LPN LPN
ATI PN Comprehensive Predictor 2020
1. A nurse is planning care for a preschool-age child who is in the acute phase of Kawasaki disease. Which of the following interventions should the nurse include in the plan of care?
- A. Administer scheduled doses of acetaminophen every 6 hr.
- B. Monitor the child's cardiac status.
- C. Administer antibiotics via intermittent IV bolus for 24 hr.
- D. Provide stimulation with children of the same age in the playroom.
Correct answer: B
Rationale: Monitoring cardiac status is crucial during the acute phase of Kawasaki disease because of the potential for coronary artery complications. Acetaminophen may be used for fever management but is not the priority intervention. Antibiotics are not indicated as Kawasaki disease is not caused by a bacterial infection. Providing stimulation in the playroom is important for the child's emotional well-being but does not address the immediate physiological concern of cardiac monitoring.
2. What is the appropriate action for a healthcare professional when administering a blood transfusion?
- A. Verify the patient's identity
- B. Monitor vital signs
- C. Stay with the patient during the first 15 minutes
- D. Stop the transfusion if a reaction occurs
Correct answer: A
Rationale: The appropriate action for a healthcare professional when administering a blood transfusion is to verify the patient's identity. This step is essential to ensure that the correct blood product is given to the right patient, preventing any errors or adverse reactions. While monitoring vital signs and staying with the patient during the initial phase of the transfusion are also important steps, the primary action of verifying the patient's identity takes precedence to uphold patient safety and prevent any potential harm.
3. 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.
4. A nurse is caring for a 37-year-old woman with metastatic ovarian cancer admitted for nausea and vomiting. The physician orders total parenteral nutrition (TPN), a nutritional consult, and diet recall. Which of the following is the BEST indication that the patient's nutritional status has improved after 4 days?
- A. The patient eats most of the food served to her
- B. The patient has gained 1 pound since admission
- C. The patient's albumin level is 4.0mg/dL
- D. The patient's hemoglobin is 8.5g/dL
Correct answer: C
Rationale: An improved albumin level is the best indicator of improved nutritional status after TPN. Albumin is a key protein that reflects the body's overall nutritional status and is commonly used to assess nutritional health. Choices A, B, and D are not as reliable indicators of improved nutritional status. Choice A may not accurately reflect nutritional improvement as it could be influenced by factors other than nutrition. Choice B may indicate fluid retention or loss rather than true nutritional improvement. Choice D, hemoglobin level, is more related to anemia and oxygen-carrying capacity of the blood, rather than nutritional status.
5. How should a healthcare provider respond to a patient experiencing a seizure?
- A. Protect the airway and monitor for post-ictal confusion
- B. Administer anticonvulsant medications
- C. Apply restraints to prevent injury
- D. Place the patient in a side-lying position
Correct answer: D
Rationale: When a patient is experiencing a seizure, the immediate priority is to ensure their safety by placing them in a side-lying position. This helps prevent aspiration in case of vomiting and maintains an open airway. Administering anticonvulsant medications is not within the scope of a healthcare provider's immediate response during a seizure. Applying restraints can potentially harm the patient by restricting movement and causing injury. Monitoring for post-ictal confusion is important after the seizure has ended, but the primary concern during the seizure is ensuring the patient's safety.
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