ATI LPN
LPN Fundamentals of Nursing
1. What action should a healthcare provider take for a client with a new colostomy?
- A. Empty the colostomy bag when it is half full.
- B. Place aspirin in the colostomy bag to decrease odor.
- C. Use sterile technique when caring for the stoma.
- D. Change the pouch every 8 hours.
Correct answer: A
Rationale: Emptying the colostomy bag when it is half full is crucial to prevent leakage and detachment from the skin. This practice helps to maintain the integrity of the colostomy system, reducing the risk of skin irritation and odor. It is essential for client comfort and overall stoma care.
2. When administering an IM injection to a 5-month-old infant, which of the following injection sites should be used?
- A. Deltoid
- B. Ventrogluteal
- C. Vastus lateralis
- D. Dorsogluteal
Correct answer: C
Rationale: For infants and young children, the vastus lateralis muscle located over the anterior thigh is the preferred site for intramuscular injections. This site is chosen for its large muscle mass and reduced risk of injury to major nerves and blood vessels. Infants have less developed muscle structures, making the vastus lateralis a safer and more effective site for injections compared to other sites like the deltoid, ventrogluteal, or dorsogluteal. Using the correct injection site is essential to prevent complications and ensure the proper absorption of the medication.
3. A healthcare professional is assessing a client who has deep-vein thrombosis (DVT). Which of the following findings should the professional expect?
- A. Swelling of the affected limb.
- B. Diminished peripheral pulses.
- C. Coolness of the affected limb.
- D. Redness and warmth of the affected limb.
Correct answer: D
Rationale: Redness and warmth of the affected limb are classic signs of deep-vein thrombosis (DVT) due to inflammation and increased blood flow. These symptoms occur as a result of the blood clot obstructing normal blood flow and causing localized inflammation in the affected limb. Swelling of the affected limb, diminished peripheral pulses, and coolness are not typically associated with DVT. Swelling can be present but is often accompanied by the characteristic redness and warmth. Diminished pulses and coolness are more indicative of arterial insufficiency rather than venous thrombosis.
4. A client has a new diagnosis of nephrotic syndrome, and the nurse is providing dietary management education. Which of the following statements should the nurse include in the teaching?
- A. You should increase your intake of high-sodium foods.
- B. You should decrease your intake of high-sodium foods.
- C. You should avoid foods that contain lactose.
- D. You should increase your intake of dairy products.
Correct answer: B
Rationale: For a client with nephrotic syndrome, decreasing the intake of high-sodium foods is essential to manage fluid retention and symptoms of the condition. Excessive sodium can lead to fluid retention, swelling, and worsen the condition. Therefore, advising the client to decrease their high-sodium food intake aligns with the dietary management approach to help control nephrotic syndrome. Choices A, C, and D are incorrect. Increasing high-sodium foods would exacerbate fluid retention, avoiding lactose is not specifically required for nephrotic syndrome, and increasing dairy products may not be necessary unless individualized based on the client's needs and lab values.
5. A client has a new diagnosis of osteoarthritis and is being taught about dietary management. Which of the following statements should be included in the teaching?
- A. Increase your intake of calcium-rich foods.
- B. Avoid foods that are high in potassium.
- C. Increase your intake of vitamin D-rich foods.
- D. Avoid foods that are high in sodium.
Correct answer: C
Rationale: The correct statement to include in the teaching is to increase the intake of vitamin D-rich foods. Vitamin D helps improve calcium absorption, which is beneficial for bone health and may help alleviate symptoms of osteoarthritis. Option A is incorrect because while calcium is important for bone health, the focus should be on vitamin D for calcium absorption. Option B is incorrect as potassium is generally not restricted in osteoarthritis. Option D is also incorrect as sodium restriction is more relevant for conditions like hypertension or heart failure, not specifically for osteoarthritis.
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