ATI LPN
Patient Care Questions Questions
Question 1 of 5
An 80 year-old client admitted with a diagnosis of possible cerebral vascular accident has had a blood pressure from 160/100 to 180/110 over the past 2 hours. The nurse has also noted increased lethargy. Which assessment finding should the nurse report immediately to the provider?
Correct Answer: A
Rationale: Slurred speech needs immediate reporting in a possible CVA with hypertension and lethargy. It signals stroke progression, requiring urgent intervention. Incontinence , weakness , and pulse are less specific. A prioritizes neuro status, making it critical.
Question 2 of 5
The nurse has just received report on a group of clients and plans the order in which they will be seen. List the order in which the nurse should see the following clients: 1) A client admitted 2 days ago with dehydration who reports vomiting x2 this morning; 2) A client admitted yesterday with 70% blockage of the left coronary artery and an episode of chest pain during the night; 3) A client with pneumonia who is receiving oxygen via nasal cannula with vital signs due in 15 minutes; 4) A client with small bowel obstruction whose nasogastric tube needs to be repositioned.
Correct Answer: C
Rationale: Order 2,1,4,3 is optimal. Chest pain with 70% coronary blockage (2) signals potential MI, requiring immediate assessment per ABCs. Vomiting with dehydration (1) risks electrolyte imbalance, needing prompt attention. NG tube repositioning for obstruction (4) is urgent to relieve pressure, while pneumonia with stable oxygen (3) is least acute with vitals pending. C prioritizes life-threatening issues (circulation, fluid status, obstruction) over routine care, aligning with nursing triage, making it the correct sequence.
Question 3 of 5
The health care team is managing the care of a client with terminal cancer. The client's spouse says, 'I don't want him to suffer anymore.' Which member of the team should develop a plan to provide optimal comfort?
Correct Answer: B
Rationale: The primary nurse should develop the comfort plan. Nurses coordinate palliative care, managing pain and symptoms, per scope. Social workers offer emotional support, dietitians nutrition, and providers prescribe, but B integrates holistic comfort, making it the best choice.
Question 4 of 5
The nurse is assessing a client with a chest tube attached to a water seal drainage system. Which finding requires immediate action by the nurse?
Correct Answer: D
Rationale: Absence of fluctuation in the water seal chamber requires immediate action. It suggests obstruction, disconnection, or lung re-expansion issues, risking tension pneumothorax, per protocol. Normal fluctuation , blood , and suction bubbling are expected. D threatens airway, making it priority.
Question 5 of 5
The nurse is caring for a client with a history of falls. Which intervention should the nurse implement to promote safety?
Correct Answer: B
Rationale: Placing the call bell within reach promotes safety for a fall-risk client. It ensures assistance access, reducing unnecessary movement, per standards. High bed increases risk, restraints harm dignity, and socks slip. B enhances safety, making it best.