LPN LPN
ATI NCLEX PN Predictor Test
1. A nurse is contributing to the plan of care for a client who has a chest tube connected to a closed drainage system. Which of the following interventions should the nurse include?
- A. Clamp the chest tube
- B. Maintain the drainage below the level of the chest
- C. Elevate the chest tube above chest level
- D. Avoid frequent dressing changes
Correct answer: B
Rationale: The correct intervention for a client with a chest tube connected to a closed drainage system is to maintain the drainage below the level of the chest. This position allows proper drainage of fluids and helps prevent complications such as backflow of blood or fluids into the chest cavity. Clamping the chest tube (Choice A) is incorrect as it can lead to a tension pneumothorax. Elevating the chest tube above chest level (Choice C) is also incorrect because it can impede proper drainage. Avoiding frequent dressing changes (Choice D) is important to prevent introducing infection, but it is not directly related to the position of the drainage system.
2. A nurse is reviewing the plan of care for a client who is postoperative following a hip replacement. Which of the following interventions should the nurse implement to prevent venous thromboembolism?
- A. Instruct the client to perform ankle pumps
- B. Administer anticoagulant therapy as prescribed
- C. Maintain the client in a prone position
- D. Encourage the client to ambulate as tolerated
Correct answer: B
Rationale: The correct intervention to prevent venous thromboembolism in a postoperative client following hip replacement is to administer anticoagulant therapy as prescribed. Anticoagulants help prevent blood clots from forming. Instructing the client to perform ankle pumps helps prevent blood clots by promoting circulation. Maintaining the client in a prone position can increase the risk of venous stasis and thrombus formation. Encouraging the client to ambulate as tolerated also helps prevent venous thromboembolism by promoting blood flow and preventing stasis.
3. A client is learning about preventing hip dislocation before total hip arthroplasty. Which instruction should be included?
- A. Avoid bending the hip more than 90 degrees
- B. Avoid lying on the unaffected side
- C. Avoid crossing the legs at the knees
- D. Avoid keeping the legs in a neutral position
Correct answer: C
Rationale: The correct instruction to prevent hip dislocation after total hip arthroplasty is to avoid crossing the legs at the knees. This position can put stress on the hip joint and increase the risk of dislocation. Choices A, B, and D are incorrect. Bending the hip more than 90 degrees, lying on the unaffected side, or keeping the legs in a neutral position are not directly related to preventing hip dislocation in this context.
4. A nurse at a long-term care facility is part of a team preparing a report on the quality of care at the facility. Which of the following information should the nurse recommend including in the report to demonstrate improvement in care quality?
- A. Increased admissions
- B. 12% fewer urinary tract infections
- C. Increased mortality rate
- D. No changes in staffing
Correct answer: B
Rationale: The correct answer is B: '12% fewer urinary tract infections.' Tracking infections, such as UTIs, is crucial in assessing care quality improvements as the reduction in infections indicates better infection control practices and overall quality of care. Choices A, C, and D are incorrect. Increased admissions (Choice A) do not directly reflect improvements in care quality. Increased mortality rate (Choice C) is a negative outcome and demonstrates a decline in care quality. No changes in staffing (Choice D) do not provide direct evidence of care quality improvements.
5. A nurse is caring for a client who is in Buck's traction. Which of the following actions should the nurse take?
- A. Remove the weights
- B. Ensure the weights hang freely
- C. Increase the traction force
- D. Loosen the ropes
Correct answer: B
Rationale: The correct action the nurse should take when caring for a client in Buck's traction is to ensure the weights hang freely. This is essential to maintain proper alignment and ensure the effectiveness of Buck's traction. Removing the weights (Choice A) would be incorrect and could compromise the treatment. Increasing the traction force (Choice C) can lead to excessive pressure and potential harm to the client. Loosening the ropes (Choice D) would also be inappropriate as it can disrupt the traction's effectiveness and alignment.
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