ATI LPN
ATI PN Comprehensive Predictor 2023
1. After sustaining a closed head injury and numerous lacerations and abrasions to the face and neck, a five-year-old child is admitted to the emergency room. The client is unconscious and has minimal response to noxious stimuli. Which of the following assessments, if observed by the nurse three hours after admission, should be reported to the physician?
- A. The client has slight edema of the eyelids
- B. There is clear fluid draining from the client's right ear
- C. There is some bleeding from the child's lacerations
- D. The client withdraws in response to painful stimuli
Correct answer: B
Rationale: Clear fluid draining from the ear can indicate cerebrospinal fluid leakage, which is a serious concern after a head injury. This leakage can signify a skull fracture or damage to the meninges, potentially leading to infection. Therefore, it should be reported immediately for further evaluation and management. Choices A, C, and D are typical findings after head trauma and are not as urgent as the presence of clear fluid draining from the ear.
2. A 56-year-old white male complains of intermittent dysphagia for the past three months, particularly with the ingestion of meat. He has no difficulties swallowing liquids. He has no history of smoking, uses no medications, and has had no weight loss. What test would be best to evaluate him?
- A. Upper endoscopy
- B. Chest/abdominal CT scan
- C. Barium swallow
- D. Esophageal manometry
Correct answer: C
Rationale: For a patient presenting with intermittent dysphagia, especially with solids like meat, a barium swallow is the most appropriate initial test. In this case, the classic presentation suggests a Schatzki’s ring, which is best visualized through a barium study. Upper endoscopy may not always visualize Schatzki’s rings effectively. Chest/abdominal CT scan and esophageal manometry are not the preferred tests for diagnosing Schatzki’s rings. Treatment for Schatzki’s rings often involves bougie dilatation, and no further therapy may be necessary.
3. What is the most important step when preparing to administer a blood transfusion?
- A. Check if the client has a fever
- B. Ensure the blood type is compatible with the client
- C. Administer the blood via IV push
- D. Ensure the blood is warmed to body temperature
Correct answer: B
Rationale: The correct answer is B: Ensure the blood type is compatible with the client. This is the most crucial step in preparing for a blood transfusion to prevent severe transfusion reactions. Checking the client for a fever (Choice A) is important but not the most critical step. Administering blood via IV push (Choice C) is incorrect as blood transfusions are usually administered as a slow drip. Warming the blood to body temperature (Choice D) is not a standard practice and can lead to hemolysis, making it an incorrect choice.
4. A nurse is assessing a client who has a calcium level of 8.0 mg/dL. Which of the following findings should the nurse expect?
- A. Constipation
- B. Absent deep-tendon reflexes
- C. Nausea and vomiting
- D. Tingling of the extremities
Correct answer: D
Rationale: Correct! A calcium level of 8.0 mg/dL indicates hypocalcemia. Hypocalcemia can lead to increased neuromuscular excitability, manifesting as tingling of the extremities. Choices A, B, and C are incorrect findings associated with other electrolyte imbalances or conditions and are not typically related to hypocalcemia. Constipation is commonly seen in hypokalemia, absent deep-tendon reflexes are associated with hypermagnesemia, and nausea and vomiting are more indicative of hypercalcemia.
5. A nurse is assisting the nurse manager with an educational session about ways to prevent TORCH infections during pregnancy with a group of newly licensed nurses. Which of the following statements by one of the session participants indicates understanding?
- A. Seeking an immunization against rubella early in pregnancy.
- B. Receiving prophylactic treatment for cytomegalovirus if detected during pregnancy.
- C. Clients should avoid crowded places during pregnancy.
- D. Clients should avoid consuming undercooked meat while pregnant.
Correct answer: D
Rationale: The correct answer is D. To prevent TORCH infections during pregnancy, it is essential for clients to avoid consuming undercooked meat, as it can be a potential source of toxoplasmosis. This infection, along with others in the TORCH group, can pose risks to the fetus, making it crucial for pregnant individuals to follow proper food safety practices. Choices A, B, and C are incorrect because seeking an immunization against rubella, receiving prophylactic treatment for cytomegalovirus, and avoiding crowded places are not directly related to preventing TORCH infections through food safety measures.
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