ATI LPN
LPN Fundamentals of Nursing Quizlet
1. A healthcare professional is preparing to administer an intramuscular injection to a client. Which of the following actions should the healthcare professional take?
- A. Use a 1-inch needle.
- B. Stretch the skin at the injection site.
- C. Insert the needle at a 90-degree angle.
- D. Aspirate for blood return before injecting.
Correct answer: D
Rationale: Aspirating for blood return before injecting is a crucial step in administering intramuscular injections. This action ensures that the needle is not in a blood vessel, reducing the risk of injecting medication into a blood vessel, which can lead to potential complications. Choices A, B, and C are incorrect. Using a longer 1-inch needle is often necessary for intramuscular injections to reach the muscle tissue properly. Stretching the skin is not recommended as it can cause unnecessary pain and tissue damage. Inserting the needle at a 90-degree angle is the preferred method for intramuscular injections to ensure proper medication delivery.
2. A nurse is caring for a client who has a prescription for metoprolol. For which of the following findings should the nurse withhold the medication?
- A. Heart rate 56/min.
- B. Oxygen saturation 93%.
- C. Respiratory rate 18/min.
- D. Blood pressure 118/74 mm Hg.
Correct answer: A
Rationale: The correct answer is A: Heart rate 56/min. Metoprolol, a beta blocker, should be withheld if the client's heart rate is below 60/min to prevent further bradycardia. Choices B, C, and D are within normal ranges and do not indicate a need to withhold metoprolol.
3. A client with cirrhosis of the liver is being cared for by the healthcare team. Which clinical manifestation indicates that the client has developed hepatic encephalopathy?
- A. Asterixis.
- B. Jaundice.
- C. Ascites.
- D. Splenomegaly.
Correct answer: A
Rationale: Asterixis, also known as flapping tremor, is a characteristic sign of hepatic encephalopathy, a severe complication of liver cirrhosis. Hepatic encephalopathy results from the liver's inability to detoxify substances in the body, leading to neurologic manifestations such as changes in mental status, confusion, and asterixis.
4. A client is receiving morphine. Which of the following should the nurse monitor?
- A. Liver function
- B. Respiratory rate
- C. Blood glucose levels
- D. Bowel sounds
Correct answer: B
Rationale: Corrected Rationale: When a client is receiving morphine, monitoring the respiratory rate is crucial because morphine can cause respiratory depression. Therefore, it is essential for the nurse to assess the client's breathing to detect any signs of respiratory distress. Choices A, C, and D are incorrect because morphine primarily affects the respiratory system, not the liver function, blood glucose levels, or bowel sounds.
5. What is the appropriate action for a healthcare professional when administering a blood transfusion?
- A. Verify the patient's identity
- B. Monitor vital signs
- C. Stay with the patient during the first 15 minutes
- D. Stop the transfusion if a reaction occurs
Correct answer: A
Rationale: The appropriate action for a healthcare professional when administering a blood transfusion is to verify the patient's identity. This step is essential to ensure that the correct blood product is given to the right patient, preventing any errors or adverse reactions. While monitoring vital signs and staying with the patient during the initial phase of the transfusion are also important steps, the primary action of verifying the patient's identity takes precedence to uphold patient safety and prevent any potential harm.
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