LPN LPN
ATI PN Comprehensive Predictor 2023 with NGN
1. A nurse is collecting data from a client who has a newly applied cast to the right lower extremity. Which of the following findings should the nurse expect?
- A. Capillary refill of 1 second
- B. Capillary refill of 5 seconds
- C. Pitting edema
- D. Shortness of breath
Correct answer: B
Rationale: When assessing a client with a newly applied cast, the nurse should expect a capillary refill of approximately 2 seconds, as this indicates adequate circulation. A capillary refill longer than 3 seconds suggests impaired circulation, which is abnormal. Therefore, a capillary refill of 5 seconds is the finding the nurse should expect. Pitting edema and shortness of breath are not typically directly related to a newly applied cast and should not be expected findings in this scenario.
2. What is the main symptom of left-sided heart failure?
- A. Shortness of breath
- B. Edema
- C. Increased heart rate
- D. Decreased urine output
Correct answer: A
Rationale: Shortness of breath is the main symptom of left-sided heart failure because it results from pulmonary congestion due to fluid buildup in the lungs. Edema, increased heart rate, and decreased urine output are associated with right-sided heart failure rather than left-sided heart failure.
3. What are the primary differences between left-sided and right-sided heart failure?
- A. Left-sided: Pulmonary congestion; Right-sided: Systemic edema
- B. Right-sided: Pulmonary congestion; Left-sided: Systemic edema
- C. Left-sided: Systemic edema; Right-sided: Pulmonary congestion
- D. Right-sided: Pulmonary congestion; Left-sided: Heart failure
Correct answer: A
Rationale: The correct answer is A: "Left-sided: Pulmonary congestion; Right-sided: Systemic edema." Left-sided heart failure primarily affects the lungs, leading to pulmonary congestion, which manifests as symptoms like shortness of breath and cough. On the other hand, right-sided heart failure causes systemic congestion and edema, often presenting as swelling in the legs and abdomen due to fluid retention. Choice B is incorrect because it swaps the features of left-sided and right-sided heart failure. Choice C is incorrect as it also incorrectly switches the characteristics of the two types of heart failure. Choice D is incorrect because it inaccurately associates left-sided heart failure with pulmonary congestion and right-sided heart failure with heart failure itself, which is not a distinguishing feature.
4. What is the most appropriate next step when a client with an NG tube attached to low suctioning becomes nauseated, and the nurse observes a decrease in the flow of gastric secretions?
- A. Increase the suction pressure
- B. Irrigate the NG tube with sterile water
- C. Turn the client on their side
- D. Replace the NG tube with a new one
Correct answer: B
Rationale: The correct answer is to irrigate the NG tube with sterile water. When a client with an NG tube attached to low suctioning becomes nauseated and there is a decrease in the flow of gastric secretions, it indicates a possible blockage in the tube. Irrigating the tube with sterile water can help clear the blockage, allowing for proper suctioning and relieving the client's nausea. Increasing the suction pressure (Choice A) can further worsen the issue by potentially causing harm to the client. Turning the client on their side (Choice C) may not address the underlying problem of tube blockage. Replacing the NG tube with a new one (Choice D) should only be considered if other interventions, like irrigation, fail to clear the blockage.
5. Which dietary restriction should be taught to a client with chronic kidney disease?
- A. Increase potassium-rich foods
- B. Limit phosphorus and potassium intake
- C. Encourage increased protein intake
- D. Increase fluid intake
Correct answer: B
Rationale: The correct answer is B: Limit phosphorus and potassium intake. In chronic kidney disease, the kidneys are unable to effectively filter these minerals from the blood, leading to their accumulation and potential complications. Restricting phosphorus and potassium intake is crucial in managing the progression of the disease. Choice A is incorrect as increasing potassium-rich foods can worsen the condition. Choice C is also incorrect as excessive protein intake can put more strain on the kidneys. Choice D is not the priority; rather, fluid intake should be monitored based on individual needs and stage of kidney disease.
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