ATI LPN
ATI PN Comprehensive Predictor 2023
1. What are the key considerations for managing a patient with COPD?
- A. Bronchodilators
- B. Smoking cessation
- C. Pulmonary rehabilitation
- D. Oxygen therapy
Correct answer: D
Rationale: The key considerations for managing a patient with COPD include oxygen therapy, which is essential to maintain adequate oxygen saturation levels. While bronchodilators are commonly used to manage COPD symptoms, they are not the primary consideration. Smoking cessation is crucial in preventing further damage but is not a direct management consideration. Pulmonary rehabilitation is beneficial for improving exercise capacity and quality of life but is not as crucial as ensuring adequate oxygen therapy.
2. A nurse is caring for a client who has end-stage osteoporosis and is reporting severe pain. The client’s respiratory rate is 14 per minute. Which of the following medications should the nurse prioritize administering?
- A. Promethazine
- B. Hydromorphone
- C. Ketorolac
- D. Amitriptyline
Correct answer: B
Rationale: Hydromorphone, an opioid, is the most appropriate option for managing severe pain in this context. Opioids provide fast-acting relief for acute pain associated with advanced osteoporosis. Promethazine (Choice A) is an antihistamine and not indicated for pain relief. Ketorolac (Choice C) is a nonsteroidal anti-inflammatory drug (NSAID) that may increase the risk of bleeding and is not recommended for severe pain management. Amitriptyline (Choice D) is a tricyclic antidepressant that is not the first-line treatment for severe acute pain.
3. A client has hyperthermia. Which of the following actions should the nurse take?
- A. Submerge the client's feet in ice water.
- B. Cover the client with a thermal blanket.
- C. Administer oral acetaminophen.
- D. Initiate seizure precautions.
Correct answer: C
Rationale: Administering oral acetaminophen is the appropriate intervention for a client with hyperthermia. Acetaminophen helps to reduce fever by lowering the body's temperature. Submerging the client's feet in ice water can lead to shock and is not recommended. Using a thermal blanket may worsen the condition by trapping heat. Initiating seizure precautions is not directly related to managing hyperthermia.
4. When a father asks why his child with tetralogy of Fallot seems to favor a squatting position, the nurse would explain that squatting:
- A. Increases peripheral vascular resistance
- B. Decreases arterial blood flow away from the heart
- C. It's a common resting position when a child is tachycardic
- D. Increases the workload of the heart
Correct answer: A
Rationale: Squatting increases systemic vascular resistance, which leads to a reduction in the right-to-left shunting of blood in children with tetralogy of Fallot. This helps improve oxygenation by balancing the pulmonary and systemic blood flow. The squatting position decreases the pressure in the right ventricle and reduces the magnitude of the right-to-left shunt by increasing afterload, thereby improving oxygenation. Choices B, C, and D are incorrect because squatting does not decrease arterial blood flow away from the heart, is not related to being tachycardic, and does not increase the workload of the heart.
5. Which of the following interventions should the nurse implement for a client with dementia who is at risk of falling?
- A. Keep the bed in the lowest position
- B. Raise all four side rails to prevent falls
- C. Assist with ambulation every 2 hours
- D. Use a bed exit alarm to notify staff of attempts to leave the bed
Correct answer: D
Rationale: The correct intervention for a client with dementia at risk of falling is to use a bed exit alarm to notify staff of attempts to leave the bed. This intervention helps in preventing falls by alerting the staff when the client tries to get out of bed. Keeping the bed in the lowest position (Choice A) may not prevent falls and could make it challenging for staff to provide care. Raising all four side rails (Choice B) can be a restraint and is not recommended as it may lead to entrapment or other risks. Assisting with ambulation every 2 hours (Choice C) may not be feasible or effective in preventing falls, as the client may attempt to get out of bed at any time.
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