The nurse is providing post procedure care to a client who had a cardiac catheterization. The client begins to manifest signs and symptoms associated with embolization. Which action should the nurse take?

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LPN Fundamentals of Nursing ATI Questions

Question 1 of 9

The nurse is providing post procedure care to a client who had a cardiac catheterization. The client begins to manifest signs and symptoms associated with embolization. Which action should the nurse take?

Correct Answer: A

Rationale: Embolization post-catheterization (e.g., limb pain, pallor) requires immediate provider notification (A) for intervention like thrombolysis. Compress (B), fluids (C), or monitoring (D) are secondary. A is correct. Rationale: Embolism is a vascular emergency; prompt reporting ensures rapid treatment, per cardiac care standards, preventing tissue loss.

Question 2 of 9

It is best described as a systematic, rational method of planning and providing nursing care for individuals, families, group and community

Correct Answer: B

Rationale: The nursing process is a systematic, rational approach encompassing all care phases.

Question 3 of 9

Which of the following statement best describe resource allocation?

Correct Answer: B

Rationale: Resource allocation is fair distribution of resources (B), per ethics e.g., beds, staff equitably. Not one patient (A), not patient-decided (C), not skill (D) system-based. B best defines allocation's justice focus, like Mr. Gary's hospital context, making it correct.

Question 4 of 9

The nurse is assessing a client with a traumatic brain injury. Which finding indicates a worsening condition that requires immediate reporting to the healthcare provider?

Correct Answer: D

Rationale: A fixed, dilated pupil (D) indicates worsening brain injury, likely herniation, needing immediate reporting. GCS 12 (A), equal pupils (B), or normal RR (C) are less urgent. D is correct. Rationale: Pupil fixation signals severe ICP elevation, a neurosurgical emergency, per brain trauma standards, requiring rapid intervention.

Question 5 of 9

The nurse asked an aide to take Mr. Gary's vitals while overseeing. This is an example of?

Correct Answer: A

Rationale: Asking an aide for vitals with oversight is delegation (A) task assignment, per definition. Thinking (B) reasons, education (C) teaches, policy (D) rules not delegation-specific. A fits supervised task, making it correct.

Question 6 of 9

Later that day, he bought his son ice cream and food. What defense mechanism is Legrande unconsciously doing?

Correct Answer: A

Rationale: Legrande's buying ice cream and food is restitution (A), compensating for shouting at his son. Conversion (B) turns stress into physical symptoms. Redoing (C) isn't a term; undoing reverses. Reaction formation (D) acts opposite to feelings. Restitution, per psychology, repairs guilt, matching his actions, making A correct.

Question 7 of 9

RN assumes 24 hour responsibility for the client to maintain continuity of care across shifts, days or visits.

Correct Answer: C

Rationale: Primary nursing assigns one RN 24-hour responsibility for a client's care plan, ensuring continuity across shifts via secondary nurses e.g., overseeing a diabetic's regimen long-term. Unlike functional (task-driven), team (group-based), or total care (shift-specific), it prioritizes accountability and consistency, enhancing patient trust and outcomes in complex cases.

Question 8 of 9

How long should the Rectal Thermometer be inserted to the clients anus?

Correct Answer: A

Rationale: Rectal thermometers insert 1-2 inches e.g., 1 inch for adults, less for kids for accurate core temp without perforation risk. Longer (3-5 inches) is unsafe; 5 to 1.5 is illogical. Nurses follow this e.g., marking depth per procedure guidelines, ensuring precision and safety.

Question 9 of 9

The nurse is caring for a client with a Sengstaken-Blakemore tube. Which finding should be reported to the physician immediately?

Correct Answer: B

Rationale: A hematocrit of 30% post-Sengstaken-Blakemore tube insertion signals significant bleeding from esophageal varices, requiring immediate physician report normal is 38-50%, and this drop suggests hemorrhage despite tamponade. Nausea, thirst, or stable pressures are less urgent. Nurses flag this drop, prompting transfusion or escalation, critical to stabilize a client in acute liver failure.

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