LPN > Exit Exams

Exam Review

ATI LPN Comprehensive Predictor 2023

We are excited to announce the release of a NEW VERSION OF THE SYSTEM! To benefit from the latest features, improvements, and component updates, please switch to the new system as soon as possible.

Total Questions : 178

Showing 20 questions, Sign in for more
Question 1:

1200:

58-year-old client reporting chest pain is admitted to the emergency department. Client states chest pain began this morning after breakfast and pain radiates to left arm. Client rates pain as 4 on a scale of 0 to 10. Client has medical history of hypertension, type 2 diabetes mellitus, and hyperlipidemia. Social history, denies alcohol use, smokes 1 pack per day for 35 years

Current medications:

Lisinopril 20 mg PO daily

Glucophage 500 mg PO BID

Simvastatin 20 mg PO daily

1230:

Nurse called to bedside. Client reports sudden onset of chest pain and shortness of breath. Client rates chest pain as 7 on a scale of 0 to 10.

1215:

ECG: sinus tachycardia

1300:

Cardiac troponin T less than 0.1 ng/mL (less than 0.1 ng/mL)

LDL 110 mg/dL (less than 130 mg/dL)

Total cholesterol 230 mg/dL (less than 200 mg/dL)

A nurse is assisting with the care of a client.

Exhibits

Complete the following sentence by using the list of options.

After notifying the provider, the nurse should first

and then

Answer and Explanation

Explanation

  • Administer sublingual nitroglycerin. Nitroglycerin is a first-line treatment for angina or suspected myocardial infarction. It dilates coronary arteries, improving blood flow and reducing myocardial oxygen demand.
  • Apply supplemental oxygen. Routine oxygen administration is no longer recommended unless the client is hypoxic (oxygen saturation below 90%) because excessive oxygen can lead to vasoconstriction and worsen myocardial injury.
  • Obtain a 12-lead ECG. While an ECG is important for diagnosing myocardial infarction, the priority in an acute chest pain episode is symptom relief and hemodynamic stability. The ECG should already have been obtained at admission.
  • Administer morphine sulfate IV. Morphine is used to manage severe chest pain that is not relieved by nitroglycerin. It reduces myocardial oxygen demand, preload, and anxiety, which can help relieve symptoms.
  • Monitor vital signs. Continuous monitoring is essential, but it is not the most immediate intervention in an acute episode of worsening chest pain. The focus should be on relieving ischemia and reducing myocardial workload.
  • Educate the client about smoking cessation. While smoking cessation is critical for long-term cardiovascular health, education is not a priority when the client is experiencing acute chest pain requiring immediate intervention.

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 2:

A nurse is reinforcing teaching with a client who is to have a plaster cast applied to his right arm. Which of the following information should the nurse include in the teaching?

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 3:

First office visit:

Client is 42 years old. Reports bilateral wrist and shoulder stiffness. Reports no history of trauma to upper extremities. Past surgical history includes appendectomy and two cesarean births.

Client takes cholesterol and diuretic medications. Family history of hypertension, hypercholesteremia, CVA, stomach cancer.

6-month follow-up:

Reports bilateral wrist and shoulder stiffness for several hours after waking up in the morning. Reports fatigue and loss of appetite.

First office visit:

  • Temperature 37.5° C (99.5° F)
  • Heart rate 92/min
  • Respiratory rate 20/min
  • Blood pressure 124/82 mm Hg
  • Oxygen saturation 100% on room air

6-month follow-up:

  • Temperature 37.7° C (99.8° F)
  • Heart rate 92/min
  • Respiratory rate 20/min
  • Blood pressure 120/78 mm Hg
  • Oxygen saturation 100% on room air

First office visit:

Erythrocyte sedimentation rate (ESR) 21 mm/hr (up to 20 mm/hr)

Hct 36% (37 to 47%)

Hgb 12 g/dL (12 to 16 g/dL)

WBC count 6,000/mm3 (5,000 to 10,000/mm3)

Uric acid 6.1 mg/dL (2.7 to 7.3 mg/dL)

6-month follow-up:

Erythrocyte sedimentation rate (ESR) 22 mm/hr (Up to 20 mm/hr)

Antinuclear antibodies (ANA) positive

Hct 35% (37 to 47%)

Hgb 11 g/dL (12 to 16 g/dL)

WBC count 4,000/mm3 (5,000 to 10,000/mm3)

Uric acid 6.3 mg/dL (2.7 to 7.3 mg/dL)

A nurse is caring for a client in an outpatient clinic.

Exhibits

Complete the following sentence by using the lists of options. The client is at highest risk for developing

evidenced by the client's

Answer and Explanation

Explanation

  • Rheumatoid arthritis is the most likely condition given the client’s bilateral wrist and shoulder stiffness lasting for several hours in the morning, fatigue, and loss of appetite. The elevated ESR and anemia further support chronic inflammation. Positive ANA, while not specific, can be present in RA and other autoimmune disorders.
  • Osteoarthritis is incorrect because it typically presents with stiffness that improves within 30 minutes of activity, not lasting for several hours. It is also a non-inflammatory condition, whereas the client has elevated ESR and anemia, suggesting an inflammatory process.
  • Gout is unlikely as it usually causes acute, severe joint pain with redness and swelling, often affecting the big toe. The client’s uric acid level is within normal range, making gout less probable.
  • Carpal tunnel syndrome primarily causes numbness, tingling, and weakness in the hands due to median nerve compression. It does not typically cause prolonged morning stiffness, fatigue, or systemic inflammation.
  • Positive ANA is not the best choice because while it is seen in rheumatoid arthritis, it is also present in other autoimmune diseases such as lupus. It does not specifically confirm RA.
  • Normal WBC count does not support an inflammatory condition, as RA can lead to mild leukopenia, which is seen in the follow-up labs.
  • Low blood pressure is not a defining feature of RA and does not correlate with the client’s symptoms or disease progression

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 4:

A nurse is reinforcing teaching with a client who is postoperative following a laparoscopic cholecystectomy. Which of the following statements by the client indicates an understanding of the teaching?

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 5:

1000:

Client states, "I am tired of undergoing treatment because it doesn't seem to be working." Client states, "I hope I am just constipated." Appendectomy scar on right lower quadrant. Abdomen is soft, tender in right lower quadrant, bowel sounds present in all four quadrants.

1200:

Surgeon has notified the client that surgical removal of the mass is advisable due to the client's history of metastasis and ongoing treatment failure. The client and their partner want to discuss end-of-life care. Client states, "I am unsure what it means to have a living will or a do-not-resuscitate order." The client's partner states, "I don't understand what power of attorney means." Both client and partner indicate that they might wish to decline further treatment as well as further lifesaving measures should they become necessary. The partner states, "How can we be sure that our decision about care will be honored?"

1000:

Client who has esophageal cancer admitted for constant abdominal pain. Has completed three rounds of chemotherapy after resection of esophageal tumor, as well as radiation to spine for metastasis.

1100:

Abdominal ultrasound: mass present in small intestine proximal to ileocecal valve. Size of mass is 6 cm x 7 cm (2.4 in x 2.8 in).

A nurse is assisting with the care of a client.

Exhibits

Select the 4 responsibilities the nurse has in relation to the client's advance directives.

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 6:

A nurse is collecting data from a client who is in renal failure. The nurse should identify that which of the following findings is a manifestation of hyperkalemia?

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 7:

3 months ago:

General: no acute distress

Respiratory: breath sounds clear bilateral

Cardiovascular: S1, S2, no murmur

Extremities: no edema

Skin: warm, dry

1 month ago:

General: fatigue

Respiratory: breath sounds clear bilaterally

Cardiovascular: S1, S2, no murmur

Extremities: 1+ bilateral lower extremity edema

Skin: dry, flaky skin

3 months ago:

Temperature 37° C (98.6° F)

Heart rate 79/min

Respiratory rate 18/min

Blood pressure 138/76 mm Hg

Weight 83.9 kg (185 lb)

Height 170.2 cm (67 in)

BMI 28.9

1 month ago:

Temperature 37° C (98.6° F)

Heart rate 75/min

Respiratory rate 19/min

Blood pressure 149/82 mm Hg

Weight 81.7 kg (180 lb)

Height 170.2 cm (67 in)

BMI 28.2

3 months ago:

Hgb 14 g/dL (14 to 18 g/dL)

Hct 42% (40% to 52%)

BUN 60 mg/dL (10 to 20 mg/dL)

Creatinine 3.38 mg/dL (0.5 to 1.1 mg/dL)

Potassium 4.8 mEq/L (3.5 to 5 mEq/L)

Calcium 9.2 mg/dL (9 to 10.5 mg/dL)

Carbon dioxide 23 mEq/L (23 to 30 mEq/L)

Brain natriuretic peptide 50 pg/mL (less than 100 pg/mL)

Iron saturation 24% (20% to 50%)

Transferrin 298 mg/dL (215 to 365 mg/dL)

1 month ago:

Hgb 13 g/dL (14 to 18 g/dL)

Hct 36% (40% to 52%)

BUN 70 (10 to 20 mg/dL)

Creatinine 4.89 mg/dL (0.5 to 1.1 mg/dL)

Potassium 4.9 mEq/L (3.5 to 5 mEq/L)

Calcium 8.9 mg/dL (9 to 10.5 mg/dL)

Carbon dioxide 20 mEq/L (23 to 30 mEq/L)

Brain natriuretic peptide 71 pg/mL (less than 100 pg/mL)

A nurse is assisting with the care of a client in an outpatient provider's office

Exhibits

Complete the following sentence by using the list of options.

The nurse should identify that the client is at risk of developing 

and may require

Answer and Explanation

Explanation

  • Chronic kidney disease. The client's laboratory results show elevated BUN and creatinine levels, which are indicative of impaired kidney function. A creatinine level of 4.89 mg/dL (normal range 0.5 to 1.1 mg/dL) and BUN of 70 mg/dL (normal range 10 to 20 mg/dL) suggest a decline in kidney function, which is characteristic of chronic kidney disease (CKD). The increasing creatinine levels and the elevated BUN over time point toward worsening kidney function, which may lead to kidney failure if not managed appropriately.
  • Dialysis. In the setting of advanced chronic kidney disease, particularly when kidney function deteriorates to a point where the kidneys can no longer adequately filter waste products from the blood, dialysis is often required. The increasing levels of creatinine and BUN indicate that the kidneys may be unable to function properly without intervention, potentially necessitating dialysis for proper waste management and fluid balance.

Rationale for Incorrect Options:

  • Heart failure: While the client has some evidence of fluid retention (1+ bilateral lower extremity edema), this alone is insufficient to confirm heart failure, especially since the heart sounds were noted as normal (S1, S2, no murmur). Further assessment is needed to evaluate the heart's pumping ability, including echocardiogram or other diagnostic tests.
  • Hypothyroidism: Although the client has dry, flaky skin and fatigue, these symptoms are not definitive for hypothyroidism. Thyroid function tests would be necessary to confirm the diagnosis.
  • Anemia: Although the client has slightly low hemoglobin (13 g/dL, normal is 14 to 18 g/dL) and hematocrit, this may be due to chronic kidney disease, and it does not directly indicate anemia without further evidence, such as low iron levels or additional laboratory findings.
  • Diuretic therapy: While diuretics are used in heart failure or fluid overload conditions, they are not indicated here for the management of chronic kidney disease unless there is fluid retention related to heart failure or other conditions.
  • Thyroid replacement therapy: There is no evidence from the client's lab results or clinical presentation suggesting hypothyroidism, so thyroid replacement therapy would not be indicated at this time.
  • Iron supplementation: While the client has a low iron saturation (24%), this alone does not warrant iron supplementation without a definitive diagnosis of iron-deficiency anemia. Further testing would be required to confirm this.

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 8:

A nurse is supervising an assistive personnel (AP) who is applying antiembolic stockings for a client. Which of the following actions by the AP requires intervention by the nurse?

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 9:

A nurse is collecting a health history from the guardian of a 4-year-old child. Which of the following statements by the guardian is the priority for the nurse to address?

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 10:

A nurse is receiving a telephone prescription from a client's provider. Which of the following actions should the nurse take? (Select all that apply.)

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 11:

Day of admission

1300:

The client is accompanied by a parent who reports that the client has become more aggressive and has been acting out at home. Few superficial cut marks on the wrist noted. The client has borderline personality disorder and alcohol use disorder.

Day 2

1000:

The client is angry and tells the nurse, "You are a horrible person." Client initiated a fight with other peers in the unit.

1300:

The client is encouraged to share their feelings. The client the nurse, "You are the best. Much better than the other.

Day of admission

1400:

Citalopram 20 mg PO daily

Consult for cognitive and behavior therapy

Day 3

1000:

Citalopram 20 mg PO twice per day

Valproate 500 mg PO daily

A nurse is assisting with the care of a client.

Exhibits

The nurse is collecting data from the client.

Drag words from the choices below to fill in each blank in the following sentence.

The nurse should identify that

and indicate manifestations of borderline personality disorder.

Answer and Explanation

Explanation

  • Emotional lability refers to rapid and intense mood swings, which are a common characteristic of borderline personality disorder. Individuals with this disorder may experience extreme shifts in emotions, such as sudden anger, sadness, or elation, often triggered by minor events.
  • Fear of abandonment is another core feature of borderline personality disorder. Individuals may go to great lengths to avoid real or perceived rejection, leading to unstable relationships and intense emotional reactions. This fear can manifest as extreme clinginess, hostility, or impulsivity when they believe they are being neglected or left alone.
  • Increased heart rate and elevated body temperature are physiological responses that can occur in various medical conditions but are not specific to borderline personality disorder. Tactile hallucinations, which involve the sensation of touch without a physical stimulus, are more commonly associated with substance use disorders or psychotic disorders rather than borderline personality disorder.

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 12:

A nurse is supervising an assistive personnel (AP) who is caring for a client who is at risk for falls. For which of the following actions by the AP should the nurse intervene?

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 13:

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

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 14:

2000:

Client presents to emergency department and states, "I have been assaulted." Client was immediately placed in a treatment room.

2015:

"Client states they were out with friends this evening and had "a little too much to drink." Client states that they fell asleep at their friend's house and when they woke up all of their clothes were off and their genitals were sore. The client states, "I think someone had sex with me, but I don't remember anything." Client reports history of depression. Client is a full-time college student who lives with roommates. Client admits to drinking socially but denies illicit drug use and tobacco use.

2030:

Sexual Assault Nurse Examiner (SANE) nurse paged to bedside.

2100:

SANE RN report:

Physical exam:

General: Tearful, young adult.

HEENT (Head, eyes, ears, nose, and throat): oropharynx clear, mucous membranes moist. Bruising noted to right side of neck and right cheek.

Gastrointestinal: Soft, nondistended, nontender.

Genitourinary: Bruising and discoloration to the perineum.

Neurologic: Alert and oriented.

2230:

Swabs and specimens collected and labeled. Photographs taken. Clothing taken and bagged.

A nurse is assisting in the care of a client.

Exhibits

Which of the following interventions should the nurse plan to implement? Select all that apply.

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 15:

A nurse is reinforcing teaching about healthy lifestyle changes with a female client who has mild hypertension. Which of the following statements by the client indicates an understanding of the teaching?

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 16:

A nurse on a mental health unit is caring for a client who is in restraints. Which of the following actions should the nurse take?

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 17:

A nurse is collecting data from a client during a routine prenatal visit. The client is in their second trimester of pregnancy and reports feeling dizzy, has a racing heart, and becomes pale while lying on their back. Which of the following actions should the nurse take?

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 18:

A nurse is assisting a client who requests to take a tub bath. Which of the following actions should the nurse take?

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 19:

A nurse is contributing to the plan of care for a client who is experiencing a herpes simplex outbreak. Which of the following interventions should the nurse recommend?

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Question 20:

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

Answer and Explanation

A
Your comment is awaiting moderation.
This field cannot be empty!!
0 Pulse Checks
No comments

Sign Up or Login to view all the 178 Questions on this Exam

Join over 100,000+ nursing students using Naxlex’s science-backend flashcards, practice tests and expert solutions to improve their grades and reach their goals.

Sign Up Now
learning

Join Naxlex Nursing for nursing questions & guides! Sign Up Now