ATI LPN
ATI PN Comprehensive Predictor 2023 with NGN
1. A nurse is reviewing the medical record of a client who has schizophrenia and is taking clozapine. Which of the following findings should the nurse identify as a contraindication to the administration of clozapine?
- A. WBC count 2,900 /mm3.
- B. Fasting blood glucose 100 mg/dl.
- C. Hgb 14 g/dl.
- D. Heart rate 58/min.
Correct answer: A
Rationale: A WBC count of 2,900/mm3 indicates leukopenia, which is a serious side effect of clozapine and contraindicates its use. Leukopenia is a significant concern with clozapine therapy due to the risk of agranulocytosis, a potentially life-threatening condition. Monitoring the WBC count is crucial to detect this adverse effect early. The other options (B, C, and D) are within normal ranges and not contraindications for administering clozapine.
2. When caring for a client with a prescription for wound irrigation, which action should the nurse take?
- A. Use a 10-mL syringe with an 18-gauge needle.
- B. Cleanse the wound from the center outward.
- C. Apply a wet-to-dry dressing.
- D. Pack the wound tightly with gauze.
Correct answer: B
Rationale: When caring for a client with a prescription for wound irrigation, the nurse should cleanse the wound from the center outward. This technique helps prevent the introduction of microorganisms into the wound, reducing the risk of contamination and promoting effective wound healing. By using a circular motion from the cleanest area to the least clean areas, debris and bacteria are moved away from the wound site, decreasing the chances of infection.
3. A client is reinforcing teaching with a nurse about how to use an incentive spirometer. Which of the following actions by the client indicates an understanding of the teaching?
- A. The client exhales deeply before inhaling
- B. The client attempts to elevate the cylinder by inhaling deeply
- C. The client inhales quickly through the spirometer
- D. The client inhales several short breaths
Correct answer: B
Rationale: The correct answer is B because inhaling deeply and slowly elevates the cylinder on the spirometer, promoting lung expansion. Choice A is incorrect as exhaling deeply before inhaling is not the correct technique for using an incentive spirometer. Choice C is incorrect as inhaling quickly through the spirometer does not promote optimal lung expansion. Choice D is incorrect as inhaling several short breaths does not facilitate the proper use of an incentive spirometer.
4. A patient is receiving chemotherapy and reports nausea. Which of the following dietary recommendations should the nurse make?
- A. Eat foods served hot
- B. Drink liquids between meals
- C. Eat dry cereal
- D. Choose foods with a strong aroma
Correct answer: C
Rationale: The correct recommendation for a patient receiving chemotherapy and experiencing nausea is to suggest eating dry, bland foods like cereal. These types of foods are often better tolerated as they are less likely to trigger nausea compared to aromatic or hot foods. Drinking liquids between meals, as suggested in option B, can be helpful to prevent dehydration but may not specifically address the nausea. Eating foods with a strong aroma, as in option D, may actually worsen nausea in patients undergoing chemotherapy.
5. Following a CVA, the nurse assesses that a client developed dysphagia, hypoactive bowel sounds, and a firm, distended abdomen. Which prescription for the client should the nurse question?
- A. Continuous tube feeding at 65 ml/hr via gastrostomy.
- B. Total parenteral nutrition to be infused at 125 ml/hour.
- C. Nasogastric tube connected to low intermittent suction.
- D. Metoclopramide (Reglan) intermittent piggyback.
Correct answer: A
Rationale: In a client with dysphagia, hypoactive bowel sounds, and a firm, distended abdomen post-CVA, continuous tube feeding at 65 ml/hr via gastrostomy may exacerbate abdominal distension and hypoactive bowel sounds. This situation requires immediate assessment and reevaluation before continuing with the prescription.
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