LPN LPN
ATI PN Comprehensive Predictor 2023
1. A nurse is caring for a client who has heart failure and is receiving digoxin. Which of the following findings should the nurse identify as a sign of digoxin toxicity?
- A. Bradycardia
- B. Tachycardia
- C. Hypotension
- D. Increased appetite
Correct answer: A
Rationale: Corrected Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin, a medication used to treat heart failure, works by slowing down the heart rate and increasing the force of heart contractions. Excessive levels of digoxin can lead to toxicity, causing bradycardia (slow heart rate), among other symptoms. Tachycardia (fast heart rate) and hypotension (low blood pressure) are not typically associated with digoxin toxicity. Increased appetite is not a recognized sign of digoxin toxicity; instead, gastrointestinal symptoms like nausea, vomiting, and anorexia are more common.
2. A client with an acute myocardial infarction is concerned about extreme fatigue. What is the best strategy to promote independence in self-care?
- A. Instruct the client to limit all activity until fully rested
- B. Encourage the client to gradually resume self-care tasks with rest periods
- C. Assign assistive personnel to complete self-care tasks
- D. Ask the client's family to assist with self-care
Correct answer: B
Rationale: Encouraging the client to gradually resume self-care tasks with rest periods is the best strategy to promote independence in self-care for a client with acute myocardial infarction. This approach allows the client to regain independence while considering the need for rest to prevent overexertion. Instructing the client to limit all activity until fully rested (Choice A) may hinder independence by promoting inactivity. Assigning assistive personnel to complete self-care tasks (Choice C) does not promote the client's independence. Asking the client's family to assist with self-care (Choice D) may not foster the client's self-reliance and may not always be feasible.
3. A client with a tracheostomy shows signs of respiratory distress. What action should the nurse take immediately?
- A. Increase the suction setting on the ventilator
- B. Administer a bronchodilator
- C. Suction the tracheostomy
- D. Encourage deep breathing exercises
Correct answer: C
Rationale: The correct immediate action for a client with a tracheostomy showing signs of respiratory distress is to suction the tracheostomy. Respiratory distress in this case is often caused by a blockage, which can be quickly relieved by suctioning to clear the airway. Increasing the suction setting on the ventilator (Choice A) may not address the immediate blockage in the tracheostomy. Administering a bronchodilator (Choice B) may help with bronchoconstriction but does not address the potential blockage in the tracheostomy. Encouraging deep breathing exercises (Choice D) may not be effective in relieving the immediate respiratory distress caused by a blocked tracheostomy.
4. What are the complications of untreated hyperglycemia?
- A. Diabetic ketoacidosis and dehydration
- B. Hypoglycemia and hypertension
- C. Infection and liver failure
- D. Pulmonary edema and electrolyte imbalance
Correct answer: A
Rationale: The correct answer is A: Diabetic ketoacidosis and dehydration. Untreated hyperglycemia can lead to diabetic ketoacidosis, a serious complication characterized by high blood sugar, the presence of ketones in the urine, and acidosis. Dehydration is also a common complication of untreated hyperglycemia. Choices B, C, and D are incorrect because hypoglycemia and hypertension are not typical complications of untreated hyperglycemia. Infection and liver failure, as well as pulmonary edema and electrolyte imbalance, are also not direct complications of untreated hyperglycemia.
5. What are the early signs of diabetic ketoacidosis?
- A. Excessive thirst and fruity breath odor
- B. Weight loss and increased urination
- C. Nausea and vomiting
- D. Hypoglycemia and fatigue
Correct answer: A
Rationale: The correct answer is A: Excessive thirst and fruity breath odor. Diabetic ketoacidosis presents with these early signs due to ketone buildup in the body. Choice B, weight loss and increased urination, are more characteristic of uncontrolled diabetes but not specific to diabetic ketoacidosis. Choice C, nausea and vomiting, can occur in diabetic ketoacidosis but are not as early or specific as excessive thirst and fruity breath odor. Choice D, hypoglycemia and fatigue, are not typical signs of diabetic ketoacidosis; rather, diabetic ketoacidosis usually presents with hyperglycemia.
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