ATI LPN
Providing Personal Care and Comfort Questions
Question 1 of 5
The nurse and a student nurse are discussing the specific points about infants born to HBsAg-positive mothers. Which of these comments by the student indicates a need for clarification of information?
Correct Answer: C
Rationale: The third dose should be at 6 months (24 weeks), not tied to 16 weeks from the second dose.
Question 2 of 5
Postoperative orders for a client undergoing a mitral valve replacement include monitoring pulmonary artery pressure together with pulmonary capillary wedge pressure with a pulmonary artery catheter. The purpose of these actions by the nurse is to assess
Correct Answer: B
Rationale: Wedge pressure reflects left ventricular preload, critical post-mitral surgery.
Question 3 of 5
A client was admitted with a diagnosis of pneumonia. When auscultating the client's breath sounds, the nurse hears inspiratory crackles in the right base. Temperature is 102.3 degrees Fahrenheit orally. What other finding would the nurse expect?
Correct Answer: A
Rationale: Fever causes flushed skin due to vasodilation.
Question 4 of 5
In a long term rehabilitation care unit, a client with spinal cord injury complains of a pounding headache. The client is sitting in a wheelchair watching television. Further assessment by the nurse reveals excessive sweating, a splotchy rash, pilomotor erection, facial flushing, congested nasal passages and a heart rate of 50. The nurse should perform which action next?
Correct Answer: C
Rationale: Symptoms suggest autonomic dysreflexia, often triggered by bladder distention.
Question 5 of 5
A nurse is caring for a 2 year-old child after corrective surgery for Tetralogy of Fallot. The mother reports that the child has suddenly begun seizing. The nurse recognizes this problem is probably due to
Correct Answer: A
Rationale: Post-surgical hypoxia or emboli from Tetralogy repair can cause a CVA.