ATI LPN
ATI PN Comprehensive Predictor 2024
1. A client has developed phlebitis at the IV site. What should the nurse do first?
- A. Apply a warm compress to the IV site
- B. Discontinue the IV and notify the provider
- C. Monitor the IV site for signs of infection
- D. Administer an anti-inflammatory medication
Correct answer: B
Rationale: When a client develops phlebitis at the IV site, the priority action for the nurse is to discontinue the IV and notify the provider. Phlebitis is inflammation of the vein, and removing the IV can help prevent further complications. Applying a warm compress may provide symptomatic relief but does not address the root cause. Monitoring for infection is important, but immediate action to remove the source of inflammation is crucial. Administering an anti-inflammatory medication is not the first-line intervention for phlebitis; removal of the IV is necessary.
2. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following findings should the nurse report to the provider?
- A. Blood glucose level of 120 mg/dL
- B. White blood cell count of 8,000/mm³
- C. Temperature of 37.2°C (99°F)
- D. Daily weight increase of 0.45 kg (1 lb)
Correct answer: D
Rationale: The correct answer is D. A sudden weight increase may indicate fluid retention, a complication of TPN therapy that should be reported. Options A, B, and C are within normal ranges and do not directly relate to TPN therapy complications. A blood glucose level of 120 mg/dL is normal, a white blood cell count of 8,000/mm³ is within the normal range, and a temperature of 37.2°C (99°F) is also normal.
3. As a new B.S.N. graduate aspiring to become a Public Health Nurse, where should you consider applying?
- A. Department of Health
- B. Provincial Health Office
- C. Regional Health Office
- D. Rural Health Unit
Correct answer: D
Rationale: As a new B.S.N. graduate aspiring to become a Public Health Nurse, the ideal place to apply would be the Rural Health Unit. This is because R.A. 7160 decentralized basic health services to local government units (LGUs), making public health nurses employees of the LGUs. Rural Health Units are typically operated by LGUs and focus on providing primary healthcare services to rural communities, making them a suitable starting point for someone interested in public health nursing.
4. A nurse is reviewing information about advance directives with a newly admitted client. Which statement by the client indicates an understanding of the teaching?
- A. My family can make decisions if I am unable to.
- B. I have a living will that outlines my wishes when I am unable to make a decision.
- C. I can write down my wishes, but they aren't legally binding.
- D. I don't need to worry about this until I’m critically ill.
Correct answer: B
Rationale: Choice B is the correct answer because having a living will is a legal document that outlines a client's wishes when they are unable to make decisions, indicating a good understanding of advance directives. Choice A is incorrect because it doesn't mention a specific document like a living will. Choice C is incorrect because advance directives, like a living will, can be legally binding. Choice D is incorrect because planning for advance directives should ideally be done before a person becomes critically ill.
5. A patient with deep vein thrombosis (DVT) is prescribed warfarin. Which dietary instruction should the nurse provide?
- A. Avoid foods high in vitamin K.
- B. Increase intake of dairy products.
- C. Limit intake of citrus fruits.
- D. Avoid high-sodium foods.
Correct answer: A
Rationale: Patients on warfarin should avoid foods high in vitamin K because vitamin K can interfere with the anticoagulant effect of the medication. Warfarin works by inhibiting vitamin K-dependent clotting factors, so consuming large amounts of vitamin K-rich foods may decrease the effectiveness of the medication. Choices B, C, and D are incorrect. Increasing intake of dairy products, limiting citrus fruits, or avoiding high-sodium foods are not directly related to the mechanism of action of warfarin or its dietary considerations.
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