ATI LPN
LPN Nursing Fundamentals
1. A client has a new diagnosis of GERD. Which of the following statements should the nurse include in the teaching about dietary management?
- A. You should increase your intake of high-fat foods.
- B. You should decrease your intake of high-fat foods.
- C. You should avoid foods that contain gluten.
- D. You should increase your intake of dairy products.
Correct answer: B
Rationale: The correct answer is to decrease the intake of high-fat foods. High-fat foods can exacerbate symptoms of GERD by delaying stomach emptying and increasing the risk of reflux. By reducing high-fat foods in the diet, the client can help manage symptoms of GERD and decrease the likelihood of complications. Choice A is incorrect because increasing high-fat foods can worsen GERD symptoms. Choice C is unrelated as gluten is not a specific concern for GERD. Choice D is incorrect as increasing dairy products may lead to increased fat intake, which is not recommended for GERD.
2. A client with a history of coronary artery disease is prescribed atorvastatin (Lipitor). What side effect should the nurse instruct the client to immediately report?
- A. Muscle pain or tenderness
- B. Constipation
- C. Dry mouth
- D. Drowsiness
Correct answer: A
Rationale: The correct answer is 'Muscle pain or tenderness.' This can be a sign of rhabdomyolysis, a serious side effect of statins like atorvastatin (Lipitor). Rhabdomyolysis is a condition in which muscle breakdown releases a protein that can damage the kidneys. Therefore, it is crucial for the client to report any muscle pain or tenderness immediately to prevent further complications. Choices B, C, and D are incorrect because they are not typically associated with atorvastatin (Lipitor) use or indicative of a serious adverse effect that requires immediate reporting.
3. A client with a tracheostomy shows signs of respiratory distress. What action should the nurse take immediately?
- A. Increase the suction setting on the ventilator
- B. Administer a bronchodilator
- C. Suction the tracheostomy
- D. Encourage deep breathing exercises
Correct answer: C
Rationale: The correct immediate action for a client with a tracheostomy showing signs of respiratory distress is to suction the tracheostomy. Respiratory distress in this case is often caused by a blockage, which can be quickly relieved by suctioning to clear the airway. Increasing the suction setting on the ventilator (Choice A) may not address the immediate blockage in the tracheostomy. Administering a bronchodilator (Choice B) may help with bronchoconstriction but does not address the potential blockage in the tracheostomy. Encouraging deep breathing exercises (Choice D) may not be effective in relieving the immediate respiratory distress caused by a blocked tracheostomy.
4. A client with chronic stable angina is prescribed nitroglycerin (Nitrostat) for chest pain. The nurse should include which instruction when teaching the client about this medication?
- A. Take nitroglycerin at the first sign of chest pain.
- B. Swallow the tablet whole with water.
- C. Take nitroglycerin with meals to prevent stomach upset.
- D. Store nitroglycerin in a cool, dry place.
Correct answer: A
Rationale: The correct instruction when teaching a client about nitroglycerin (Nitrostat) is to take it at the first sign of chest pain. Nitroglycerin works rapidly to dilate blood vessels, improving blood flow to the heart muscle. Taking it promptly can help alleviate symptoms quickly and prevent the condition from worsening. Choice B is incorrect because nitroglycerin is usually taken sublingually (under the tongue) and not swallowed. Choice C is incorrect because nitroglycerin is not typically taken with meals. Choice D is incorrect because nitroglycerin should be stored in its original container away from heat and light.
5. A nurse is caring for a client who has a chest tube following a thoracotomy. Which of the following findings should the nurse report to the provider?
- A. Drainage of 75 mL in the first hour after surgery.
- B. Constant bubbling in the water seal chamber.
- C. Tidaling in the water seal chamber.
- D. Client report of pain at the chest tube insertion site.
Correct answer: B
Rationale: Constant bubbling in the water seal chamber indicates an air leak, which should be reported to the provider. This finding suggests that the chest tube system is not functioning properly, leading to potential complications such as pneumothorax. Drainage of 75 mL in the first hour after surgery is within the expected range for a chest tube. Tidaling in the water seal chamber is a normal fluctuation and indicates proper functioning of the system. Client report of pain at the chest tube insertion site is expected after surgery and can be managed with appropriate pain management measures.
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