Review ATI LPN Fundamentals exam 7

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ATI LPN Fundamentals exam 7

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Total Questions : 46

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Question 1:

A nurse is preparing to administer an intradermal injection for a client who requires a tuberculin skin test. Which of the following actions should the nurse plan to take?

A. Hold the syringe at a 20° angle to the client's skin. B. Draw up 0.5 mL of purified protein derivative (PPD) from the vial. C. Place a 1 in needle on the syringe. D. Hold the skin taut at the chosen site with the nondominant hand before inserting the needle.

Answer and Explanation

Choice A:

The syringe should be held at a 5 to 15-degree angle to the client's skin, not 20 degrees.

Choice B:

For a tuberculin skin test (PPD test), typically 0.1 mL (one-tenth of a milliliter) of PPD is injected intradermally. This is a very small amount compared to 0.5 mL.

Choice C:

The length of the needle for an intradermal injection is typically shorter than 1 inch, usually around 3/8 to 5/8 inches (10-16 mm). Using a longer needle may increase the risk of inserting the needle too deeply, potentially leading to subcutaneous rather than intradermal injection.

Choice D:

Holding the skin taut helps stabilize the area and ensures that the needle penetrates the skin smoothly and at the correct angle. This also helps prevent the needle from going too deep or slipping out of the site during injection.

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Question 2:

A nurse is preparing to administer amoxicillin 250 mg PO every 8 hr. The amount available is amoxicillin 125 mg tablets. How many tablets should the nurse administer per dose?

(Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Answer and Explanation

Correct Answer: "2" tablets

Explanation

To administer a dose of 250 mg of amoxicillin when only 125 mg tablets are available, the nurse would need to give two tablets. This is because each tablet contains 125 mg, and two tablets would equal the required dose of 250 mg

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Question 3:

A nurse is preparing an injection using a single dose glass ampule. Which of the following actions should the nurse take?

A. Shake the ampule to move the solution below the neck. B. Use a filter needle to draw up the medication. C. Wear sterile gloves when withdrawing the medication from the ampule. D. Snap the top of the ampule towards hands.

Answer and Explanation

Choice A:

Shaking a glass ampule is not recommended because it can lead to the introduction of glass particles or cause the solution to foam or become contaminated. Instead, gently flicking the ampule with a finger can help move any solution that may be adhering to the neck downward, but shaking should be avoided.

Choice B:

When drawing medication from an ampule, especially if it's a solution that may contain particulate matter or to ensure sterility, using a filter needle is recommended. A filter needle has a membrane filter that prevents particles from being drawn into the syringe while allowing the medication to pass through.

Choice C:

While wearing gloves is important for infection control, sterile gloves are not typically required for withdrawing medication from a single-dose glass ampule. Standard aseptic technique and hand hygiene are usually sufficient.

Choice D:

Ampules are designed to be opened by snapping the top away from the body to avoid potential injury from glass shards. The nurse should use a gauze pad or an ampule opener to break the ampule open safely, directing any breakage away from themselves and others.

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Question 4:

A nurse is reinforcing teaching with a client who has diabetes mellitus about using a glucometer to monitor her blood glucose. Which of the following actions should the nurse identify as an indication that the client understands the instructions?

A. Avoids using the fingers of her dominant hand as puncture sites. B. Avoids using the thumbs as puncture sites C. Uses the side of a fingertip as the puncture site D. Uses the ball of a finger as the puncture site

Answer and Explanation

Choice A:

Avoiding the use of the thumbs is not necessary unless they are calloused or used frequently for other tasks that could affect sensitivity.

Choice B:

Avoiding the use of the dominant hand's fingers are not necessary unless they are calloused or used frequently for other tasks that could affect sensitivity.

Choice C:

This method is recommended because it is less painful, as the sides of the fingertips have fewer nerve endings compared to the pads or 'balls' of the fingers.

Choice D:

Using the ball of the finger is not recommended for blood glucose monitoring because it can be more painful and may lead to less blood flow, resulting in difficulty obtaining an adequate blood sample.

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Question 5:

A nurse is reinforcing teaching with a client who reports taking bisacodyl daily. Which of the following information should the nurse include?

A. "Daily bowel movements are necessary for good intestinal health." B. "Decrease your intake of high-fiber foods." C. "Chronic use of laxatives can lead to a tear in the rectal mucosa." D. "Excessive laxative use can cause rectal burning, dehydration and electrolyte imbalance."

Answer and Explanation

Choice A:

While regular bowel movements are important for many individuals, daily bowel movements are not necessary for everyone and can vary depending on diet, hydration, and individual health conditions.

Choice B:

Bisacodyl is a stimulant laxative used for short-term relief of constipation. It does not interact with dietary fiber intake, nor should the client necessarily decrease high-fiber foods unless specifically advised by their healthcare provider for other reasons.

Choice C:

Chronic use of bisacodyl, a stimulant laxative, can indeed lead to dependence and potentially harmful effects on the body's water and salt balance

Choice D:

Excessive use of bisacodyl or other laxatives can indeed cause these adverse effects. Rectal burning can occur due to irritation from frequent bowel movements, while dehydration and electrolyte imbalance can result from fluid loss caused by frequent laxative use.

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Question 6:

A nurse is caring for an 8-month-old infant who is receiving intravenous (IV) fluids via a 24-gauge catheter. Which of the following statements by the client's mother indicates that the nurse should check the site for signs of infiltration?

A. "There's blood backing up my baby's IV tubing." B. "My baby's fingers are looking swollen." C. "There's a long red streak up my baby's arm." D. "The tape is coming off the IV needle."

Answer and Explanation

Choice A:

Blood backing up in the IV tubing could indicate issues like a clot in the line or a slow flow rate, but it does not specifically suggest infiltration. It might prompt the nurse to check for other issues such as patency of the IV line or the need for flushing.

Choice B:

Swelling around the IV site or in the extremity (such as the fingers) can be a sign of infiltration. This occurs because the IV fluid leaks into the surrounding tissues, causing localized swelling.

Choice C:

A long red streak up the arm could indicate inflammation or infection along the vein (phlebitis) rather than infiltration. Phlebitis can be caused by mechanical irritation, chemical irritation from the IV fluids, or infection.

Choice D:

Tape coming off the IV needle suggests a need for re-securing the IV, but it does not directly indicate infiltration. However, if the tape is coming off, it's important to check the entire IV site to ensure the catheter is still properly inserted and there are no signs of infiltration or dislodgment.

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Question 7:

A charge nurse is observing a nurse performing a Mantoux tuberculin skin test for a client. Which of the following actions should prompt the charge nurse to intervene?

A. Creating a 6 mm (1/4 in) bleb in the intradermal space of the forearm B. Visualizing the tip of the needle under the skin C. Stretching the skin tightly before injection D. Withdrawing the needle and massages the site gently

Answer and Explanation

Choice A:

For a Mantoux tuberculin skin test, the standard technique involves injecting a small amount of tuberculin purified protein derivative (PPD) intradermally to create a wheal or bleb that is typically 6 mm in diameter. If the nurse creates a bleb significantly larger or smaller than the recommended size, it could affect the interpretation of the test result.

Choice B:

It's important to avoid visualizing the needle tip under the skin during the injection. This can lead to inaccurate placement of the PPD solution, potentially resulting in an improperly administered test.

Choice C:

Stretching the skin tightly before injection is actually a correct technique for performing a Mantoux tuberculin skin test. This helps stabilize the injection site and ensures the needle is inserted at the correct angle for an intradermal injection.

Choice D:

After administering the PPD solution intradermally, the nurse should not withdraw the needle and massage the site. Massaging can cause the PPD to disperse outside the intended area and affect the accuracy of the test result. Instead, the nurse should gently blot the site with a gauze pad if there is any bleeding, without massaging.

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Question 8:

A nurse is assisting with the care of a client who is receiving an IV infusion of dextrose 10% in water. The nurse should monitor the client for which of the following adverse effects?

A. Hypercalcemia B. Hyperglycemia C. Hypovolemia D. Hypokalemia

Answer and Explanation

Choice A:

Dextrose 10% in water does not contain calcium. Hypercalcemia refers to elevated calcium levels in the blood, which can occur due to various causes such as hyperparathyroidism or excessive vitamin D intake, but not from D10W infusion.

Choice B:

Dextrose 10% in water is a solution that contains a high concentration of glucose (dextrose). Infusing D10W can lead to an increase in blood glucose levels, especially if the client's body cannot metabolize the glucose effectively (e.g., in diabetic patients or those with impaired glucose tolerance).

Choice C:

Dextrose 10% in water is not used to treat hypovolemia (low blood volume). It is a solution primarily used to provide calories and prevent ketosis rather than to expand circulating blood volume.

Choice D:

Dextrose 10% in water does not contain potassium. Hypokalemia (low potassium levels) can occur due to various reasons such as diuretic use, gastrointestinal losses, or inadequate intake, but it is not directly related to D10W infusion.

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Question 9:

A nurse is caring for a patient who is receiving DSW with 20 mEq of KCL at 75 mL/hr. The provider has prescribed 1 g of ceftriaxone IV. When preparing to administer this medication by IV piggyback, which of the following data is the highest priority for the nurse to consider before administration?

A. The patient's vital signs<br> B. The medication's compatibility with the primary IV solution C. The patient's level of consciousness D. The amount of IV solution in the primary bag

Answer and Explanation

Choice A:

Vital signs provide crucial information about the patient's overall condition, but they do not directly impact the administration of the IV medication ceftriaxone. However, if there are significant changes in vital signs (e.g., fever, hypotension), these could influence the decision to administer ceftriaxone or any medication.

Choice B:

This is the highest priority. Before administering ceftriaxone via IV piggyback, the nurse must ensure compatibility with the primary IV solution (D5W with KCl). Certain medications can interact chemically or physically with other IV solutions or medications, leading to precipitation, inactivation, or other adverse effects. Compatibility should be verified through appropriate resources or pharmacy guidelines.

Choice C:

Important, but not directly related to medication administration. The patient's level of consciousness is crucial for assessing their neurological status and response to treatment, but it does not affect the administration of ceftriaxone IV piggyback specifically.

Choice D:

Important, but not the highest priority in this context. Monitoring the amount of IV solution in the primary bag is essential to ensure continuous fluid delivery and prevent interruptions in therapy. However, for the immediate preparation and administration of ceftriaxone IV piggyback, ensuring compatibility with the primary IV solution takes precedence.

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Question 10:

A nurse is assisting with supervising a newly licensed nurse replace a short-peripheral IV device for a client. Which of the following actions by the new nurse indicates an understanding of the procedure?

A. Leaves small air bubbles in the new infusion tubing. B. Inserts the new device distal to the old IV site. C. Wears clean gloves during the new IV insertion. D. Shaves the hair on the client's skin before inserting the new IV.

Answer and Explanation

Choice A:

Leaving air bubbles in the new infusion tubing is not correct practice. Air bubbles can potentially enter the client's bloodstream and cause an air embolism, which is a serious complication. Therefore, this action indicates a lack of understanding of IV therapy safety.

Choice B:

A When replacing a short-peripheral IV device, it is standard practice to insert the new device distal (further down) from the old IV site. This helps to minimize the risk of complications such as phlebitis at the previous insertion site and allows for better venous access for future IV placements.

Choice C:

When performing any invasive procedure like inserting an IV, the nurse should wear sterile gloves, not just clean gloves. Sterile gloves help maintain aseptic technique and reduce the risk of introducing infection into the client's bloodstream or surrounding tissues.

Choice D:

Shaving the hair on the client's skin is unnecessary and not recommended before inserting a short- peripheral IV device. It can cause microabrasions or irritation to the skin, increasing the risk of infection. The nurse should select a suitable insertion site where hair is minimal and use appropriate cleaning techniques instead.

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Amanda: Wouldn't you want to change arms when inserting a new IV rather than just distal of the olld site? ~ 3mos ago

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ATI LPN Fundamentals exam 7

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