ATI LPN
Study Guide for Fundamentals of Nursing Care: Concepts, Connections & Skills
Chapter 4 : The Nursing Process: Critical Thinking and Decision Making Questions
Question 1 of 5
Which step of the nursing process is most associated with action?
Correct Answer: D
Rationale: Implementation is the action-oriented step where nurses carry out the planned interventions to address patient needs.
Question 2 of 5
You enter the room to find your patient ashen and gasping for breath. Which part of the nursing process should you perform, formally or informally, in the first 5 minutes?
Correct Answer: F
Rationale: In an emergency, nurses perform all steps of the nursing process rapidly: assessing the patient's condition, diagnosing the problem, planning immediate actions, implementing interventions, and evaluating their effectiveness.
Question 3 of 5
You are caring for a male patient who had a total hip replacement 3 days earlier. You have not cared for the patient before and are assessing him to establish a baseline of information about his health status. The patient states he felt feverish during the night and broke into a sweat. You check his temperature readings from the previous night and see that it was 99.2?°F at midnight and 98.2?°F at 6 a.m. It now is 99?°F. Which of the following actions represents the best response to his statement and gives the best explanation for the action as it relates to critical thinking?
Correct Answer: C
Rationale: Assessing for signs and symptoms of infection (
C) is the best response as it involves critical thinking by validating the patient's subjective complaint with objective data, ensuring a thorough evaluation of a potential postoperative complication.
Question 4 of 5
You have passed your NCLEX-PN examination and have just been employed as an LPN on a medical surgical unit. The registered nurse (RN) in charge asks you to do the admission assessment on a new patient who has just arrived by ambulance from a long-term care facility. The patient had undergone a total hip replacement within the previous 2 weeks and has developed a fever. You tell the nurse you thought an LPN could not do the admission assessment or, at most, could do only certain portions of it. The nurse, who is very busy, says, 'Please just do it. I'll cosign it, so it will be fine.' Which of the following actions should you take next?
Correct Answer: B,C
Rationale: Checking the facility's policy manual (
C) ensures you act within your scope of practice. Refusing to do the admission assessment but offering to perform tasks within your role (
B) is appropriate, as LPNs typically cannot perform initial admission assessments, which are reserved for RNs.
Question 5 of 5
You are performing the daily assessment of your patient's status. You notice some purplish marks on her arm where the bandage for her IV had been and the skin is torn. Which of the following techniques did you use to obtain these data?
Correct Answer: A
Rationale: Inspection involves visually observing the patient's skin, which allowed you to notice the purplish marks and torn skin.