ATI LPN
LPN ATI Fundamental Exam Questions
Extract:
Question 1 of 5
A nurse is contributing to the plan of care for a client who has a prescription for elastic bandages to the lower extremities. Which of the following actions should the nurse recommend for the plan of care?
Correct Answer: B
Rationale: Check the capillary refill every 4 hrs: Incorrect. The nurse should check capillary refill distally every 4 hr for a client who has elastic bandages on their lower extremities. Compare the pedal pulses every 4 hrs: CORRECT. The nurse should compare the pedal pulses bilaterally every week to check for adequate circulation for a client who has elastic bandages on their lower extremities.
Question 2 of 5
A nurse is caring for a client who has a terminal illness and a family member asks why the client’s mouth is continually open. Which of the following responses should the nurse make?
Correct Answer: A
Rationale: The reduced muscle tone relaxed the jaw muscles.' CORRECT. Prior to death, decreased muscle tone causes jaw muscles to relax resulting in an open mouth. 'That happens when a person gets close to death.' INCORRECT. This automatic response is nontherapeutic and does not address the family member’s question. 'I can apply a chin strap to help hold the mouth closed.' INCORRECT. Applying a chin strap is a postmortem action that the nurse can take to keep the mouth closed.
Question 3 of 5
A nurse is preparing to collect data from a client for a health assessment. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: Provide privacy for the client: CORRECT. The nurse should promote a therapeutic environment by providing privacy while data is being collected for a health assessment. Expose hair of the body as an: INCORRECT.
To promote a therapeutic environment, the nurse should expose only the area of the body from which data is being collected.
Question 4 of 5
A nurse is preparing to administer enteral feeding to a client who has an NG tube in place. Which of the following methods should the nurse use to verify the correct placement of the NG tube?
Correct Answer: A
Rationale: Correct. Checking the pH of the gastric aspirate is the most reliable method to verify the correct placement of the NG tube. Gastric aspirate typically has an acidic pH (pH < 5), indicating that the tube is in the stomach. Observing the color of the gastric aspirate after adding blue dye to the formula is not a standard or recommended method for verifying NG tube placement. Auscultating over the epigastrium may help to identify the presence of air in the stomach, but it does not confirm that the NG tube is correctly placed in the stomach or the intestines. Measuring the length of the inserted NG tube can help determine the distance from the nose to the stomach, but it does not ensure correct placement in the stomach.
Question 5 of 5
A charge nurse smells smoke, enters the visitor restroom, and sees flames in the trash can. What is the sequence of actions that the nurse should take? (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)
Order the Items
Source Container
Correct Answer: A,B,C,D
Rationale: Sequence of Actions: A: Evacuate clients from the area. This is the first and most crucial step to ensure the safety of all individuals in the vicinity of the fire. B: Pull the lever on the fire alarm box. Once the immediate area is clear of individuals, the next step is to alert the rest of the building by activating the fire alarm system. C: Close the fire doors on the unit. This action helps to contain the fire and prevent smoke from spreading to other areas, which can be vital in slowing the fire’s progress and safeguarding other parts of the building. D: Use a fire extinguisher to put out the fire. If the fire is small and contained, and the nurse is trained in its use, a fire extinguisher can be used to douse the flames, preventing further damage.