ATI LPN
Patient Care Questions Questions
Question 1 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 2 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 3 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.
Question 4 of 5
The nurse instructs the client taking dexamethasone (Decadron) to take it with food or milk. The physiological basis for this instruction is that the medication
Correct Answer: B
Rationale: Dexamethasone stimulates hydrochloric acid production , increasing gastric irritation risk, per pharmacology. Taking it with food or milk buffers this effect, protecting the stomach lining. Pepsin isn't primarily affected, emptying time isn't slowed, and acid production isn't decreased . B explains the physiological need for this instruction.
Question 5 of 5
A client has been admitted with complaints of lower abdominal pain, difficulty swallowing, nausea, dizziness, headaches and fatigue. The client is agitated, fearful, tachycardia and complains of being 'too sick to return to work.' The client is diagnosed as having somatoform disorder. In formulating a plan of care, the nurse must consider that the client's behavior
Correct Answer: A
Rationale: Behavior controlled by the subconscious mind fits somatoform disorder. Symptoms are involuntary, physical manifestations of psychological stress, per psychiatric standards. Manipulation implies intent, psychoeducation aids but doesn't control, and reality therapy may help but isn't primary. A guides care toward addressing underlying stress.