ATI LPN
ATI PN Comprehensive Predictor 2020
1. A nurse is reviewing the laboratory results for a client who has Cushing's disease. The nurse should expect the client to have an increase in which of the following laboratory values?
- A. Serum glucose level.
- B. Serum calcium level.
- C. Lymphocyte count.
- D. Serum potassium level.
Correct answer: A
Rationale: The correct answer is A: Serum glucose level. In Cushing's disease, there is an excess production of cortisol, leading to hyperglycemia. This results in an increase in serum glucose levels. Choices B, C, and D are incorrect because Cushing's disease does not directly affect serum calcium levels, lymphocyte count, or serum potassium levels.
2. What action should the nurse take for a client struggling to void after having an indwelling catheter removed?
- A. Assess for bladder distention after 2 hours
- B. Encourage the client to try urinating in a sitting position
- C. Pour warm water over the client's perineum
- D. Restrict the client's fluid intake
Correct answer: C
Rationale: The correct action for the nurse to take is to pour warm water over the client's perineum. This intervention helps stimulate urination after catheter removal by providing warmth and promoting relaxation of the muscles. Assessing for bladder distention after 2 hours (Choice A) is not the initial intervention to facilitate voiding. Encouraging the client to try urinating in a sitting position (Choice B) may be uncomfortable if the client is struggling to void. Restricting the client's fluid intake (Choice D) is not appropriate as it can further exacerbate the issue by concentrating the urine.
3. After abdominal surgery, a client has a nasogastric tube attached to low suctioning. The client becomes nauseated, and the nurse observes a decrease in the flow of gastric secretions. Which of the following nursing interventions would be MOST appropriate?
- A. Irrigate the nasogastric tube with distilled water
- B. Aspirate the gastric contents with a syringe
- C. Administer an antiemetic medication
- D. Insert a new nasogastric tube
Correct answer: B
Rationale: The most appropriate nursing intervention when a client with a nasogastric tube experiences nausea and a decrease in gastric secretions is to aspirate the gastric contents with a syringe. This action helps relieve nausea by removing excess fluid and gas. Option A, irrigating the nasogastric tube with distilled water, is not indicated as it does not address the underlying issue of decreased gastric secretions. Option C, administering an antiemetic medication, may provide symptomatic relief but does not address the mechanical issue of decreased flow in the nasogastric tube. Option D, inserting a new nasogastric tube, is not necessary unless there are specific complications or obstructions in the current tube.
4. A client who is to undergo surgery for a hip fracture is being taught by a nurse about postoperative pain management. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will ask for pain medication only if the pain becomes unbearable.
- B. I will ask the nurse to increase my medication if the pain doesn't subside.
- C. I will wait until the pain is severe before taking my medication.
- D. I will take my medication at regular intervals to stay ahead of the pain.
Correct answer: D
Rationale: The correct answer is D because taking pain medication at regular intervals helps maintain consistent pain control after surgery. Option A is incorrect because waiting for the pain to become unbearable can lead to inadequate pain management. Option B is incorrect as it suggests increasing medication without a schedule. Option C is incorrect because waiting for the pain to be severe before taking medication is not proactive pain management.
5. When teaching a client with left-leg weakness how to use a cane, which instruction should the nurse include?
- A. Use the cane on the weak side of the body
- B. Advance the cane and the strong leg simultaneously
- C. Maintain two points of support on the floor
- D. Advance the cane 30 to 45 cm (12-18 in) with each step
Correct answer: C
Rationale: The correct instruction for the client with left-leg weakness using a cane is to maintain two points of support on the floor. This ensures stability and balance while walking. Choice A is incorrect because the cane should be used on the strong side of the body to provide additional support. Choice B is incorrect as the cane and the weak leg should move together for support. Choice D is incorrect as advancing the cane too far with each step may compromise balance and stability.
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