ATI LPN
Adult Medical Surgical ATI Questions
Question 1 of 5
The nurse is caring for a client with a history of deep vein thrombosis (DVT) who is receiving warfarin (Coumadin). Which laboratory value should the nurse monitor closely?
Correct Answer: B
Rationale: The correct answer is B: Prothrombin time (PT). Warfarin affects the clotting process by inhibiting vitamin K-dependent clotting factors. Monitoring PT helps assess the effectiveness of warfarin therapy and prevent complications like bleeding. Platelet count (A) is important but not directly affected by warfarin. Hemoglobin level (C) and white blood cell count (D) are not typically affected by warfarin therapy.
Question 2 of 5
The healthcare provider is preparing to administer a blood transfusion. Which action is most important to ensure client safety?
Correct Answer: B
Rationale: The correct answer is B: Verify the client's identity and blood compatibility. This step is crucial to prevent transfusion reactions due to compatibility issues. By confirming the client's identity and ensuring that the blood type matches, the healthcare provider minimizes the risk of adverse reactions such as hemolytic transfusion reactions. Checking vital signs (A) is important but ensuring blood compatibility takes precedence. Administering blood with normal saline (C) is incorrect as blood should be infused with the appropriate blood administration set. Monitoring the client for the first 15 minutes (D) is essential but verification of identity and blood compatibility is the primary step to prioritize safety.
Question 3 of 5
A client is receiving chemotherapy and is at risk for neutropenia. Which precaution should the nurse implement?
Correct Answer: C
Rationale: The correct answer is C: Place the client in a private room. This is important to reduce the risk of infection for the client with neutropenia, as being in a private room minimizes exposure to pathogens from other individuals. Neutropenia is a condition where there is a low level of neutrophils, a type of white blood cell that helps fight infections. By placing the client in a private room, the nurse can control the environment and limit the client's exposure to potential sources of infection. Choice A is incorrect because regular visitors may introduce pathogens that could increase the client's risk of infection. Choice B is incorrect as live vaccines are contraindicated in clients receiving chemotherapy due to their weakened immune system. Choice D is incorrect because while fresh fruits and vegetables are important for overall health, in this case, the risk of infection outweighs the benefits of a diet high in these foods.
Question 4 of 5
A client with a history of deep vein thrombosis (DVT) is receiving warfarin (Coumadin). Which instruction should the nurse provide?
Correct Answer: C
Rationale: The correct answer is C: Use a soft-bristled toothbrush. Patients on warfarin are at risk for bleeding due to its anticoagulant effect. Using a soft-bristled toothbrush helps prevent gum bleeding and injury to the gums, reducing the risk of bleeding complications. Avoiding green leafy vegetables (choice A) is not necessary, as consistent intake is key for warfarin dosing. Taking aspirin (choice B) can increase the risk of bleeding. Limiting fluid intake (choice D) is not indicated in this case.
Question 5 of 5
When teaching a client postoperative breathing techniques with an incentive spirometer (IS), what should the nurse encourage the client to do to maintain sustained maximal inspiration?
Correct Answer: B
Rationale: The correct answer is B: Inspire deeply and slowly over 3 to 5 seconds. This technique is recommended for using an incentive spirometer (IS) to maintain sustained maximal inspiration. Slow, deep inhalation helps fully expand the lungs and improve lung function postoperatively. A: Exhaling forcefully into the tubing is incorrect because the purpose of using an IS is to promote deep inhalation, not forceful exhalation. C: Breathing into the spirometer using normal breath volumes is incorrect as it does not promote maximal inspiration and may not fully expand the lungs. D: Performing IS breathing exercises every 6 hours is incorrect as regular, consistent practice throughout the day is recommended for optimal lung recovery.