ATI LPN
Fundamentals of Nursing Skin Integrity and Wound Care Practice Questions Questions
Question 1 of 4
Which statement by the daughter of an 80-year-old female client who lives alone warrants immediate intervention by the nurse?
Correct Answer: C
Rationale: Changing furniture can create fall hazards, especially for elderly individuals.
Question 2 of 4
A client is admitted to the emergency department with chest pain that is consistent with myocardial infarction based on elevated troponin levels. Heart sounds are normal and vital signs are noted on the client's chart. The nurse should alert the health care provider because these changes are most consistent with which complication?
Correct Answer: A
Rationale: Progressive hypotension and tachycardia (BP 140/88 to 88/58, pulse 92 to 118) suggest cardiogenic shock post-MI.
Question 3 of 4
The nurse is caring for a client who had a resection of an abdominal aortic aneurysm yesterday. The client has an intravenous (IV) infusion at a rate of 150 mL/hour, unchanged for the last 10 hours. The client's urine output for the last 3 hours has been 90, 50, and 28 mL (28 mL is most recent). The client's blood urea nitrogen level is 35 mg/dL and the serum creatinine level is 1.8 mg / dL, measured this morning. Which nursing action is the priority?
Correct Answer: B
Rationale: Decreasing urine output and elevated BUN/creatinine suggest renal compromise, requiring HCP notification.
Question 4 of 4
The nurse is monitoring a client diagnosed with acromegaly who was treated with transsphenoidal hypophysectomy and is recovering in the intensive care unit. Which finding should alert the nurse to the presence of a possible postoperative complication?
Correct Answer: D
Rationale: Urinary output of 800 mL/hour suggests diabetes insipidus, a common complication post-hypophysectomy due to pituitary damage, unlike the other findings which are less specific.