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ATI PN Comprehensive Predictor 2020 Answers
1. How should a healthcare professional assess a patient for potential deep vein thrombosis (DVT)?
- A. Assess for unilateral leg swelling
- B. Encourage early mobilization
- C. Check for calf tenderness
- D. Observe for redness and warmth
Correct answer: A
Rationale: To assess a patient for potential deep vein thrombosis (DVT), healthcare professionals should look for unilateral leg swelling. This is a classic sign of DVT. While encouraging early mobilization is generally beneficial for preventing DVT, it is not a method of assessment. Checking for calf tenderness is also relevant but not as specific as unilateral leg swelling. Observing for redness and warmth can be signs of inflammation but are not as specific to DVT as unilateral leg swelling.
2. What is the primary action the nurse should take first for a client with a pressure ulcer who has a serum albumin level of 3 g/dL?
- A. Increase the protein intake in the diet
- B. Consult with a dietitian to create a high-protein diet
- C. Increase the IV fluid infusion rate
- D. Administer a protein supplement
Correct answer: B
Rationale: The correct answer is to consult with a dietitian to create a high-protein diet. A serum albumin level of 3 g/dL indicates hypoalbuminemia, which can impair wound healing. Consulting with a dietitian to optimize the client's protein intake is crucial in promoting wound healing for pressure ulcers. Increasing the protein intake in the diet (Choice A) may not be sufficient without proper guidance from a dietitian. Increasing the IV fluid infusion rate (Choice C) is not directly related to addressing the protein deficiency. Administering a protein supplement (Choice D) should be guided by a healthcare professional's recommendation after consulting with a dietitian.
3. A nurse is providing discharge instructions to a client who has a prescription for the use of oxygen in his home. Which of the following should the nurse teach the client about using oxygen safely in his home?
- A. Family members who smoke should be at least 10 ft away from the client when oxygen is in use
- B. Nail polish should not be used near a client who is receiving oxygen
- C. A 'No Smoking' sign should be placed on the front door
- D. Cotton bedding and clothing should be replaced with items made from wool
Correct answer: C
Rationale: The correct answer is C. Placing a 'No Smoking' sign on the front door is crucial for fire safety when using oxygen at home. Choice A is incorrect as family members who smoke should not be around the client when oxygen is in use, not just at a distance. Choice B is not directly related to oxygen safety. Choice D is also irrelevant as the type of bedding and clothing material does not impact oxygen safety.
4. What is the first step in managing a patient with a suspected pneumothorax?
- A. Insert a chest tube
- B. Monitor respiratory status
- C. Administer oxygen
- D. Call for assistance
Correct answer: A
Rationale: The correct answer is to insert a chest tube. In managing a patient with a suspected pneumothorax, the priority is to relieve the pressure from the pneumothorax by inserting a chest tube. Monitoring respiratory status (choice B) is important but comes after ensuring proper management of the pneumothorax. Administering oxygen (choice C) can help support oxygenation but does not address the underlying issue of pressure in the thoracic cavity. Calling for assistance (choice D) can be done concurrently with managing the pneumothorax, but the immediate intervention to address the pneumothorax itself is chest tube insertion.
5. A healthcare professional is managing a client with a wound infection. What is the priority action?
- A. Change the wound dressing every 12 hours
- B. Perform a wound culture before applying antibiotics
- C. Apply a wet-to-dry dressing to the wound
- D. Cleanse the wound with a solution of alcohol and water
Correct answer: B
Rationale: Performing a wound culture before applying antibiotics is crucial to identify the specific pathogen causing the infection. This helps in selecting the most effective antibiotics for treatment. Changing the wound dressing, applying a wet-to-dry dressing, or cleansing the wound are important interventions but should follow the assessment and identification of the infecting organism through a wound culture to guide appropriate treatment.
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