LPN LPN
ATI PN Comprehensive Predictor 2020
1. A nurse is caring for a client who has a prescription for metoprolol. For which of the following findings should the nurse withhold the medication?
- A. Heart rate 56/min.
- B. Oxygen saturation 93%.
- C. Respiratory rate 18/min.
- D. Blood pressure 118/74 mm Hg.
Correct answer: A
Rationale: The correct answer is A: Heart rate 56/min. Metoprolol, a beta blocker, should be withheld if the client's heart rate is below 60/min to prevent further bradycardia. Choices B, C, and D are within normal ranges and do not indicate a need to withhold metoprolol.
2. A nurse is caring for a client who is scheduled for surgery in the morning. The nurse learns that the client has decided not to have surgery even though they have already signed the informed consent form. Which of the following actions should the nurse take?
- A. Ignore the client's decision and proceed
- B. Report the situation to the provider
- C. Ask the family to convince the client
- D. Reassess the need for surgery with the client
Correct answer: B
Rationale: The correct action for the nurse to take is to report the client's decision to the provider who obtained informed consent. This ensures that the provider is informed of the client's change in decision and can discuss the situation further with the client. Choice A is incorrect as ignoring the client's decision is not appropriate and goes against the principles of patient autonomy. Choice C is incorrect because involving the family in convincing the client can be coercive and may not respect the client's autonomy. Choice D is incorrect because the nurse should not re-sign the informed consent form without the client's consent and a discussion with the provider.
3. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following interventions should the nurse include in the plan of care?
- A. Monitor the client's temperature every 4 hours
- B. Monitor blood glucose levels every 6 hours
- C. Administer insulin as prescribed
- D. Monitor daily fluid intake
Correct answer: B
Rationale: Corrected Rationale: Monitoring blood glucose levels is crucial in clients receiving TPN because the solution has a high glucose content. This monitoring helps prevent hyperglycemia and allows for timely adjustments in the TPN formulation if needed. Monitoring the client's temperature (Choice A) is not directly related to TPN administration. Administering insulin (Choice C) should be based on blood glucose levels and the healthcare provider's orders; it is not a standard intervention for all clients on TPN. Monitoring daily fluid intake (Choice D) is important for overall fluid balance but is not as critical as monitoring blood glucose levels specifically for clients on TPN.
4. When providing family education for those who have a relative with Alzheimer's disease about minimizing stress, which of the following suggestions is most relevant?
- A. Allow the client to rest four to five times during the day
- B. Assess the cognitive functioning of the client regularly
- C. Provide reality orientation even if the memory loss is severe
- D. Maintain consistency in environment, routine, and caregivers
Correct answer: D
Rationale: The most relevant suggestion for minimizing stress in individuals with Alzheimer's disease is to maintain consistency in the environment, routine, and caregivers. This approach helps create a sense of familiarity and security for the individual, reducing stress and anxiety. Choice A is incorrect as it suggests allowing the client to go to bed multiple times during the day, which may disrupt their routine and lead to confusion. Choice B is incorrect as continuously testing cognitive functioning can be overwhelming and stressful for the individual. Choice C is also incorrect as providing reality orientation in cases of severe memory loss can cause frustration and confusion, ultimately increasing stress levels.
5. What is the role of the nurse in the care of a patient with a pressure ulcer?
- A. Clean the wound and apply a protective dressing
- B. Assess the wound and reposition the patient frequently
- C. Apply pressure to the ulcer and monitor for signs of healing
- D. Provide pain relief and administer antibiotics as needed
Correct answer: B
Rationale: The correct answer is B: Assess the wound and reposition the patient frequently. When caring for a patient with a pressure ulcer, it is crucial for the nurse to assess the wound regularly to monitor its progress and prevent complications. Additionally, repositioning the patient frequently helps to relieve pressure on the affected area, prevent further damage, and promote healing. Choice A is incorrect because while cleaning the wound is important, applying a protective dressing is not the primary role of the nurse in managing a pressure ulcer. Choice C is incorrect as applying pressure to the ulcer is harmful, and monitoring for signs of healing should not involve applying pressure. Choice D is incorrect as providing pain relief and administering antibiotics may be necessary but are not the primary interventions for managing a pressure ulcer.
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