ATI LPN
LPN Fundamentals Final Exam Questions
Question 1 of 5
When looking at a model for evidence-based practice, what is the final step of the process?
Correct Answer: D
Rationale: Evidence-based practice (EBP) follows a systematic process to integrate research into care, with evaluating practice change as the final step. It begins with formulating a clinical question to identify the issue, followed by searching and appraising the literature to gather and assess evidence. Implementing the change comes next, but evaluation critically appraising the change's impact, like improved patient outcomes or cost-effectiveness completes the cycle. This step ensures the intervention works in practice, not just theory, by analyzing data like recovery rates or patient feedback. It's a reflective process, allowing nurses to refine or discard changes, ensuring EBP remains dynamic and patient-focused. This closure distinguishes EBP from mere research application, embedding continuous improvement into nursing practice for sustained quality and safety.
Question 2 of 5
A client who is dying states to the nurse, 'I'm not ready to go yet; there's so much left to do.' Which nursing action promotes the client's health at this time?
Correct Answer: B
Rationale: When a dying client expresses unfinished business, promoting health means supporting emotional and spiritual peace, not physical longevity. Asking what remains undone maybe reconciling with a loved one or recording memories and planning to address it empowers the client, reducing distress and fostering closure. This aligns with nursing's holistic focus, prioritizing psychological well-being at life's end over false cures. Reassuring without action dismisses their fears, while life-prolonging strategies ignore the terminal reality, potentially increasing frustration. Calling family hastily might overwhelm, not directly tackling the client's needs. By facilitating resolution like arranging a call to a estranged child the nurse promotes dignity and acceptance, key to health in dying, ensuring the client's final moments reflect their values, not just physical care.
Question 3 of 5
The nurse is providing care for a 2-month-old infant scheduled for a pyloromyotomy. Which of the following pre-operative actions can the nurse expect to perform? Select all that apply.
Correct Answer: D
Rationale: For a 2-month-old infant undergoing a pyloromyotomy to correct pyloric stenosis, pre-operative nursing actions focus on safety and preparation for anesthesia and surgery. Keeping the infant NPO (nothing by mouth) as ordered (D) is critical to prevent aspiration during anesthesia, a standard pre-operative protocol for all surgical patients, especially infants. Allowing breastfeeding 1 hour before surgery (A) contradicts NPO guidelines, risking complications like vomiting or aspiration, making it incorrect. Reviewing coagulation study results (B) is important, as infants with pyloric stenosis may have electrolyte imbalances affecting clotting, but it's not the most immediate action. Avoiding all pre-operative sedation (C) is impractical, as sedation may be needed based on medical orders, not universally avoided. Other options like beginning IV fluids (E) and placing an NG tube (F) are relevant but context-specific. Since the CSV requires one correct answer, D is chosen as the most universally applicable and critical action, ensuring the infant's safety by adhering to NPO status, a fundamental pre-operative standard.
Question 4 of 5
The nurse is performing nasotracheal suctioning of a client. The nurse interprets that the client is adequately tolerating the procedure if which observation is made?
Correct Answer: C
Rationale: During nasotracheal suctioning, coughing (C) indicates adequate tolerance, as it's a natural reflex to clear airways without distress. Cyanosis (A) signals hypoxia, a complication. Bloody secretions (B) suggest trauma, not tolerance. A heart rate drop from 78 to 54 (D) may indicate vagal stimulation, a potential adverse effect. C is correct. Rationale: Coughing reflects an intact airway defense mechanism, showing the client can respond without decompensation, per respiratory nursing protocols. Other signs like cyanosis or bradycardia warrant stopping the procedure to reassess, as they indicate oxygenation or cardiac compromise, making C the safest indicator of tolerance.
Question 5 of 5
The nurse is monitoring the respiratory status of a client following insertion of a tracheostomy. The nurse understands that oxygen saturation measurements obtained by pulse oximetry may be inaccurate if the client has which coexisting problem?
Correct Answer: C
Rationale: Pulse oximetry measures oxygen saturation but can be inaccurate with hypotension (C), as low blood pressure reduces peripheral perfusion, skewing readings. Fever (A) may increase metabolic demand but doesn't directly affect accuracy. Epilepsy (B) impacts neurological status, not perfusion. Respiratory failure (D) alters oxygenation but not oximetry reliability unless perfusion is compromised. C is correct. Rationale: Hypotension decreases blood flow to capillaries where oximeters detect hemoglobin saturation, leading to falsely low or erratic results, a known limitation per critical care monitoring standards. Nurses must correlate oximetry with clinical signs and possibly arterial blood gases (ABGs) in such cases, ensuring accurate respiratory assessment post-tracheostomy, unlike the other conditions which don't directly impair device function.