ATI LPN
ATI PN Comprehensive Predictor 2020
1. A nurse is caring for a client who has a chest tube following a thoracotomy. Which of the following findings should the nurse report to the provider?
- A. Drainage of 75 mL in the first hour after surgery.
- B. Constant bubbling in the water seal chamber.
- C. Tidaling in the water seal chamber.
- D. Client report of pain at the chest tube insertion site.
Correct answer: B
Rationale: Constant bubbling in the water seal chamber indicates an air leak, which should be reported to the provider. This finding suggests that the chest tube system is not functioning properly, leading to potential complications such as pneumothorax. Drainage of 75 mL in the first hour after surgery is within the expected range for a chest tube. Tidaling in the water seal chamber is a normal fluctuation and indicates proper functioning of the system. Client report of pain at the chest tube insertion site is expected after surgery and can be managed with appropriate pain management measures.
2. When receiving change-of-shift report for a group of clients, which time-management strategy should the nurse plan to implement?
- A. Prepare a priority list of client needs for the shift
- B. Complete less time-consuming tasks first
- C. Handle urgent client needs at the end of the shift
- D. Work on each client as they are seen
Correct answer: A
Rationale: Preparing a priority list of client needs for the shift is the most effective time-management strategy for a nurse receiving change-of-shift report. This approach helps the nurse identify and address the most urgent client needs first, ensuring efficient use of time. Choice B is incorrect because focusing on less time-consuming tasks first may result in crucial tasks being delayed. Choice C is incorrect as urgent client needs should be handled promptly, not postponed until the end of the shift. Choice D is inefficient as it does not prioritize tasks based on urgency, potentially leading to delays in addressing critical client needs.
3. 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.
4. 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.
5. A client with diabetes is being discharged. What is an essential teaching point?
- A. Monitor blood sugar levels once a week
- B. Instruct the client to administer insulin before meals
- C. Teach the client to exercise regularly to maintain glucose control
- D. Administer oral hypoglycemics as needed
Correct answer: B
Rationale: Instructing the client to administer insulin before meals is a crucial teaching point for a client with diabetes. This action ensures proper glucose management by helping to control blood sugar levels. Monitoring blood sugar levels once a week (Choice A) may not be frequent enough to manage diabetes effectively. While regular exercise (Choice C) is beneficial for glucose control, the immediate administration of insulin is more critical at the time of discharge. Administering oral hypoglycemics as needed (Choice D) is inappropriate as it does not address the need for insulin administration for a client being discharged.
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