ATI LPN
LPN Fundamentals of Nursing
1. A healthcare provider is planning care for a client who has a pressure ulcer. Which of the following actions should the healthcare provider take?
- A. Massage the reddened area.
- B. Apply a heating pad to the area.
- C. Elevate the head of the bed to 45 degrees.
- D. Reposition the client every 2 hours.
Correct answer: D
Rationale: Repositioning the client every 2 hours is crucial in preventing pressure ulcers from worsening. This action helps relieve pressure on specific areas, improving circulation and reducing the risk of tissue damage. Massaging the reddened area can further damage the skin, applying heat can increase the risk of skin breakdown, and elevating the head of the bed to 45 degrees may not directly address the pressure ulcer prevention. Proper positioning is essential to avoid prolonged pressure on the affected areas and promote healing.
2. A healthcare professional is preparing to perform nasotracheal suctioning for a client. Which of the following actions should the healthcare professional take?
- A. Suction during inhalation.
- B. Apply intermittent suction during insertion.
- C. Place the client in a supine position.
- D. Insert the catheter while the client is inhaling.
Correct answer: D
Rationale: Inserting the catheter while the client is inhaling helps to align the trachea and vocal cords, reducing the risk of trauma to the respiratory tract. This technique also facilitates easier passage of the catheter into the trachea, enhancing the effectiveness of the suctioning procedure.
3. A client with celiac disease is being taught about dietary management. Which statement by the client indicates an understanding of the teaching?
- A. I should avoid foods that contain gluten.
- B. I should increase my intake of foods high in gluten.
- C. I should avoid foods that contain lactose.
- D. I should increase my intake of foods high in lactose.
Correct answer: A
Rationale: The correct answer is A: 'I should avoid foods that contain gluten.' Celiac disease requires the avoidance of gluten-containing foods to manage symptoms and prevent complications. Gluten is found in wheat, barley, and rye. Choices B, C, and D are incorrect as they do not align with the dietary requirements for managing celiac disease. Increasing intake of foods high in gluten or lactose would be detrimental for someone with celiac disease.
4. A client has a prescription for a clear liquid diet. Which of the following foods should the nurse offer?
- A. Milk
- B. Vegetable juice
- C. Chicken broth
- D. Orange juice with pulp
Correct answer: C
Rationale: A clear liquid diet consists of easily digestible transparent liquids. Chicken broth is an appropriate choice as it meets the criteria of being clear and liquid, making it suitable for a clear liquid diet. Milk, vegetable juice, and orange juice with pulp are not considered clear liquids. Milk is not transparent, vegetable juice is not clear, and orange juice with pulp contains solid particles, all of which do not align with the requirements of a clear liquid diet.
5. A healthcare professional is assessing a client who has chronic pain. Which of the following findings should the healthcare professional expect?
- A. Hypotension
- B. Tachycardia
- C. Hyperthermia
- D. Depression
Correct answer: D
Rationale: The correct answer is D: Depression. Chronic pain is often associated with psychological effects like depression. Patients with chronic pain may experience feelings of hopelessness, helplessness, and despair, which are characteristic of depression. While chronic pain can lead to changes in vital signs like increased blood pressure and heart rate, hypotension, tachycardia, or hyperthermia are not typically expected findings solely due to chronic pain. Therefore, the healthcare professional should be alert to signs of depression in clients with chronic pain and address these psychological impacts appropriately.
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