what should the nurse do to minimize the risk of injury for a client with dementia
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ATI PN Comprehensive Predictor 2020 Answers

1. What should be done to minimize the risk of injury for a client with dementia?

Correct answer: A

Rationale: The correct answer is to ensure the client has consistent caregivers. This helps reduce confusion and stress for clients with dementia by providing familiarity and routine. Dimming the lights in the client's room (Choice B) may not directly address the risk of injury. Allowing the client to sleep with the bedrails raised (Choice C) can pose a risk if not properly monitored. Encouraging family members to stay with the client (Choice D) may not always be feasible and may not provide the necessary professional support and consistency that consistent caregivers can offer.

2. A nurse is providing dietary teaching for a client with chronic kidney disease. What should be emphasized?

Correct answer: B

Rationale: The correct answer is to emphasize limiting the intake of potassium and phosphorus for a client with chronic kidney disease. Excessive intake of potassium and phosphorus can lead to complications in kidney disease patients. Choice A is incorrect because increasing protein intake can put additional stress on the kidneys. Choice C is incorrect as excessive fluid intake can worsen kidney function in such clients. Choice D is incorrect as encouraging high-sodium foods can lead to fluid retention and hypertension, which are not beneficial for individuals with chronic kidney disease.

3. A nurse has just received change-of-shift report for four clients. Which of the following clients should the nurse assess first?

Correct answer: A

Rationale: The client with low blood glucose needs immediate assessment to ensure that the orange juice has corrected the hypoglycemia. Monitoring the effectiveness of the intervention for low blood glucose is the priority. The other options, such as a client scheduled for a procedure in 1 hour, a client with fluid remaining in the IV bag, and a client who received pain medication 30 minutes ago, do not require immediate assessment like the client with low blood glucose.

4. A client has developed phlebitis at the IV site. What should the nurse do first?

Correct answer: B

Rationale: When a client develops phlebitis at the IV site, the priority action for the nurse is to discontinue the IV and notify the provider. Phlebitis is inflammation of the vein, and removing the IV can help prevent further complications. Applying a warm compress may provide symptomatic relief but does not address the root cause. Monitoring for infection is important, but immediate action to remove the source of inflammation is crucial. Administering an anti-inflammatory medication is not the first-line intervention for phlebitis; removal of the IV is necessary.

5. What are the nursing responsibilities when administering intravenous (IV) antibiotics?

Correct answer: A

Rationale: When administering IV antibiotics, it is essential for the nurse to verify the antibiotic dosage and check for any allergies the patient may have. This is crucial to ensure that the correct medication is being given at the proper dose and to prevent potential adverse reactions. Choice B is incorrect because administering medication without verification can lead to errors. Choice C is incorrect as it goes against safe medication administration practices. Choice D is incorrect as the focus should be on checking if the patient has allergies to antibiotics, not ensuring the patient is allergic to them.

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