which of the following is an early sign that suctioning is needed for a client with a tracheostomy
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Nursing Elites

ATI LPN

ATI NCLEX PN Predictor Test

1. What is an early sign that suctioning is needed for a client with a tracheostomy?

Correct answer: B

Rationale: Irritability is an early sign that suctioning is needed for a client with a tracheostomy. When secretions accumulate in the airway, it can lead to discomfort and irritability in the client. Bradycardia, hypotension, and decreased oxygen saturation are usually later signs of inadequate airway clearance and oxygenation. Bradycardia may indicate severe hypoxia, while hypotension and decreased oxygen saturation are consequences of prolonged airway obstruction.

2. A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following actions should the nurse take to promote wound healing?

Correct answer: B

Rationale: The correct answer is to ensure the client consumes adequate protein. Protein is essential for wound healing as it supports tissue repair. Applying heat to the surgical site (choice A) is not recommended as it can increase inflammation. Although ambulation (choice C) is beneficial for circulation and preventing complications, it is not directly related to promoting wound healing. Instructing the client to drink 4 liters of water daily (choice D) is excessive and not specifically related to wound healing in this context.

3. What is the healthcare provider's role in providing patient education about hypertension management?

Correct answer: A

Rationale: The correct answer is A: Encourage lifestyle modifications and medication adherence. Patient education in hypertension management should focus on encouraging lifestyle changes like a healthy diet, exercise, stress management, and adherence to prescribed medications. Choices B, C, and D are incorrect because advising patients to avoid physical activity, recommending a low-sodium diet, and increasing potassium intake, although related to hypertension management, do not encompass the comprehensive approach needed for effective patient education on this topic.

4. A nurse is reviewing the medical record of a client who has diabetes mellitus and is receiving insulin. Which of the following findings should the nurse report to the provider?

Correct answer: C

Rationale: A blood glucose level of 200 mg/dL indicates hyperglycemia and should be reported for potential insulin adjustment.

5. A client expresses doubt about the benefits of surgery. Which response by the nurse is most appropriate?

Correct answer: D

Rationale: Option D is the most appropriate response as it acknowledges the client's expressed uncertainty about the surgery. By acknowledging the client's feelings, the nurse validates their concerns and opens the door for further discussion. This approach can help build trust and rapport with the client. Option A focuses more on seeking justification for the client's belief rather than addressing the underlying emotion. Option B, while acknowledging doubt, does not directly address the client's feelings. Option C, although well-intentioned, dismisses the client's concerns without exploring them further.

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