ATI LPN
LPN Pediatrics
1. Which of the following techniques represents the MOST appropriate method of opening the airway of an infant with no suspected neck injury?
- A. Perform the technique as you would for an older child or adult.
- B. Lift up the chin and hyperextend the neck.
- C. Gently lift the chin while maintaining slight flexion of the neck.
- D. Tilt the head back without hyperextending the neck.
Correct answer: D
Rationale: Tilting the head back without hyperextending the neck is the safest way to open an infant's airway. Hyperextending the neck can potentially cause harm to the infant, making option D the most appropriate method for opening an infant's airway without suspected neck injury.
2. When developing a care plan for a patient with borderline personality disorder, which intervention should be included to address self-harm behaviors?
- A. Encouraging the patient to keep a journal of their thoughts and feelings.
- B. Setting clear and consistent boundaries with the patient.
- C. Providing the patient with coping skills to manage their emotions.
- D. Developing a safety plan with the patient.
Correct answer: D
Rationale: Developing a safety plan with the patient is crucial when addressing self-harm behaviors in individuals with borderline personality disorder. This intervention helps outline steps to take during a crisis, identifies triggers, and provides strategies to prevent self-harm incidents. It involves collaboratively creating a plan between the patient and the healthcare team to ensure a structured and supportive approach to managing potentially dangerous situations.
3. An older adult client from a minority culture refuses to eat at the nursing home, stating, 'I just do not like the food here.' What factor should the staff assess for this problem?
- A. The client does not like eating with other residents of the home.
- B. The client is using this as an excuse to go home.
- C. The food served may not be culturally appropriate.
- D. The food served may violate religious beliefs.
Correct answer: C
Rationale: The correct answer is C. Residents in long-term care settings often have limited food choices, which may not align with their cultural preferences. When assessing why a client is refusing to eat, it is essential to consider if the food served is culturally appropriate. Choices A, B, and D are incorrect. There is no indication in the scenario that the client's refusal to eat is due to not liking to eat with other residents, using it as an excuse to go home, or violating religious beliefs.
4. The client admitted to the hospital with pulmonary edema is preparing for discharge. The client should be reminded of the importance of complying with which measure to prevent a recurrence?
- A. Weigh oneself every morning before breakfast.
- B. Sleep with the head elevated on multiple pillows.
- C. Adjust diuretic dose without healthcare provider guidance.
- D. Take additional digoxin (Lanoxin) as a preventive measure.
Correct answer: A
Rationale: Monitoring weight daily, especially in the morning before breakfast, is crucial in detecting fluid retention early and preventing pulmonary edema. Sudden weight gain can indicate fluid accumulation, prompting timely intervention to prevent complications. Choice A is the correct answer because daily weight monitoring is a key component in managing heart failure and preventing pulmonary edema recurrence. Choices B and D are not directly related to preventing fluid retention or pulmonary edema recurrence. Choice C is unsafe as adjusting diuretic doses without healthcare provider guidance can lead to electrolyte imbalances and worsening of the condition.
5. A nurse is monitoring a client who has been receiving intermittent enteral feedings. What should the nurse identify as an intolerance to the feeding?
- A. Increased appetite
- B. Nausea
- C. Weight gain
- D. Regular bowel movements
Correct answer: B
Rationale: Nausea is a common sign of intolerance to enteral feedings. When a client experiences nausea, it can indicate difficulty in tolerating the feeding formula. This intolerance may also manifest as vomiting and dumping syndrome. Choices A, C, and D are incorrect because increased appetite, weight gain, and regular bowel movements are not typical signs of intolerance to enteral feedings.
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