ATI LPN
ATI PN Comprehensive Predictor 2024
1. A nurse is planning discharge teaching about cord care for the parents of a newborn. Which of the following instructions should the nurse plan to include in the teaching?
- A. Clean the base of the cord with hydrogen peroxide daily.
- B. The cord stump will fall off in 5 days.
- C. Contact the provider if the cord stump turns black.
- D. Keep the cord stump dry until it falls off.
Correct answer: D
Rationale: The correct answer is to keep the cord stump dry until it falls off. This is important to promote natural healing and prevent infection. Choice A is incorrect because cleaning the cord with hydrogen peroxide daily can actually delay healing and increase the risk of infection. Choice B is incorrect as the cord stump typically falls off within 1 to 3 weeks, not in 5 days. Choice C is incorrect because a cord stump turning black is a normal part of the healing process and does not necessarily indicate a problem requiring immediate provider contact.
2. A client receiving chemotherapy has developed stomatitis. Which of the following actions should the nurse take?
- A. Provide lemon-glycerin swabs
- B. Encourage the client to eat soft foods
- C. Avoid using toothpaste
- D. Instruct the client to use a mouthwash containing alcohol
Correct answer: B
Rationale: The correct action for the nurse to take when caring for a client with stomatitis due to chemotherapy is to encourage the client to eat soft foods. Soft foods help prevent further irritation to the already inflamed and sore oral mucosa. Providing lemon-glycerin swabs may further irritate the mucosa due to the acidic nature of lemon. Avoiding toothpaste is advisable as many toothpaste products contain ingredients that can aggravate stomatitis. Instructing the client to use a mouthwash containing alcohol is contraindicated as alcohol-based mouthwashes can be too harsh and drying for the already sensitive oral tissues.
3. A nurse in the emergency department is caring for a client who has full-thickness burns of the thorax and upper torso. After securing the client's airway, which of the following is the nurse's priority intervention?
- A. Providing pain management.
- B. Offering emotional support.
- C. Preventing infection.
- D. Initiating IV fluids.
Correct answer: D
Rationale: After securing the airway, initiating IV fluids is the priority to prevent hypovolemic shock in clients with severe burns. IV fluids help maintain circulating volume and prevent a drop in blood pressure due to fluid loss. Providing pain management, offering emotional support, and preventing infection are important aspects of care but are secondary to ensuring adequate fluid resuscitation in clients with severe burns.
4. What are the side effects of chemotherapy, and how should they be managed?
- A. Nausea, vomiting; manage with antiemetics
- B. Hair loss and anemia; manage with blood transfusions
- C. Diarrhea and fatigue; manage with hydration
- D. Weight gain and high blood pressure; manage with diuretics
Correct answer: A
Rationale: The correct side effects of chemotherapy mentioned in this question are nausea and vomiting. These side effects are commonly managed with antiemetics to improve the quality of life for patients undergoing chemotherapy. Choice B (Hair loss and anemia) is incorrect as hair loss and anemia are potential side effects of chemotherapy but are not addressed in this question. Choice C (Diarrhea and fatigue) is also incorrect as it does not match the side effects provided. Choice D (Weight gain and high blood pressure) is inaccurate as these are not typical side effects of chemotherapy.
5. A home health nurse is preparing for an initial visit with an older adult client who lives alone. Which of the following actions should the nurse take first?
- A. Educate the client about their current medical diagnosis.
- B. Refer the client to a meal delivery program.
- C. Identify environmental hazards in the home.
- D. Arrange transportation for the client to follow-up appointments.
Correct answer: C
Rationale: Identifying environmental hazards in the client's home is the priority during the initial visit with an older adult living alone. This action is crucial to prevent accidents, falls, and ensure the client's safety. While educating the client about their medical diagnosis, referring them to a meal delivery program, and arranging transportation for follow-up appointments are essential, addressing environmental hazards takes precedence as it directly impacts the client's immediate safety and well-being.
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