LPN LPN
ATI PN Comprehensive Predictor 2023 with NGN
1. A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following actions should the nurse take to prevent atelectasis?
- A. Encourage deep breathing exercises
- B. Encourage the client to cough every 2 hours
- C. Administer an incentive spirometer
- D. Assist the client to ambulate in the hallway
Correct answer: C
Rationale: The correct answer is C: Administer an incentive spirometer. Using an incentive spirometer helps prevent atelectasis by encouraging lung expansion after surgery. Encouraging deep breathing exercises (choice A) is beneficial but may not be as effective as an incentive spirometer. Encouraging the client to cough (choice B) helps with airway clearance but does not directly prevent atelectasis. Assisting the client to ambulate (choice D) is important for preventing complications such as deep vein thrombosis, but it is not the most effective intervention for preventing atelectasis.
2. 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.
3. What is the key management strategy for diabetic ketoacidosis (DKA)?
- A. Administer insulin
- B. Monitor blood glucose
- C. Administer IV fluids
- D. All of the above
Correct answer: D
Rationale: The key management strategy for diabetic ketoacidosis (DKA) involves a comprehensive approach that includes administering insulin to lower blood glucose levels, monitoring blood glucose levels to ensure they are within the target range, and administering IV fluids to correct dehydration and electrolyte imbalances. Choosing 'All of the above' as the correct answer is the most appropriate because all three interventions are essential components of DKA management. Administering insulin alone without addressing fluid status and monitoring blood glucose could lead to complications. Similarly, solely focusing on IV fluids or blood glucose monitoring without insulin administration would not effectively manage DKA.
4. What are the key interventions for managing a patient with asthma?
- A. Administer bronchodilators and monitor oxygen levels
- B. Encourage deep breathing exercises
- C. Provide corticosteroids and monitor for respiratory distress
- D. Provide antihistamines and monitor blood pressure
Correct answer: A
Rationale: The correct answer is A: Administer bronchodilators and monitor oxygen levels. Asthma management involves using bronchodilators to help open the airways and improve breathing. Monitoring oxygen levels is essential to ensure the patient is getting enough oxygen. Choice B, encouraging deep breathing exercises, can be helpful for some respiratory conditions but is not a key intervention for managing an acute asthma attack. Choice C, providing corticosteroids and monitoring for respiratory distress, is important for long-term asthma management and severe exacerbations but is not the immediate key intervention during an acute attack. Choice D, providing antihistamines and monitoring blood pressure, is not typically indicated for asthma management as asthma is primarily an airway disease, not a histamine-mediated condition.
5. A nurse is reviewing the medical record of a client who has schizophrenia and is taking clozapine. Which of the following findings should the nurse identify as a contraindication to the administration of clozapine?
- A. WBC count 2,900 /mm3.
- B. Fasting blood glucose 100 mg/dl.
- C. Hgb 14 g/dl.
- D. Heart rate 58/min.
Correct answer: A
Rationale: A WBC count of 2,900/mm3 indicates leukopenia, which is a serious side effect of clozapine and contraindicates its use. Leukopenia is a significant concern with clozapine therapy due to the risk of agranulocytosis, a potentially life-threatening condition. Monitoring the WBC count is crucial to detect this adverse effect early. The other options (B, C, and D) are within normal ranges and not contraindications for administering clozapine.
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