What is the most important action for the nurse to

ATI LPN

ATI LPN Test Bank

What is the most important action for the nurse to take when caring for a client with a recent stroke?

A. Monitor for seizures B. Assess swallowing ability C. Provide speech therapy D. Promote mobility

Correct Answer: B

Rationale: Assessing swallowing ability prevents aspiration and ensures safe oral intake, reducing the risk of pneumonia.

The statement 'Upon exertion, the client is wheezing and experiencing some dyspnea' is an example of:

A. The P of PIE B. FOCUS documentation C. The R in DAR documentation D. The S in SOAP documentation

Correct Answer: A

Rationale: These data are examples of the P of PIE because they describe the problem.

Problem Oriented Medical Record(POMR) method of documentation includes which of the following sections? Select one that doesn't apply.

A. Database B. Care plan C. Evaluations D. Problem list

Correct Answer: C

Rationale: The POMR has the following major sections: database, problem list, care plan, and progress notes.

What is the best method for verifying a client's identity?

A. Ask the client's name B. Check the ID band C. Ask a family member D. Assume identity based on room number

Correct Answer: B

Rationale: Checking the ID band is the most reliable method for verifying a client's identity and preventing errors.

When working in a PEC, an IV technician must open the outer package of a supply item to maintain aseptic technique.

A. outside the PEC B. at least six inches inside of the PEC C. in the anteroom D. on the line of demarcation

Correct Answer: A

Rationale: Opening packages outside the PEC prevents non-sterile materials from entering the sterile primary engineering control (PEC).

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