ATI LPN
LPN Pediatrics
1. 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.
2. A client is admitted to the hospital with a diagnosis of myocardial infarction (MI). Which diagnostic test is most likely to be ordered to confirm this diagnosis?
- A. Echocardiogram
- B. Electrocardiogram (ECG)
- C. Chest X-ray
- D. Complete blood count (CBC)
Correct answer: B
Rationale: An Electrocardiogram (ECG) is the primary diagnostic tool used to confirm a myocardial infarction. An ECG provides immediate information on cardiac function and can show characteristic changes indicative of a myocardial infarction, such as ST-segment elevation or depression. An echocardiogram (Choice A) is useful for assessing heart structure and function but is not typically used as the primary test for confirming an acute myocardial infarction. Chest X-ray (Choice C) may show certain changes in heart size or pulmonary congestion but is not the primary diagnostic test for MI. A Complete Blood Count (CBC) (Choice D) provides information about the cellular components of blood and is not specific to confirming a myocardial infarction.
3. A nurse is planning care for a client who has chronic kidney disease. Which finding indicates the need for hemodialysis?
- A. BUN 14 mg/dL
- B. Serum potassium 4.2 mEq/L
- C. Serum creatinine 5 mg/dL
- D. Serum calcium 9 mg/dL
Correct answer: C
Rationale: The correct answer is C. A serum creatinine level of 5 mg/dL is significantly elevated and indicates the need for hemodialysis to help filter waste products from the blood. Elevated creatinine levels suggest impaired kidney function and the inability to effectively filter waste from the body. Choices A, B, and D are within normal ranges and do not indicate the need for immediate hemodialysis in a client with chronic kidney disease.
4. A client gave birth 2 hours ago, and their blood pressure is 60/50 mm Hg. What action should the nurse take first?
- A. Evaluate the firmness of the uterus.
- B. Initiate oxygen therapy via a non-rebreather mask.
- C. Administer oxytocin infusion.
- D. Obtain a type and crossmatch.
Correct answer: A
Rationale: Assessing the firmness of the uterus is crucial in this situation. A uterus that is not firm could indicate postpartum hemorrhage, a common cause of low blood pressure after childbirth. By evaluating the firmness of the uterus, the nurse can quickly identify and address potential complications, such as excessive bleeding. Initiating oxygen therapy, administering oxytocin infusion, or obtaining a type and crossmatch may be necessary interventions later, but assessing the firmness of the uterus takes precedence as the first step in managing postpartum complications.
5. A nurse is caring for a client who is 2 days postoperative following abdominal surgery and has a new prescription for a regular diet. For which of the following findings should the nurse notify the provider?
- A. Presence of bowel sounds
- B. Client reports nausea
- C. Client is vomiting
- D. Absent bowel sounds
Correct answer: D
Rationale: The correct answer is D. Absent bowel sounds are concerning as they indicate potential complications such as ileus, which is a risk after abdominal surgery. The absence of bowel sounds can suggest decreased or absent intestinal motility, which may lead to complications if not addressed promptly. The nurse should notify the provider immediately to assess the situation and intervene accordingly. Choices A and B are common postoperative occurrences and do not necessarily warrant immediate provider notification. Choice C, vomiting, while concerning, may be a common postoperative symptom; however, absent bowel sounds are a more critical finding that requires prompt attention.
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