ATI LPN
LPN Fundamentals of Nursing
1. What is a true statement about caring for a client with a nasogastric (NG) tube?
- A. The NG tube should be flushed with 30 mL of water every 4 hours.
- B. The client should be positioned in a supine position.
- C. The NG tube should be advanced 5 cm if resistance is met.
- D. The client's nasal mucosa should be inspected daily.
Correct answer: A
Rationale: Flushing the NG tube with 30 mL of water every 4 hours is crucial to maintain its patency and prevent blockages. This routine ensures the tube stays clear and functional, enabling proper delivery of medications and nutrition to the client. Regular flushing also helps prevent residue buildup or clogs within the tube, reducing risks like aspiration or inaccurate medication dosing.
2. A nurse is reinforcing teaching about a clear liquid diet. What should the client avoid?
- A. Lemon-lime sports drinks
- B. Orange sherbet
- C. Black coffee
- D. Ginger ale
Correct answer: D
Rationale: The correct answer is D, Ginger ale. A clear liquid diet includes fluids that are see-through and easily digestible. Ginger ale is a carbonated beverage that is allowed on a clear liquid diet. Orange sherbet, choice B, is not suitable for a clear liquid diet as it contains dairy products and solid particles, which are not transparent. Lemon-lime sports drinks, choice A, may contain added colorings or particles that are not allowed on a clear liquid diet. Black coffee, choice C, is also not recommended on a clear liquid diet as it is not a clear liquid and contains substances that may be hard to digest.
3. A nurse is planning to administer chlorothiazide 20 mg/kg/day PO divided equally and administered twice daily for a toddler who weighs 28.6 lb. How many mL should the nurse administer per dose? (Round to the nearest tenth)
- A. 2.6 mL
- B. 2.2 mL
- C. 3.5 mL
- D. 5.0 mL
Correct answer: A
Rationale: The correct calculation is as follows: The toddler's weight in kg is 13 kg (28.6 lb / 2.2 lb/kg). The total daily dose is 260 mg (20 mg x 13 kg). Therefore, the dose per administration is 130 mg (260 mg / 2). Given the concentration of 250 mg/5 mL, the dose in mL is 2.6 mL (130 mg / (250 mg/5 mL)). Therefore, the nurse should administer 2.6 mL per dose. Choice B, 2.2 mL, is incorrect as it does not reflect the correct calculation. Choices C and D, 3.5 mL and 5.0 mL, are also incorrect and do not align with the accurate dosage calculation based on the given scenario.
4. The client with a new prescription for warfarin (Coumadin) is receiving teaching from the LPN/LVN. Which statement by the client indicates an understanding of the medication?
- A. I will avoid eating foods high in vitamin K, like spinach and broccoli.
- B. I will take aspirin instead of acetaminophen for headaches while on this medication.
- C. I can stop taking the medication once my symptoms improve.
- D. I will double my dose if I miss a dose to catch up.
Correct answer: A
Rationale: Clients prescribed with warfarin (Coumadin) need to maintain a consistent intake of vitamin K and avoid sudden increases in foods rich in vitamin K as it can interfere with the effectiveness of the medication. Choice A, 'I will avoid eating foods high in vitamin K, like spinach and broccoli,' is the correct statement indicating an understanding of the medication. This choice demonstrates knowledge of the importance of consistent vitamin K intake to prevent fluctuations in warfarin's effectiveness. Choices B, C, and D are incorrect. Choice B suggests a substitution that is not advised without consulting a healthcare provider. Choice C is incorrect as stopping warfarin suddenly can lead to serious health risks. Choice D is unsafe and incorrect since doubling the dose is not the correct action if a dose is missed.
5. A nurse receives a report on four clients. Which client should the nurse assess first?
- A. A client scheduled for chemotherapy with a hemoglobin of 9 g/dL
- B. A client 24 hours post-TURP with small blood clots in the catheter
- C. A client receiving a blood transfusion who reports low back pain
- D. A client with a new colostomy and a reddish-pink stoma
Correct answer: C
Rationale: The correct answer is C. Low back pain during a blood transfusion is a classic sign of a transfusion reaction, specifically a transfusion-associated circulatory overload (TACO) or hemolytic reaction, both of which require immediate attention to prevent serious complications. Assessing this client first is crucial to ensure prompt intervention. Choices A, B, and D do not indicate immediate life-threatening complications and can be addressed after the client experiencing low back pain during a blood transfusion is stabilized.
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