ATI LPN
ATI PN Comprehensive Predictor 2023 with NGN
1. Which dietary restriction should be taught to a client with chronic kidney disease?
- A. Increase potassium-rich foods
- B. Limit phosphorus and potassium intake
- C. Encourage increased protein intake
- D. Increase fluid intake
Correct answer: B
Rationale: The correct answer is B: Limit phosphorus and potassium intake. In chronic kidney disease, the kidneys are unable to effectively filter these minerals from the blood, leading to their accumulation and potential complications. Restricting phosphorus and potassium intake is crucial in managing the progression of the disease. Choice A is incorrect as increasing potassium-rich foods can worsen the condition. Choice C is also incorrect as excessive protein intake can put more strain on the kidneys. Choice D is not the priority; rather, fluid intake should be monitored based on individual needs and stage of kidney disease.
2. What is the most appropriate next step when a client with an NG tube attached to low suctioning becomes nauseated, and the nurse observes a decrease in the flow of gastric secretions?
- A. Increase the suction pressure
- B. Irrigate the NG tube with sterile water
- C. Turn the client on their side
- D. Replace the NG tube with a new one
Correct answer: B
Rationale: The correct answer is to irrigate the NG tube with sterile water. When a client with an NG tube attached to low suctioning becomes nauseated and there is a decrease in the flow of gastric secretions, it indicates a possible blockage in the tube. Irrigating the tube with sterile water can help clear the blockage, allowing for proper suctioning and relieving the client's nausea. Increasing the suction pressure (Choice A) can further worsen the issue by potentially causing harm to the client. Turning the client on their side (Choice C) may not address the underlying problem of tube blockage. Replacing the NG tube with a new one (Choice D) should only be considered if other interventions, like irrigation, fail to clear the blockage.
3. How should a healthcare professional assess a patient with chest pain?
- A. Assess the severity of pain and monitor ECG
- B. Administer nitroglycerin and provide oxygen
- C. Administer aspirin and provide pain relief
- D. Monitor for nausea and administer IV fluids
Correct answer: A
Rationale: When assessing a patient with chest pain, the initial step is to assess the severity of pain and monitor the electrocardiogram (ECG) to look for signs of cardiac issues. Administering nitroglycerin and oxygen (Choice B) is a treatment option for suspected cardiac chest pain but should not precede a thorough assessment. Administering aspirin and providing pain relief (Choice C) may be indicated later, but the priority is to assess the situation first. Monitoring for nausea and administering IV fluids (Choice D) is not the initial assessment for chest pain unless there are specific indications present.
4. A nurse is planning care for a preschool-age child who is in the acute phase of Kawasaki disease. Which of the following interventions should the nurse include in the plan of care?
- A. Administer scheduled doses of acetaminophen every 6 hr.
- B. Monitor the child's cardiac status.
- C. Administer antibiotics via intermittent IV bolus for 24 hr.
- D. Provide stimulation with children of the same age in the playroom.
Correct answer: B
Rationale: Monitoring cardiac status is crucial during the acute phase of Kawasaki disease because of the potential for coronary artery complications. Acetaminophen may be used for fever management but is not the priority intervention. Antibiotics are not indicated as Kawasaki disease is not caused by a bacterial infection. Providing stimulation in the playroom is important for the child's emotional well-being but does not address the immediate physiological concern of cardiac monitoring.
5. Which nursing action is best when managing a client with severe anxiety?
- A. Maintain a calm manner
- B. Help the client identify thoughts prior to the anxiety
- C. Administer anti-anxiety medication
- D. Initiate seclusion if anxiety escalates
Correct answer: A
Rationale: The correct answer is to maintain a calm manner. When managing a client with severe anxiety, the nurse's calm presence can help the client feel more secure and reduce their anxiety levels. It is essential to create a safe and supportive environment. Helping the client identify thoughts prior to anxiety (choice B) may be beneficial in cognitive-behavioral interventions but may not be the initial best action for severe anxiety. Administering anti-anxiety medication (choice C) should be done by a healthcare provider's order and is not the first-line intervention for managing severe anxiety. Initiating seclusion (choice D) should only be considered as a last resort if the client is at risk of harm to themselves or others, as it can further escalate anxiety and should not be the initial action.
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