LPN LPN
ATI PN Comprehensive Predictor 2023 with NGN
1. A nurse is collecting data from a client who is experiencing a situational crisis following the loss of a job. The client states, 'I don't think I can go through this again.' Which of the following actions is the nurse's priority?
- A. Determine if the client is experiencing psychotic thinking
- B. Determine the client's support system
- C. Ask how the client copes with stress
- D. Assess the client's vital signs
Correct answer: A
Rationale: The priority is to determine if the client is experiencing psychotic thinking or suicidal ideation. In this situation, the nurse needs to assess if the client is having distorted thoughts or losing touch with reality, which could pose an immediate risk to the client's safety. While determining the client's support system, asking how the client copes with stress, and assessing vital signs are important aspects of care, they are not the priority when there is a concern about potential psychotic thinking or suicidal ideation.
2. What is the best teaching point for a client with left-leg weakness learning to use a cane?
- A. Use the cane on the weaker side
- B. Maintain two points of support on the floor at all times
- C. Advance the cane 30 to 45 cm with each step
- D. Advance the cane and the strong leg together
Correct answer: B
Rationale: The correct teaching point for a client with left-leg weakness learning to use a cane is to maintain two points of support on the floor at all times. This ensures better stability and support for the client while walking. Choice A is incorrect because the cane should be used on the stronger side to support the weaker leg. Choice C is incorrect as advancing the cane too far with each step may compromise balance. Choice D is incorrect because advancing the cane and the strong leg together may not provide adequate support for the weaker leg.
3. A nurse is observing an assistive personnel (AP) apply antiembolic stockings for a client. Which of the following actions by the AP demonstrates an understanding of how to perform this skill?
- A. Apply the stocking while the client is seated
- B. Apply the stocking before the client gets out of bed
- C. Use lotion under the stocking to ease application
- D. Bunch the stocking around the heel before applying
Correct answer: B
Rationale: The correct answer is B. Applying antiembolic stockings before the client gets out of bed is crucial as it helps prevent venous stasis and clot formation. Choice A is incorrect because stockings should be applied before the client gets out of bed. Choice C is incorrect as using lotion under the stocking can cause the stocking to slip. Choice D is incorrect because the stocking should be smooth and not bunched to prevent pressure points.
4. How should a healthcare professional manage a patient with a suspected deep vein thrombosis (DVT)?
- A. Administer anticoagulants and monitor for bleeding
- B. Elevate the limb and administer pain relief
- C. Restrict mobility and apply warm compress
- D. Administer IV fluids and provide bed rest
Correct answer: A
Rationale: Corrected DVT management involves administering anticoagulants to prevent clot growth and monitoring for signs of bleeding. Elevating the limb and administering pain relief (Choice B) may help alleviate symptoms but do not address the underlying issue of preventing clot progression. Restricting mobility and applying warm compress (Choice C) could potentially dislodge the clot and worsen the condition. Administering IV fluids and providing bed rest (Choice D) are not primary interventions for managing DVT.
5. A nurse manager of a med surge unit is assigning care responsibilities for the oncoming shift. A client is waiting transfer back to the unit from the PACU following thoracic surgery. To which staff member should the nurse assign the client?
- A. Charge nurse
- B. RN
- C. LVN
- D. AP
Correct answer: B
Rationale: The correct answer is B: RN. An RN is required for managing post-surgical care in the immediate postoperative period, especially for a client following thoracic surgery. The RN is equipped with the necessary knowledge and skills to assess the client's condition, provide complex care, and recognize and respond to any complications that may arise. Assigning the client to the Charge nurse (A) may not be appropriate as the Charge nurse focuses more on administrative and managerial tasks rather than direct patient care. LVNs (C) and APs (D) may have limitations in their scope of practice when it comes to managing post-surgical care following thoracic surgery, which requires a higher level of assessment and intervention that an RN can provide.
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