ATI LPN
LPN Fundamentals of Nursing
1. When assessing a client with chronic pain, which of the following is the most reliable indicator of the client's pain?
- A. The client's vital signs.
- B. The client's self-report of pain.
- C. The client's body language.
- D. The client's medical history.
Correct answer: B
Rationale: The client's self-report of pain is the most reliable indicator of pain. Pain is a subjective experience, and the client's self-report provides direct insight into their perception of pain intensity, quality, and impact on daily life. Vital signs, body language, and medical history can offer additional information but may not accurately reflect the client's actual pain experience. Therefore, relying on the client's self-report ensures a more accurate assessment of their pain and helps in tailoring appropriate interventions and treatment plans.
2. While assessing a client with fluid volume deficit, which of the following findings should the nurse expect?
- A. Bradycardia
- B. Increased skin turgor
- C. Dry mucous membranes
- D. Hypertension
Correct answer: C
Rationale: Dry mucous membranes are a classic clinical manifestation of fluid volume deficit. Dehydration leads to reduced fluid intake or excessive fluid loss, resulting in decreased moisture in the mucous membranes. Bradycardia, increased skin turgor, and hypertension are not typically associated with fluid volume deficit. Bradycardia is more commonly seen in conditions like hypothyroidism or increased intracranial pressure. Increased skin turgor is a sign of dehydration, not deficit. Hypertension is not a typical finding in fluid volume deficit.
3. A client has a new prescription for a low-sodium diet. Which of the following foods should the nurse recommend?
- A. Pickles
- B. Canned soup
- C. Fresh fruits
- D. Smoked salmon
Correct answer: C
Rationale: Fresh fruits are naturally low in sodium, making them a suitable choice for a low-sodium diet. They provide essential nutrients and are a healthy option for individuals who need to limit their sodium intake. Pickles (Choice A) and canned soup (Choice B) are typically high in sodium and should be avoided in a low-sodium diet. Smoked salmon (Choice D) is also usually high in sodium due to the smoking process, so it is not a recommended choice for a low-sodium diet.
4. A client has a new diagnosis of renal calculi, and the nurse is teaching about dietary management. Which of the following statements should the nurse include in the teaching?
- A. You should increase your intake of calcium-rich foods.
- B. You should decrease your intake of calcium-rich foods.
- C. You should increase your intake of sodium-rich foods.
- D. You should decrease your intake of potassium-rich foods.
Correct answer: B
Rationale: The correct answer is to decrease the intake of calcium-rich foods when managing renal calculi. Calcium can contribute to the formation of stones in the kidneys, so reducing its intake can help prevent the development of new calculi and manage existing ones.
5. When teaching a client with a new diagnosis of hepatitis about dietary management, which of the following statements should the nurse include?
- A. Increase your intake of high-protein foods.
- B. Decrease your intake of high-protein foods.
- C. Avoid foods that contain lactose.
- D. Increase your intake of dairy products.
Correct answer: B
Rationale: For a client with hepatitis, it is important to decrease the intake of high-protein foods. High-protein foods can be harder for the liver to process and may exacerbate symptoms or contribute to liver damage. Recommending a diet with moderate protein intake is beneficial for managing symptoms and promoting liver health. Choice A is incorrect as increasing high-protein foods can strain the liver. Choice C is not directly related to hepatitis unless there is an intolerance present. Choice D is also incorrect because increasing dairy products may not be suitable for all individuals with hepatitis, especially if there are underlying liver conditions that could be aggravated by certain dairy components.
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