LPN LPN
ATI PN Comprehensive Predictor 2020 Answers
1. A patient is being educated about a clear liquid diet. Which of the following should the nurse instruct the patient to avoid?
- A. Lemon-lime sports drinks
- B. Ginger ale
- C. Black coffee
- D. Orange sherbet
Correct answer: D
Rationale: The correct answer is D: Orange sherbet. A clear liquid diet consists of liquids that are transparent and easily digestible. Orange sherbet, being a frozen dessert, is not a clear liquid and should be avoided. Choices A, B, and C are all acceptable in a clear liquid diet. Lemon-lime sports drinks, ginger ale, and black coffee are clear liquids that can be included in the diet as they are transparent and leave little residue in the gastrointestinal tract, unlike orange sherbet.
2. A nurse is caring for a client who is taking digoxin. Which of the following findings should the nurse identify as a sign of digoxin toxicity?
- A. Bradycardia
- B. Tachycardia
- C. Hypotension
- D. Hyperkalemia
Correct answer: A
Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin, a cardiac glycoside, can lead to toxicity manifesting as bradycardia due to its effect on the heart's electrical conduction system. Tachycardia (choice B) is not typically associated with digoxin toxicity. Hypotension (choice C) and hyperkalemia (choice D) are not direct signs of digoxin toxicity. Therefore, the correct answer is bradycardia.
3. What is the proper technique for obtaining a blood specimen from a central venous line?
- A. Use sterile gloves and discard the first 10 mL of blood
- B. Flush the line with heparin and then draw the specimen
- C. Draw the specimen and then administer heparin
- D. Use non-sterile gloves to reduce contamination risk
Correct answer: A
Rationale: The correct technique for obtaining a blood specimen from a central venous line is to use sterile gloves and discard the first 10 mL of blood. This practice helps ensure that the blood sample collected is not contaminated. Choice B is incorrect because flushing the line with heparin before drawing the specimen can contaminate the sample. Choice C is incorrect as administering heparin before drawing the specimen can affect the accuracy of the blood sample. Choice D is incorrect as using non-sterile gloves increases the risk of contamination, which is not recommended when obtaining a blood specimen from a central venous line.
4. A client is experiencing difficulty voiding following the removal of an indwelling catheter. What action should the nurse take to assist the client?
- A. Assess for bladder distention after 4 hours
- B. Pour warm water over the perineum
- C. Restrict the client's oral fluid intake
- D. Restrict movement for at least 12 hours
Correct answer: B
Rationale: The correct action for the nurse to assist the client who is experiencing difficulty voiding after the removal of an indwelling catheter is to pour warm water over the perineum. This technique can help stimulate urination by promoting relaxation of the perineal muscles and improving blood flow to the area. Assessing for bladder distention after 4 hours (Choice A) is important but not the immediate intervention needed to assist the client in voiding. Restricting the client's oral fluid intake (Choice C) can exacerbate the issue by reducing urine production. Restricting movement for at least 12 hours (Choice D) is unnecessary and may lead to discomfort and other complications.
5. A nurse is caring for a client who has been experiencing chronic pain. Which of the following interventions should the nurse implement?
- A. Provide the client with distractions such as television
- B. Administer pain medication around the clock
- C. Teach the client relaxation techniques
- D. Perform massage therapy on the client
Correct answer: C
Rationale: The correct intervention for a client experiencing chronic pain is to teach relaxation techniques. This helps the client manage pain more effectively by reducing stress and anxiety, which can contribute to the perception of pain. Providing distractions like television (Choice A) may offer temporary relief but does not address the underlying issue of chronic pain. Administering pain medication around the clock (Choice B) may lead to dependency and not promote holistic pain management. Massage therapy (Choice D) can be beneficial but may not be as effective as teaching relaxation techniques in the long term for managing chronic pain.
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