LPN LPN
ATI PN Comprehensive Predictor 2020
1. What should the nurse do first when a client with a tracheostomy exhibits respiratory distress?
- A. Notify the provider
- B. Suction the tracheostomy
- C. Administer a bronchodilator
- D. Increase the oxygen flow rate
Correct answer: B
Rationale: The correct initial action when a client with a tracheostomy exhibits respiratory distress is to suction the tracheostomy. This helps to clear secretions and improve the client's ability to breathe. Notifying the provider (choice A) can cause a delay in immediate intervention. Administering a bronchodilator (choice C) may be necessary but is not the priority in this situation. Increasing the oxygen flow rate (choice D) can be helpful but should come after addressing the immediate need for suctioning to clear the airway.
2. A nurse is contributing to the plan of care for a client who is at risk of developing pressure injuries. Which of the following interventions should the nurse include?
- A. Place the client in a prone position
- B. Place the client in a 30-degree lateral position
- C. Encourage the client to reposition every 4 hours
- D. Place the client in a high Fowler's position
Correct answer: B
Rationale: The correct answer is B: Place the client in a 30-degree lateral position. Positioning the client laterally reduces pressure on bony prominences, improving circulation and helping prevent pressure injuries. Placing the client in a prone position (choice A) increases pressure on the bony prominences, raising the risk of pressure injuries. Similarly, placing the client in a high Fowler's position (choice D) can also increase pressure on certain areas. While encouraging the client to reposition every 4 hours (choice C) is important, the specific lateral positioning is more beneficial in preventing pressure injuries.
3. A nurse is reviewing the laboratory results for a client who has Cushing's disease. The nurse should expect the client to have an increase in which of the following laboratory values?
- A. Serum glucose level.
- B. Serum calcium level.
- C. Lymphocyte count.
- D. Serum potassium level.
Correct answer: A
Rationale: The correct answer is A: Serum glucose level. In Cushing's disease, there is an excess production of cortisol, leading to hyperglycemia. This results in an increase in serum glucose levels. Choices B, C, and D are incorrect because Cushing's disease does not directly affect serum calcium levels, lymphocyte count, or serum potassium levels.
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. What is a key nursing action for a client with a wound infection?
- A. Change the dressing daily
- B. Perform a wound culture before applying antibiotics
- C. Cleanse the wound with alcohol-based solutions
- D. Apply a wet-to-dry dressing to the wound
Correct answer: B
Rationale: Performing a wound culture before applying antibiotics is crucial for determining the specific type of infection present and selecting the most effective antibiotic treatment. Changing the dressing daily (Choice A) is a routine wound care practice but may not address the root cause of the infection. Cleansing the wound with alcohol-based solutions (Choice C) can be too harsh and delay wound healing. Applying a wet-to-dry dressing (Choice D) is an outdated practice that can cause trauma to the wound bed and hinder the healing process.
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