ATI LPN
ATI PN Comprehensive Predictor 2020
1. 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.
2. What are the key signs of increased intracranial pressure (ICP) that a nurse should monitor for?
- A. Monitor for changes in level of consciousness
- B. Check for pupil dilation
- C. Assess for bradycardia
- D. Monitor for vomiting
Correct answer: A
Rationale: The correct answer is A: 'Monitor for changes in the level of consciousness.' Key signs of increased intracranial pressure (ICP) include changes in the level of consciousness and pupil dilation. Assessing for bradycardia and monitoring for vomiting are not typically considered primary signs of increased ICP. While bradycardia and vomiting can occur with increased ICP, they are not as specific or sensitive as changes in consciousness and pupil dilation.
3. What are the risk factors for stroke, and how can it be prevented?
- A. High cholesterol and hypertension; prevent with regular exercise
- B. Obesity and smoking; prevent with medication and weight loss
- C. Diabetes and alcohol consumption; prevent with regular checkups
- D. Lack of exercise and poor diet; prevent with lifestyle changes
Correct answer: A
Rationale: The correct answer is A. High cholesterol and hypertension are significant risk factors for stroke. Regular exercise is an effective way to prevent stroke by managing these risk factors. Choice B is incorrect as while obesity and smoking are risk factors, preventing stroke through medication and weight loss is not the primary method. Choice C is incorrect as diabetes and alcohol consumption are risk factors, but preventing stroke through regular checkups is not as direct as managing cholesterol and hypertension. Choice D is incorrect as lack of exercise and a poor diet are indeed risk factors, but the prevention of stroke through lifestyle changes needs to specifically address high cholesterol and hypertension.
4. What are the nursing interventions for a patient with neutropenia?
- A. Monitor for signs of infection and administer antibiotics
- B. Isolate the patient and provide a low-microbial diet
- C. Monitor vital signs and avoid unnecessary invasive procedures
- D. Encourage the patient to engage in social activities
Correct answer: A
Rationale: The correct nursing interventions for a patient with neutropenia include monitoring for signs of infection and administering antibiotics. Neutropenia is characterized by a low neutrophil count, which increases the risk of infections. Monitoring for signs of infection allows for early detection and prompt treatment, while administering antibiotics helps prevent or treat any infections that may occur. Isolating the patient and providing a low-microbial diet (Choice B) are not necessary unless the patient develops an active infection. Monitoring vital signs and avoiding unnecessary invasive procedures (Choice C) are important but do not specifically address the increased infection risk in neutropenic patients. Encouraging the patient to engage in social activities (Choice D) is not appropriate for a neutropenic patient due to the risk of exposure to infectious agents.
5. A nurse is teaching a client who is taking warfarin about food and medication interactions. Which of the following foods should the nurse instruct the client to avoid?
- A. Tomatoes
- B. Apples
- C. Broccoli
- D. Green leafy vegetables
Correct answer: D
Rationale: Correct Answer: Green leafy vegetables - Green leafy vegetables are high in vitamin K, which can interfere with the effectiveness of warfarin. Tomatoes, apples, and broccoli are not contraindicated with warfarin therapy. While they are healthy choices, they do not have a significant impact on warfarin's effectiveness.
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