ATI LPN
ATI PN Comprehensive Predictor
1. When managing a physically assaultive client, the nurse's INITIAL priority is to
- A. Restrict the client to the room
- B. Place the client under one-to-one supervision
- C. Restore the client's self-control and prevent further loss of control
- D. Clear the immediate area of other clients to prevent harm
Correct answer: C
Rationale: When dealing with a physically assaultive client, the initial priority is to focus on restoring the client's self-control and preventing further escalation. Restricting the client to the room (choice A) may escalate the situation and is not the initial priority. Placing the client under one-to-one supervision (choice B) is important but comes after ensuring the client's self-control. Clearing the immediate area of other clients (choice D) is essential for safety but is not the initial priority when compared to restoring the client's self-control.
2. When assessing a client reporting severe pain in the right lower quadrant of the abdomen, which sign would most likely indicate appendicitis?
- A. Rebound tenderness at McBurney's point.
- B. Positive Murphy's sign.
- C. Rovsing's sign.
- D. Cullen's sign.
Correct answer: A
Rationale: Rebound tenderness at McBurney's point is a classic sign of appendicitis. This sign indicates peritoneal irritation, a common feature of appendicitis. McBurney's point is located in the right lower quadrant of the abdomen and is a focal point for assessing tenderness. Positive Murphy's sign is associated with cholecystitis, not appendicitis. Rovsing's sign is elicited by palpation of the left lower quadrant resulting in pain in the right lower quadrant, also suggestive of appendicitis. Cullen's sign is associated with acute pancreatitis and manifests as periumbilical ecchymosis.
3. A nurse has administered medications to a group of clients. For which of the following client situations should the nurse complete an incident report?
- A. Administering acetaminophen to an NPO client
- B. Administering insulin lispro to an NPO client
- C. Administering medication to the incorrect client
- D. Administering anticoagulants without checking INR
Correct answer: B
Rationale: The correct answer is B because administering insulin lispro to an NPO client can lead to hypoglycemia due to the lack of food to balance the medication. This situation poses a serious risk to the client's safety and should be documented in an incident report. Choice A is not as critical as insulin administration for an NPO client. Choice C is also serious but does not pose an immediate risk to the client's health. Choice D, administering anticoagulants without checking the INR, is important but does not require an incident report unless adverse effects occur, as it may not immediately endanger the client's life.
4. A client at 28 weeks of gestation is experiencing preterm labor. Which of the following medications should the nurse plan to administer?
- A. Oxytocin
- B. Nifedipine
- C. Dinoprostone
- D. Misoprostol
Correct answer: B
Rationale: Nifedipine is the correct choice in this scenario. It is a calcium channel blocker that helps suppress uterine contractions and halt preterm labor. Nifedipine is commonly used to manage preterm labor in pregnant women by relaxing the smooth muscle of the uterus. Oxytocin (Choice A) is used to induce or augment labor, not to inhibit contractions. Dinoprostone (Choice C) and Misoprostol (Choice D) are prostaglandins used for cervical ripening and induction of labor, not for stopping preterm labor.
5. Where is the most appropriate location to perform a procedure on a preschooler?
- A. Perform the procedure in the child's hospital bed.
- B. Perform the procedure in the treatment room.
- C. Allow the child to decide when the procedure will be performed.
- D. Ask the parents to help restrain the child so the procedure can be performed.
Correct answer: B
Rationale: When performing a procedure on a preschooler, it is most appropriate to do so in the treatment room. This setting is specifically designed to provide a suitable environment with necessary equipment and resources to ensure the procedure is carried out safely and efficiently. It helps minimize distractions and provides a controlled environment for healthcare providers to focus on the child's needs. Choices A, C, and D are incorrect because performing the procedure in the child's hospital bed may lack the necessary resources and equipment, allowing the child to decide when the procedure will be performed may not be feasible due to medical necessity and urgency, and asking parents to help restrain the child is not ideal as it may not provide a professional and controlled setting for the procedure.
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