ATI LPN
ATI PN Comprehensive Predictor 2020
1. A nurse is preparing to administer medications to a client who is NPO and is receiving enteral feedings through an NG tube. Which of the following prescriptions should the nurse clarify with the provider?
- A. Metoprolol ER 50 mg via NG tube BID
- B. Acetaminophen 650 mg PO BID
- C. Lisinopril 10 mg PO daily
- D. Ondansetron 4 mg IV push PRN
Correct answer: B
Rationale: The nurse should clarify prescription B, Acetaminophen 650 mg PO BID, with the provider. When a patient is NPO and receiving enteral feedings through an NG tube, medications administered orally may be contraindicated due to the risk of aspiration. Therefore, Acetaminophen should be confirmed for safety in this situation. The other options (Metoprolol ER 50 mg via NG tube BID, Lisinopril 10 mg PO daily, Ondansetron 4 mg IV push PRN) are appropriate and do not need clarification in this scenario.
2. What is the most appropriate next step when a client with an NG tube attached to low suctioning becomes nauseated, and the nurse observes a decrease in the flow of gastric secretions?
- A. Increase the suction pressure
- B. Irrigate the NG tube with sterile water
- C. Turn the client on their side
- D. Replace the NG tube with a new one
Correct answer: B
Rationale: The correct answer is to irrigate the NG tube with sterile water. When a client with an NG tube attached to low suctioning becomes nauseated and there is a decrease in the flow of gastric secretions, it indicates a possible blockage in the tube. Irrigating the tube with sterile water can help clear the blockage, allowing for proper suctioning and relieving the client's nausea. Increasing the suction pressure (Choice A) can further worsen the issue by potentially causing harm to the client. Turning the client on their side (Choice C) may not address the underlying problem of tube blockage. Replacing the NG tube with a new one (Choice D) should only be considered if other interventions, like irrigation, fail to clear the blockage.
3. A client with a new prescription for prednisone for the treatment of Addison's disease needs teaching. Which instruction should the nurse include?
- A. Take the medication with food
- B. Avoid taking aspirin
- C. Schedule a bone density test
- D. Expect increased appetite
Correct answer: C
Rationale: The correct instruction for the nurse to include is to schedule a bone density test. Prednisone can lead to reduced bone density, making regular monitoring crucial for clients on long-term therapy. Instructing the client to take the medication with food (choice A) or avoid taking aspirin (choice B) are not directly related to prednisone therapy for Addison's disease. While prednisone can cause increased appetite, it is not the priority instruction in this scenario, compared to monitoring bone density (choice D).
4. A nurse is teaching a client with diabetes about insulin administration. What is the most important point to emphasize?
- A. Check blood sugar once in the morning
- B. Administer insulin before meals as prescribed
- C. Administer insulin only when feeling unwell
- D. Monitor blood sugar only in the evening
Correct answer: B
Rationale: The most important point to emphasize when teaching a client with diabetes about insulin administration is to administer insulin before meals as prescribed. This is crucial for maintaining proper blood sugar control throughout the day. Choice A is incorrect because blood sugar levels need to be monitored multiple times a day, not just once in the morning. Choice C is incorrect because insulin should be administered according to the prescribed schedule, not only when feeling unwell. Choice D is incorrect because blood sugar monitoring should be done at various times during the day, not just in the evening.
5. When assessing a client with signs of delirium, which factor should be the nurse's priority in determining the cause?
- A. Medication history
- B. Fluid and electrolyte imbalances
- C. Psychosocial stressors
- D. Environmental factors
Correct answer: B
Rationale: When a nurse assesses a client with signs of delirium, the priority in determining the cause should be focusing on fluid and electrolyte imbalances. Delirium can often be linked to imbalances in these essential elements, making it crucial to address them promptly. While medication history, psychosocial stressors, and environmental factors can also contribute to delirium, they should be assessed after addressing fluid and electrolyte imbalances due to their immediate impact on cognitive function.
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