mucositis. Encouraging the client to eat high-protein foods (Choice A) is important for overall health but not directly related to preventing infection. Encouraging the client to drink 2 liters of fluid daily (Choice B) is essential for hydration but does not specifically prevent infection. Instructing the client to use a mouthwash containing alcohol (Choice D) is contraindicated as alcohol-containing mouthwashes can cause irritation and dryness in the oral mucosa, increasing the risk of infection.
3. When caring for a client diagnosed with delirium, which condition is most important for the nurse to investigate?
- A. Cancer of any kind
- B. Impaired hearing
- C. Prescription drug intoxication
- D. Heart failure
Correct answer: C
Rationale: When caring for a client diagnosed with delirium, the most important condition for the nurse to investigate is prescription drug intoxication. Delirium can be caused by various factors, and prescription drug intoxication is a common reversible cause. Investigating this factor first is crucial to identify and address the underlying cause promptly. Choices A, B, and D are less likely to be directly associated with delirium compared to prescription drug intoxication. While cancer, impaired hearing, and heart failure can have their complications and effects, they are not typically the primary causes of delirium in a client.
4. A nurse is caring for a client post-abdominal surgery who has an NG tube. The client reports nausea and a decrease in gastric output. What should the nurse do first?
- A. Turn the client onto their left side
- B. Irrigate the NG tube with sterile water
- C. Increase the suction pressure to relieve the blockage
- D. Remove the NG tube and replace it with a new one
Correct answer: B
Rationale: The correct answer is to irrigate the NG tube with sterile water first. This action helps to relieve blockages that may be causing the decrease in gastric output and nausea. Turning the client onto their left side may not directly address the issue with the NG tube. Increasing the suction pressure can further exacerbate the problem and should not be done without assessing the situation first. Removing the NG tube and replacing it with a new one is a more invasive step that should be considered only if other measures are unsuccessful.
5. Which dietary advice should a healthcare provider provide to a client with acute gout?
- A. Increase intake of dairy products
- B. Limit intake of red meat and shellfish
- C. Limit intake of fresh fruits and vegetables
- D. Limit intake of fruit juices and milk
Correct answer: B
Rationale: The correct dietary advice for a client with acute gout is to limit the intake of red meat and shellfish. These foods are high in purines, which can lead to increased uric acid levels in the body, exacerbating gout symptoms. Dairy products, fresh fruits, and vegetables are generally recommended for individuals with gout as they can help lower uric acid levels. Fruit juices and milk, in moderation, can also be part of a gout-friendly diet as they do not significantly contribute to uric acid buildup.
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