ATI LPN
ATI PN Comprehensive Predictor 2023 with NGN
1. How should a healthcare provider manage care for a patient with a wound infection?
- A. Administer prescribed antibiotics
- B. Clean the wound with saline
- C. Apply a sterile dressing
- D. Monitor for signs of sepsis
Correct answer: A
Rationale: When managing care for a patient with a wound infection, administering prescribed antibiotics is crucial. Antibiotics are necessary to treat the infection and prevent it from worsening. While cleaning the wound with saline and applying a sterile dressing are important components of wound care, the primary treatment for a wound infection is antibiotics. Monitoring for signs of sepsis is also essential, but administering antibiotics promptly is the most critical step in managing a wound infection.
2. What is the first nursing action when caring for a client with a wound infection?
- A. Change the dressing every 12 hours
- B. Perform a wound culture before applying antibiotics
- C. Cleanse the wound with normal saline
- D. Apply a wet-to-dry dressing to the wound
Correct answer: B
Rationale: The first nursing action when caring for a client with a wound infection is to perform a wound culture before applying antibiotics. This step is crucial to identify the specific infecting organism and determine the most effective antibiotic therapy. Choices A, C, and D are incorrect because changing the dressing, cleansing the wound, or applying a wet-to-dry dressing should only be done after obtaining the culture results and starting appropriate antibiotic treatment.
3. What intervention is essential for a client with dehydration?
- A. Monitor electrolyte levels regularly
- B. Administer oral rehydration solutions
- C. Increase fluid intake to maintain hydration
- D. Administer intravenous fluids to treat dehydration
Correct answer: B
Rationale: Administering oral rehydration solutions is essential for a client with dehydration as it helps replenish lost fluids and electrolytes directly through the oral route. Monitoring electrolyte levels regularly (Choice A) is important but not as essential as providing immediate rehydration. Increasing fluid intake to maintain hydration (Choice C) may not be sufficient for a client already dehydrated and needing rapid replenishment. Administering intravenous fluids (Choice D) is a more invasive intervention typically reserved for severe cases of dehydration or when the client cannot tolerate oral fluids.
4. What is the priority nursing action for a client with dehydration?
- A. Administer oral fluids
- B. Monitor electrolyte levels
- C. Administer antiemetics as needed
- D. Encourage bed rest
Correct answer: B
Rationale: The priority nursing action for a client with dehydration is to monitor electrolyte levels. Dehydration can cause imbalances in electrolytes such as sodium and potassium, affecting essential bodily functions. Monitoring electrolyte levels is crucial to promptly identify and correct any imbalances. While administering oral fluids (Choice A) is vital in treating dehydration, monitoring electrolyte levels takes precedence as it directly addresses the underlying imbalance. Administering antiemetics (Choice C) may be necessary for nausea and vomiting but is not the priority over electrolyte monitoring. Encouraging bed rest (Choice D) can conserve energy but is not as critical as monitoring electrolyte levels to prevent complications related to electrolyte imbalances.
5. A nurse is teaching a client who has diabetes mellitus about foot care. Which of the following instructions should the nurse include?
- A. Soak feet in hot water daily
- B. Use a heating pad on the feet daily
- C. Cut toenails straight across
- D. Massage feet with lotion daily
Correct answer: C
Rationale: The correct answer is C: 'Cut toenails straight across.' This instruction is crucial for clients with diabetes to prevent ingrown toenails and potential foot complications. Soaking feet in hot water daily (Choice A) can lead to skin damage and is not recommended for diabetic individuals. Using a heating pad on the feet daily (Choice B) can cause burns or injuries due to reduced sensation in the feet that often accompanies diabetes. Massaging feet with lotion daily (Choice D) is generally safe but may not address the specific preventive measure of cutting toenails correctly.
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