ATI LPN
Nursing Fundamental Physical Assessment LPN Questions
Question 1 of 5
Which positioning technique should the nurse use to prevent pressure ulcers in a patient with limited mobility?
Correct Answer: C
Rationale: Supporting bony prominences with pillows or foam pads prevents pressure ulcers by distributing weight and reducing pressure on vulnerable spots in limited-mobility patients. Prone positioning or prolonged sitting increases risk, and a 90-degree head elevation causes shear. Nurses use this technique to protect skin, ensuring comfort and circulation, a primary defense against tissue breakdown in restricted movement cases.
Question 2 of 5
A client is sent to the psychiatric unit for forensic evaluation after he is accused of arson. His tentative diagnosis is antisocial personality disorder. In reviewing the client's record, the nurse could expect to find:
Correct Answer: C
Rationale: Antisocial personality disorder often manifests with a history of cruelty to animals, a behavioral marker reflecting disregard for others' rights, common in childhood conduct issues progressing to this diagnosis. Consistent employment contradicts the impulsivity and irresponsibility typical of the disorder, while intelligence varies and isn't characteristically low. Remorse is rare due to limited empathy. Nurses reviewing such records anticipate these patterns to inform care, focusing on safety and behavioral management rather than expecting regret or stability.
Question 3 of 5
Phototherapy is ordered for a newborn with physiologic jaundice. The nurse caring for the infant should:
Correct Answer: C
Rationale: Covering the newborn's eyes with shields during phototherapy prevents retinal damage from bilirubin-breaking light, a critical safety measure in treating physiologic jaundice. Oil-based lotions interfere with light penetration, turning is helpful but secondary, and removal during feedings isn't standard. Nurses prioritize eye protection, ensuring effective therapy while safeguarding vision.
Question 4 of 5
The nurse is preparing to give an oral potassium supplement. The nurse should:
Correct Answer: B
Rationale: Giving an oral potassium supplement with 4oz. of juice dilutes its irritating effects on the stomach, reducing nausea or ulcers a standard administration practice. Undiluted doses, water-only, or empty stomach increase GI distress. Nurses use this method, enhancing tolerability, ensuring electrolyte correction without discomfort.
Question 5 of 5
The nurse is preparing a client with myasthenia gravis for a Tensilon test. The nurse should have which of the following equipment available at the bedside?
Correct Answer: C
Rationale: An intubation tray is essential for a Tensilon test in myasthenia gravis, as edrophonium can trigger a cholinergic crisis, worsening weakness and risking respiratory failure oxygen or monitors help but airway readiness is critical. Nurses prepare this, ensuring safety during diagnosis, ready to assist breathing if the test overstimulates acetylcholine.