ATI LPN
ATI PN Comprehensive Predictor
1. Which of the following is an early sign that suctioning is required for a client with a tracheostomy?
- A. Bradycardia
- B. Irritability
- C. Confusion
- D. Hypotension
Correct answer: B
Rationale: Irritability is an early sign that suctioning is necessary to clear the airway in a client with a tracheostomy. When secretions build up in the tracheostomy tube, the client may become irritable due to the discomfort and the compromised airway. Bradycardia, confusion, and hypotension are not typically early signs that suctioning is required. Bradycardia may occur if the airway becomes severely compromised, confusion may be a late sign of hypoxia, and hypotension is not directly related to the need for suctioning in a client with a tracheostomy.
2. A nurse is caring for four clients. Which client should the nurse assess first?
- A. A client scheduled to receive chemotherapy for the first time
- B. A client post-appendectomy with diminished bowel sounds
- C. A client with hypothyroidism who is stuporous
- D. A client with burns requiring a sterile dressing change
Correct answer: C
Rationale: The correct answer is C. The client with hypothyroidism who is stuporous should be assessed first as this may indicate a critical condition, possibly related to severe hypothyroidism. Stupor is a state of near-unconsciousness or insensibility, suggesting a decline in neurological function that requires immediate evaluation. Choices A, B, and D do not present with immediate life-threatening conditions that require urgent assessment. While chemotherapy, post-appendectomy complications, and burn care are important, they do not pose the same level of immediate risk as a stuporous client.
3. A patient is being discharged with a prescription for an antidepressant for their depression. Which instruction is most important?
- A. Take the medication with food to prevent stomach upset.
- B. Refrain from driving until you understand the effects of the medication.
- C. Do not discontinue the medication suddenly.
- D. Avoid alcohol consumption while taking this medication.
Correct answer: C
Rationale: The most critical instruction is to not discontinue the antidepressant medication suddenly. Abrupt discontinuation can lead to withdrawal symptoms and potentially trigger a relapse of depression. Options A, B, and D are important but not as crucial as ensuring the patient follows the prescribed regimen and consults with a healthcare provider before making any changes to the medication routine.
4. When a patient with schizophrenia is taking haloperidol, what is a priority assessment for the nurse?
- A. Assessing for signs of tardive dyskinesia
- B. Monitoring for signs of neuroleptic malignant syndrome
- C. Checking for signs of depression
- D. Monitoring for changes in appetite
Correct answer: B
Rationale: Monitoring for signs of neuroleptic malignant syndrome is crucial for patients taking haloperidol. Neuroleptic malignant syndrome is a rare but serious side effect that can occur with antipsychotic medications like haloperidol. It presents with symptoms such as high fever, unstable blood pressure, confusion, muscle rigidity, and autonomic dysfunction. Early detection and intervention are essential to prevent serious complications.
5. A healthcare professional is reviewing the lab report of a client who has been experiencing a fever for the last 3 days. What lab result indicates the client is experiencing fluid volume deficit (FVD)?
- A. Decreased hematocrit
- B. Increased BUN
- C. Increased hematocrit
- D. Decreased urine specific gravity
Correct answer: C
Rationale: An increased hematocrit level indicates dehydration or fluid volume deficit. Hematocrit measures the proportion of blood volume that is occupied by red blood cells, and when a client is experiencing fluid volume deficit, there is less fluid in the blood, causing the concentration of red blood cells to be higher, leading to an increased hematocrit level. Decreased hematocrit (Choice A) is more indicative of fluid volume excess. Increased BUN (Choice B) is associated with renal function and dehydration but is not a direct indicator of FVD. Decreased urine specific gravity (Choice D) is also associated with dehydration, but an increased hematocrit is a more specific indicator of fluid volume deficit.
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