ATI LPN
PN Comprehensive Predictor 2020 Questions
Extract:
Nurses' Notes
Day 1, 12:00:
Transferred to medical-surgical unit from emergency department (ED) for continued care following a closed reduction and immobilization of a fracture of the right arm. Accompanied by adult child.
Client in visibly soiled night clothes with multiple stains, including what appears to be dried blood. Hair, teeth, and fingernails unclean. Strong body odor noted. Bruising of various stages noted around upper arms, back, shoulders, and neck area.
Client is soft-spoken, speaks almost in a whisper, does not make eye contact with nurse.
Client looks at their child before answering the nurse's questions and, when asked how the injury occurred, mumbles "I don't know. Ask them." Client's child states, "He gets confused sometimes. I can answer your questions."
Question 1 of 5
A nurse is caring for a newly admitted older adult client. Nurses' Notes Day 1, 12:00: Transferred to medical-surgical unit from emergency department (ED) for continued care following a closed reduction and immobilization of a fracture of the right arm. Accompanied by adult child. Client in visibly soiled night clothes with multiple stains, including what appears to be dried blood. Hair, teeth, and fingernails unclean. Strong body odor noted. Bruising of various stages noted around upper arms, back, shoulders, and neck area. Client is soft-spoken, speaks almost in a whisper, does not make eye contact with nurse. Client looks at their child before answering the nurse's questions and, when asked how the injury occurred, mumbles 'I don't know. Ask them.' Client's child states, 'He gets confused sometimes. I can answer your questions.' Which of the following interventions should the nurse recommend to include in the client's plan of care? Select all that apply.
Correct Answer: B,C,D
Rationale: Asking for details about the fracture gathers information, discussing respite care supports the caregiver, and speaking privately assesses for abuse safely. Threatening reporting lacks evidence, and legal advice is outside nursing scope.
Extract:
Question 2 of 5
A nurse is administering a client's morning oral medications. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The 'three checks'—verifying medication with the record three times—prevents errors. Documentation occurs after administration, time-critical meds need tighter timing, and two identifiers are standard.
Question 3 of 5
A nurse is preparing to administer eye drops to a child. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: Applying pressure to the lacrimal punctum prevents systemic absorption of the drops. Side-lying isn't required, wiping outward prevents contamination, and flushing isn't standard pre-administration.
Question 4 of 5
A nurse in an acute care setting is assisting in collecting client information to include in a referral for a physical therapist. Which of the following information should the nurse plan to include?
Correct Answer: C
Rationale: Physical assessment findings (e.g., range of motion, strength) are critical for a PT referral to tailor treatment. Family history, prior meds, and insurance claims are less directly relevant.
Question 5 of 5
A nurse is preparing to provide tracheostomy care for a client. Which of the following actions should the nurse plan to take?
Correct Answer: A
Rationale: Cleaning the stoma inward to outward removes debris safely. Alcohol irritates mucosa, two finger widths is standard for ties, and sterile supplies should be ready beforehand.