ATI LPN
ATI Pediatrics Proctored Exam 2023 with NGN
1. The client is being taught about perineal care postpartum. Which instruction should the client receive?
- A. Use ice packs to reduce swelling for the first 24 hours.
- B. Apply heat packs immediately after birth to reduce pain.
- C. Avoid using a peri-bottle to cleanse the perineum.
- D. Use tampons to absorb lochia discharge.
Correct answer: A
Rationale: The correct instruction for the client postpartum is to use ice packs to reduce swelling for the first 24 hours. This helps alleviate discomfort and promote healing. Applying heat packs immediately after birth is not recommended as they can increase swelling. A peri-bottle is advised for cleansing the perineum, not to be avoided. Tampons should not be used to absorb lochia discharge as they can increase the risk of infection. Therefore, the use of ice packs is the most appropriate and beneficial instruction for perineal care postpartum.
2. A nurse is assessing a client who gave birth 1 week ago. The client states, 'I don't know what's wrong. I love my baby, but I feel so let down and I seem to cry for no reason.' The nurse should identify that the client is experiencing which of the following emotional responses to birth?
- A. Postpartum depression
- B. Taking-in phase
- C. Postpartum blues
- D. Taking-hold phase
Correct answer: C
Rationale: The client is experiencing postpartum blues, not postpartum depression. Postpartum blues are common and characterized by mood swings, tearfulness, and emotional letdown shortly after delivery. The 'Taking-in phase' involves the mother focusing on her own needs, while the 'Taking-hold phase' is characterized by a desire to learn and feel competent in caring for the baby. Postpartum depression is a more severe and long-lasting condition that requires professional intervention.
3. When assessing a client with suspected meningitis, which finding is indicative of meningeal irritation?
- A. Brudzinski's sign
- B. Positive Babinski reflex
- C. Kernig's sign
- D. Both A and C
Correct answer: D
Rationale: Both Brudzinski's sign and Kernig's sign are classic signs of meningeal irritation, commonly associated with meningitis. Brudzinski's sign is positive when flexing the neck causes involuntary flexion of the hips and knees due to irritation of the meninges. Kernig's sign is positive when there is pain and resistance with knee extension after hip flexion, indicating meningeal irritation or inflammation. The Babinski reflex, mentioned in choice B, is a test used to assess upper motor neuron damage and is not specific to meningitis. Therefore, choices A and C are the correct options as they are indicative of meningeal irritation in a suspected case of meningitis.
4. A highly successful individual presents to the community mental health center complaining of sleeplessness and anxiety over their financial status. What action should the nurse take to assist this client in diminishing their anxiety?
- A. Encourage them to initiate daily rituals.
- B. Reinforce the reality of their financial situation.
- C. Direct them to drink a glass of red wine at bedtime.
- D. Teach them to limit sugar and caffeine intake.
Correct answer: D
Rationale: Teaching the individual to limit sugar and caffeine intake is an appropriate intervention to reduce anxiety and improve sleep quality. Sugar and caffeine can exacerbate anxiety symptoms and disrupt sleep patterns. By reducing their intake, the individual may experience a decrease in anxiety levels and better sleep. Encouraging daily rituals, reinforcing financial realities, or suggesting alcohol consumption before bed are not evidence-based strategies for managing anxiety and sleeplessness.
5. Which lifestyle change should be emphasized for a client with hypertension?
- A. Increase sodium intake to prevent fluid retention
- B. Reduce sodium and caffeine intake
- C. Increase protein intake to promote muscle strength
- D. Increase intake of high-fat foods
Correct answer: B
Rationale: The correct answer is B: 'Reduce sodium and caffeine intake.' Clients with hypertension benefit from reducing sodium intake as it can help lower blood pressure levels. Caffeine also has a vasoconstrictive effect, which can increase blood pressure. Choices A, C, and D are incorrect. Increasing sodium intake would exacerbate hypertension due to fluid retention. While protein intake is important for overall health, it is not a primary focus in managing hypertension. Increasing intake of high-fat foods can lead to weight gain and negatively impact heart health, which is counterproductive for someone with hypertension.
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