Review ATI PN Exit 2023

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ATI PN Exit 2023

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Total Questions : 180

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Question 1:

The practical nurse (PN) is providing instructions to the unlicensed assistive personnel (UAP) preparing to give a total bed bath to an immobile client who has a continuous feeding via gastrostomy tube (GT).

Which instruction is most important for the PN to emphasize?

A. Raise the entire bed while bathing the client to reduce back strain B. Report any drainage observed around the GT insertion site C. Keep the head of the bed raised while the tube feeding is infusing D. Use plenty of pillows to position the client on the side after bathing.

Answer and Explanation

Choice A:

-Raising the entire bed while bathing the client is a good practice as it helps to reduce back strain for the caregiver. However, this is not directly related to the care of a client with a gastrostomy tube (GT).

Choice B:

Reporting any drainage observed around the GT insertion site is important as it could indicate an infection or other complication. However, this is not the most critical action when caring for a client with a GT.

Choice C:

Keeping the head of the bed raised while the tube feeding is infusing is the correct answer. This is crucial in preventing aspiration, a serious complication where the contents of the stomach enter the lungs. Aspiration can lead to pneumonia, a potentially life-threatening condition. Therefore, the head of the bed should be kept at a 30-45 degree angle during feeding and for at least 30 minutes after feeding.

Choice D:

-Using plenty of pillows to position the client on the side after bathing can contribute to the client’s comfort. However, this is not the most critical action when caring for a client with a GT.

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Question 2:

Prior to administering pain medication to an adult postoperative client, what information should the practical nurse (PN) obtain? (Select all that apply.)

A. Height and weight of client prior to admission B. Client's pain rating on a scale of 1 to 10 C. Time of last administration of pain medication D. Eﬀectiveness of last pain medication administered E. History of pain medication use during the past year

Answer and Explanation

Choice A:

Height and weight of client prior to admission are not relevant for administering pain medication and may not aﬀect the dosage or route of the medication.

Choice B:

These are the information that the PN should obtain prior to administering pain medication to an adult postoperative client because they help to assess the client's current pain level, response to previous medication, and need for further intervention. The PN should also document these information in the medical record and report any changes or concerns.

Choice C:

Choice D:

Choice E:

History of pain medication use during the past year is not relevant for administering pain medication and may not indicate the client's tolerance or preference for the medication

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Question 3:

A nurse is reinforcing teaching with the parents of an infant who has a Pavlik harness.
Which of the following statements should the nurse include in the teaching?

A. "You should place the diaper over the strap of the harness.” B. "The harness can be removed for sleeping each night.” C. "You can apply lotion under the straps of the harness.” D. "The harness can promote hip joint development.”

Answer and Explanation

Choice A:

The nurse should not recommend placing the diaper over the strap of the Pavlik harness. Placing the diaper over the strap can cause discomfort and may interfere with the proper function of the harness, which is designed to maintain hip joint alignment in infants with developmental hip dysplasia.

Choice B:

The Pavlik harness is typically worn continuously, including during sleep. It should not be removed for sleeping each night because consistent use is essential for its effectiveness in promoting hip joint development.

Choice C:

Applying lotion under the straps of the harness is not recommended. Lotions or creams can create friction and moisture, which may lead to skin irritation or discomfort for the infant. It's best to follow the healthcare provider's instructions regarding the care and maintenance of the harness.

Choice D:

The correct choice is D. The nurse should include the statement that "The harness can promote hip joint development" in the teaching. This is because the Pavlik harness is used to treat developmental hip dysplasia by maintaining the hip joint in a stable position, allowing for proper development. It is important for parents to understand the purpose and benefits of the harness in order to ensure compliance and effectiveness of the treatment.

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Question 4:

A nurse is reviewing laboratory findings for three clients.
Which of the following laboratory results should the nurse expect for a client who has cirrhosis?

A. Elevated amylase. B. Decreased bilirubin. C. Elevated lipase. D. Elevated ammonia.

Answer and Explanation

Choice A:

Elevated amylase is not typically associated with cirrhosis. Amylase is an enzyme produced by the pancreas and salivary glands, and elevated levels are more commonly associated with pancreatic disorders or acute pancreatitis.

Choice B:

Decreased bilirubin is not an expected laboratory finding in cirrhosis. Cirrhosis often leads to impaired liver function, which can result in elevated bilirubin levels, causing jaundice.

Choice C:

Elevated lipase is not a characteristic laboratory finding in cirrhosis. Lipase is an enzyme produced by the pancreas, and elevated levels are more often seen in pancreatic disorders or acute pancreatitis.

Choice D:

The correct choice is D. Elevated ammonia levels are commonly associated with cirrhosis. In cirrhosis, the damaged liver is unable to effectively metabolize ammonia, leading to its accumulation in the blood. Elevated ammonia levels can result in hepatic encephalopathy, a neurological complication often seen in cirrhotic patients.

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Question 5:

A nurse is assisting with discharge planning for a client who is prescribed home oxygen at 1 to 2 L/min.
The nurse should ensure that the client has which of the following supplies upon discharge?

A. Oxygen mask. B. Reservoir bag. C. Petroleum jelly. D. Nasal cannula.

Answer and Explanation

Choice A:

The client does not need an oxygen mask for a low flow rate of 1 to 2 L/min. Oxygen masks are typically used for higher flow rates and may not be comfortable or necessary for a client requiring such a low oxygen flow.

Choice B:

A reservoir bag is not required for a client receiving low flow oxygen at 1 to 2 L/min. Reservoir bags are commonly used with oxygen masks at higher flow rates to ensure a consistent supply of oxygen during inhalation.

Choice C:

Petroleum jelly is not a necessary supply for a client prescribed home oxygen at 1 to 2 L/min. Its use may not be recommended due to the risk of flammability in the presence of oxygen.

Choice D:

The correct choice is D. The client should have a nasal cannula as a supply upon discharge. A nasal cannula is the appropriate delivery device for low flow oxygen therapy at 1 to 2 L/min. It is comfortable and allows for adequate oxygen supplementation for the client.

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Question 6:

A nurse is preparing a client's body for a postmortem family viewing.
Which of the following actions should the nurse take?

A. Remove the client's dentures to close their mouth. B. Place medical equipment to the side of the client's bed. C. Lie on the head of the client's bed flat. D. Ask the family if they want to participate in postmortem care.

Answer and Explanation

Choice A:

This option is incorrect because removing the client's dentures may not be necessary and can alter the client's appearance, causing unnecessary distress to the family during the viewing. Dentures should generally be left in place to maintain the natural shape of the client's face and preserve their appearance as closely as possible. However, if the family expresses a preference for removing the dentures or if it is medically necessary, the nurse should discuss this option with them and follow facility protocols accordingly.

Choice B:

While it is essential to create a serene and comfortable environment for the family during the viewing, simply placing medical equipment to the side of the client's bed may not be sufficient. Medical equipment should be removed from the room entirely to minimize distractions and create a more peaceful atmosphere for the family. This ensures that the focus remains on the client and their loved ones during this sensitive time.

Choice C:

This option is incorrect because lying the head of the client's bed flat is not appropriate for postmortem care. Elevating the head of the bed is essential to prevent blood pooling and discoloration of the client's face and neck, which can occur when the body is in a supine position for an extended period. Maintaining proper positioning also helps preserve the dignity and appearance of the deceased individual during the family viewing. Therefore, the nurse should ensure that the bed is appropriately positioned based on facility protocols and the client's condition.

Choice D:

While it is important to involve the family in postmortem care decisions, asking the family if they want to participate should be done before the actual preparation of the body begins. It is a crucial part of providing holistic and patient-centered care, but it is not a specific action related to preparing the body for viewing.

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Question 7:

A nurse is participating in an interprofessional team meeting for a client.
Which of the following information about the client should the nurse include?

A. The client has developed difficulty ambulating. B. The client's next dressing change is scheduled in 4 hr. C. The client has state-sponsored health insurance. D. The client's vital signs are checked every 8 hr.

Answer and Explanation

Choice A:

In an interprofessional team meeting for a client, it is essential to include information about changes in the client's condition or any new developments that may impact their care. The statement that "The client has developed difficulty ambulating" is relevant as it indicates a change in the client's mobility status and may require additional interventions or assessments.

Choice B:

The timing of the client's next dressing change (scheduled in 4 hr) is important information but may not be the highest priority to discuss in an interprofessional team meeting. It is more pertinent to focus on the client's current condition and any changes that have occurred.

Choice C:

The client's health insurance status (state-sponsored health insurance) is not typically a central topic of discussion in an interprofessional team meeting unless it directly affects the client's care plan or access to specific treatments.

Choice D:

The frequency of the client's vital sign checks (every 8 hr) is important information for the healthcare team to be aware of, but it may not be the most critical piece of information to include in the interprofessional team meeting. Changes in vital signs or trends would be more relevant to discuss.

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Question 8:

A nurse is reinforcing teaching with a client who is at 36 weeks of gestation and is about to undergo an amniocentesis.
Which of the following information should the nurse include in the instructions?

A. "I will need to give you Rh(D) immune globulin because you are Rh positive.” B. "You will need to have an empty bladder for the test.” C. "You will have to lie on your left side during the test.” D. "You will have to drink 50 grams of oral glucose before the test.”

Answer and Explanation

Choice A:

The administration of Rh(D) immune globulin (RhoGAM) is typically indicated for Rh-negative mothers who are carrying Rh-positive fetuses to prevent sensitization to Rh antigens. It is not directly related to the amniocentesis procedure. Therefore, this information is not necessary for the client undergoing an amniocentesis.

Choice B:

This is the correct answer. Having an empty bladder is crucial during an amniocentesis procedure because a full bladder can obscure visualization of the fetus and the needle placement. It is essential for a successful and safe procedure. The nurse should instruct the client to empty their bladder before the test.

Choice C:

The position during an amniocentesis is typically dorsal recumbent or semi-Fowler's position to allow for proper visualization of the fetus and needle placement. Lying on the left side is not a standard position for this procedure, so this information is incorrect and not necessary for the client.

Choice D:

Drinking 50 grams of oral glucose is not a requirement for an amniocentesis procedure. This information is unrelated to the amniocentesis and can be confusing for the client. Therefore, it is not necessary to include this in the instructions.

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Question 9:

A nurse is reviewing the plan of care for a group of clients.
The nurse should identify that informed consent is required for which of the following procedures?

A. Placement of a central venous catheter. B. Insertion of a nasogastric tube. C. Irrigation of a wound with antibiotic solution. D. Administration of an iron injection using Z-track technique.

Answer and Explanation

Choice A:

Informed consent is required for invasive procedures that carry significant risks or potential complications. Placement of a central venous catheter is an invasive procedure that involves inserting a catheter into a large vein, often in the neck, chest, or groin. It carries potential risks such as infection, bleeding, and injury to nearby structures. Therefore, informed consent is necessary before performing this procedure.

Choice B:

Insertion of a nasogastric tube is an invasive procedure, but it is generally considered a routine and less risky procedure compared to others. Informed consent is typically not required for nasogastric tube insertion unless there are specific institutional policies or the client lacks decision-making capacity.

Choice C:

Irrigation of a wound with antibiotic solution is a standard nursing procedure, and informed consent is not typically required for wound care unless there are specific circumstances that make it necessary, such as unusual risks or patient-specific considerations.

Choice D:

Administration of an iron injection using Z-track technique is also an invasive procedure, but it is a common and well-established technique for administering intramuscular injections. Informed consent is not routinely required for this procedure unless there are specific institutional policies or the client's condition warrants it.

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Question 10:

A nurse in a provider's office is reinforcing teaching about skin care with a client who has a new diagnosis of systemic lupus erythematosus.
Which of the following statements by the client indicates an understanding of the teaching?

A. "I will cleanse my skin using an antibacterial soap.” B. "I will dry my skin by patting it with a towel.” C. "I will use an astringent on my face.” D. "I will limit my time in the tanning bed to 15 minutes.”

Answer and Explanation

Choice A:

Cleansing the skin with an antibacterial soap is not typically recommended for clients with systemic lupus erythematosus (SLE) unless there is a specific medical indication for antibacterial soap. Using mild, non-irritating, hypoallergenic soap is usually preferred to avoid skin irritation in individuals with SLE.

Choice B:

This is the correct answer. Patting the skin dry with a towel instead of rubbing it helps to prevent excessive friction and irritation, which can be particularly important for individuals with SLE who may have sensitive skin. The client demonstrates an understanding of appropriate skin care by choosing this option.

Choice C:

Using an astringent on the face is generally discouraged for individuals with SLE. Astringents can be harsh and may irritate the skin, which can exacerbate skin problems commonly associated with SLE. This statement indicates a misunderstanding of appropriate skin care.

Choice D:

Limiting time in the tanning bed is advisable for anyone, as excessive exposure to UV radiation can increase the risk of skin damage and skin cancers. However, individuals with SLE are especially sensitive to UV radiation, and they should avoid tanning beds altogether. This statement indicates a lack of understanding of the specific needs of individuals with SLE regarding sun exposure.

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Total Questions : 180

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ATI PN Exit 2023

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