ATI LPN
ATI PN Comprehensive Predictor 2020
1. What is the most important action when providing wound care to a client with a pressure ulcer?
- A. Apply a dry, sterile dressing to the wound
- B. Cleanse the wound with normal saline
- C. Perform a wound culture before applying ointment
- D. Cover the wound with a wet-to-dry dressing
Correct answer: C
Rationale: Performing a wound culture before applying ointment is crucial when providing wound care to a client with a pressure ulcer. This action helps identify any underlying infections, allowing healthcare providers to select the most appropriate treatment. Options A, B, and D are not as critical as performing a wound culture, as they focus on wound dressing and cleansing rather than identifying potential infections.
2. Which lifestyle change should be emphasized for a client with hypertension?
- A. Increase sodium intake to prevent fluid retention
- B. Reduce sodium and caffeine intake
- C. Increase protein intake to promote muscle strength
- D. Increase intake of high-fat foods
Correct answer: B
Rationale: The correct answer is B: 'Reduce sodium and caffeine intake.' Clients with hypertension benefit from reducing sodium intake as it can help lower blood pressure levels. Caffeine also has a vasoconstrictive effect, which can increase blood pressure. Choices A, C, and D are incorrect. Increasing sodium intake would exacerbate hypertension due to fluid retention. While protein intake is important for overall health, it is not a primary focus in managing hypertension. Increasing intake of high-fat foods can lead to weight gain and negatively impact heart health, which is counterproductive for someone with hypertension.
3. A healthcare provider is assessing a client who has received a preoperative dose of morphine. Which of the following findings is the priority to report to the provider?
- A. Client reports nausea.
- B. Urinary output of 20 mL/hr.
- C. Oxygen saturation 90%.
- D. Respiratory rate 14/min.
Correct answer: C
Rationale: An oxygen saturation of 90% is below the expected reference range and could indicate respiratory depression, a serious side effect of morphine. This finding requires immediate attention as it may lead to hypoxia. Nausea (choice A) is a common side effect of morphine but does not pose an immediate threat. A urinary output of 20 mL/hr (choice B) may indicate decreased renal perfusion but is not as critical as respiratory compromise. A respiratory rate of 14/min (choice D) is within the normal range and does not suggest immediate danger.
4. A client with type 2 diabetes mellitus is being taught about insulin administration by a nurse. Which of the following instructions should the nurse include?
- A. Inject insulin into the muscle
- B. Rotate injection sites with each dose
- C. Store insulin at room temperature
- D. Massage the injection site after administration
Correct answer: B
Rationale: The correct instruction that the nurse should include is to rotate injection sites with each dose. This practice is essential to prevent tissue damage and ensure proper insulin absorption. Option A is incorrect because insulin should not be injected into the muscle, but rather into the subcutaneous tissue. Option C is incorrect as insulin should be stored in the refrigerator to maintain its effectiveness. Option D is incorrect as massaging the injection site after administration can lead to faster absorption and potentially hypoglycemia.
5. A nurse is teaching a client who has irritable bowel syndrome (IBS) about dietary modifications. Which of the following instructions should the nurse include?
- A. Increase fiber intake to 35 grams per day
- B. Avoid dairy products
- C. Eat small, frequent meals
- D. Avoid fruits and vegetables
Correct answer: C
Rationale: The correct answer is C: 'Eat small, frequent meals.' Eating small, frequent meals helps manage IBS symptoms by avoiding overloading the digestive system. Choice A is incorrect because increasing fiber intake may worsen symptoms in some individuals with IBS. Choice B is not a blanket recommendation for all IBS patients; some may tolerate dairy products well. Choice D is incorrect as fruits and vegetables are important sources of nutrients and should not be completely avoided unless specific triggers are identified.
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