ATI LPN
ATI Adult Medical Surgical
1. After performing a paracentesis on a client with ascites, 3 liters of fluid are removed. Which assessment parameter is most critical for the nurse to monitor following the procedure?
- A. Pedal pulses.
- B. Breath sounds.
- C. Gag reflex.
- D. Vital signs.
Correct answer: D
Rationale: Following a paracentesis where a significant amount of fluid is removed, it is crucial to monitor the client's vital signs. This helps in detecting any signs of hypovolemia, such as changes in blood pressure, heart rate, and respiratory rate, which could indicate complications post-procedure. Monitoring the vital signs allows for prompt intervention if there are any deviations from the baseline values.
2. When inserting an oropharyngeal airway in a small child, what is the preferred method?
- A. Insert the airway with the curvature towards the roof of the mouth and then rotate it 180 degrees.
- B. Insert the airway as you would in an adult, but use an airway that is one size smaller than usual.
- C. Depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue.
- D. Open the airway with the tongue-jaw lift maneuver and insert the airway until slight resistance is met.
Correct answer: C
Rationale: When inserting an oropharyngeal airway in a small child, it is crucial to depress the tongue with a tongue blade and insert the airway with the downward curve facing the tongue. This technique helps in maintaining an open airway and preventing obstruction by the tongue. Placing the airway with the curve facing the roof of the mouth or using a smaller size is not recommended for small children, as it may not effectively keep the airway patent. The tongue-jaw lift maneuver is not the preferred method for inserting an oropharyngeal airway in small children.
3. A nurse in a long-term care facility is assisting with an in-service for newly hired assistive personnel about legal issues within the facility. Which of the following should the nurse include as an example of assault?
- A. Threatening to withhold food from a client
- B. Informing a client about an upcoming procedure
- C. Informing a client about risks of refusing treatment
- D. Informing a client that they will be given an injection against their will
Correct answer: D
Rationale: The correct answer is D because assault involves threatening a client with harm or unwanted procedures. In this scenario, informing a client that they will be given an injection against their will constitutes assault. Choices A, B, and C do not involve the element of threatening harm or unwanted procedures, making them incorrect. Choice A is more related to neglect, choice B is related to informing the client about a procedure, and choice C is related to informed consent and refusal of treatment, not assault.
4. A client with a peptic ulcer had a partial gastrectomy and vagotomy (Billroth I). In planning the discharge teaching, the client should be cautioned by the nurse about which of the following?
- A. Sit up for at least 30 minutes after eating
- B. Avoid fluids between meals
- C. Increase the intake of high-carbohydrate foods
- D. Avoid eating large meals that are high in simple sugars and liquids
Correct answer: D
Rationale: The correct answer is D: 'Avoid eating large meals that are high in simple sugars and liquids.' Clients who have undergone partial gastrectomy are at risk of dumping syndrome, which can occur due to the rapid emptying of stomach contents into the small intestine. Consuming large meals high in simple sugars and liquids can exacerbate this syndrome, leading to symptoms like abdominal cramping and diarrhea. Choices A, B, and C are not directly related to preventing dumping syndrome and are not the priority concerns for a client post-partial gastrectomy.
5. How should a healthcare professional assess a patient for potential deep vein thrombosis (DVT)?
- A. Assess for unilateral leg swelling
- B. Encourage early mobilization
- C. Check for calf tenderness
- D. Observe for redness and warmth
Correct answer: A
Rationale: To assess a patient for potential deep vein thrombosis (DVT), healthcare professionals should look for unilateral leg swelling. This is a classic sign of DVT. While encouraging early mobilization is generally beneficial for preventing DVT, it is not a method of assessment. Checking for calf tenderness is also relevant but not as specific as unilateral leg swelling. Observing for redness and warmth can be signs of inflammation but are not as specific to DVT as unilateral leg swelling.
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