ATI LPN
LPN Fundamentals of Nursing
1. When teaching a client how to perform self-catheterization, which of the following instructions should be included?
- A. Use sterile gloves during the procedure.
- B. Clean the catheter with alcohol after each use.
- C. Insert the catheter 2-4 inches into the urethra.
- D. Perform the procedure every 8 hours.
Correct answer: C
Rationale: To ensure effective drainage, the catheter should be inserted 2-4 inches into the urethra. This length allows the catheter to reach the bladder, bypass the urethral sphincters, and ensure proper drainage without causing discomfort or injury. Using sterile gloves, cleaning the catheter with alcohol, and performing the procedure every 8 hours are not accurate instructions for self-catheterization.
2. When teaching a client with a new diagnosis of hypertension about medication adherence, which statement should the nurse include?
- A. You can stop taking your medication once your blood pressure is normal.
- B. You should take your medication at the same time every day.
- C. You can double your dose if you miss a dose.
- D. You should take your medication with a high-fat meal.
Correct answer: B
Rationale: The correct answer is B: 'You should take your medication at the same time every day.' Taking medication consistently at the same time daily is crucial for maintaining steady blood levels and effectively managing hypertension. It helps ensure that the medication works optimally and provides the best control of blood pressure throughout the day. Choice A is incorrect because stopping medication once blood pressure is normal can lead to a relapse or worsening of hypertension. Choice C is incorrect as doubling the dose without healthcare provider guidance can be dangerous. Choice D is incorrect as taking medication with a high-fat meal can affect its absorption and efficacy.
3. A healthcare provider is planning care for a client who has a pressure ulcer. Which of the following interventions should the healthcare provider include?
- A. Massage the ulcer
- B. Apply a heating pad
- C. Reposition the client every 2 hours
- D. Use alcohol-based cleansers
Correct answer: C
Rationale: Repositioning the client every 2 hours is a crucial intervention in the management of pressure ulcers. This action helps redistribute pressure, reducing the risk of further skin breakdown and promoting wound healing. Massaging the ulcer can cause further damage to the skin and underlying tissues. Applying a heating pad can increase the risk of skin breakdown and should be avoided. Alcohol-based cleansers are too harsh for pressure ulcers and can irritate the skin, potentially delaying healing.
4. A client with lactose intolerance is being taught about dietary management by a nurse. Which statement by the client shows an understanding of the teaching?
- A. I should avoid foods that contain lactose.
- B. I should increase my intake of dairy products.
- C. I should avoid foods that contain gluten.
- D. I should increase my intake of high-fiber foods.
Correct answer: A
Rationale: The correct answer is A: 'I should avoid foods that contain lactose.' Lactose intolerance results from the inability to digest lactose, a sugar found in dairy products. Avoiding foods that contain lactose is essential in managing symptoms like bloating, diarrhea, and abdominal pain. Choice B is incorrect because increasing dairy intake would worsen symptoms. Choice C is incorrect because gluten is unrelated to lactose intolerance. Choice D is incorrect because high-fiber foods are beneficial for other conditions but do not specifically address lactose intolerance.
5. Which of the following statements indicates the client understands the colostomy care instructions?
- A. I will change the colostomy bag once a week.
- B. I will avoid eating high-fiber foods.
- C. I will clean around the stoma with mild soap and water.
- D. I will apply lotion to the skin around the stoma.
Correct answer: C
Rationale: The correct answer is C. Cleaning around the stoma with mild soap and water is crucial for colostomy care as it helps prevent infection and skin irritation. Changing the colostomy bag frequency, dietary modifications, or applying lotion are not primary aspects of stoma care. Proper cleaning around the stoma helps maintain hygiene and prevents complications, making it a key component of caring for a colostomy.
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