ATI LPN Comprehensive Predictor 2023 Review Flashcards

ATI LPN Comprehensive Predictor 2023 Proctored Exam Study Notes

Client Case 1: Adolescent in Clinic

• A nurse is assisting with the care of a client in a clinic. The following findings require immediate follow-up:
    - Vital Signs
      - Temperature: 36.7° C (98°F)
      - Blood pressure: 122/80 mm Hg
      - Respiratory rate: 20/min
      - Heart rate: 99/min
    - Nurses' Notes
      - 16-year-old client:
        - Reports major emotional distress due to recent traumatic events (tornado, loss of family)
        - Symptoms: anxiety, nightmares, increased marijuana use, social withdrawal.
        - Considered significant findings for immediate follow-up:
          - C. Client experiences nightmares
          - F. Friend reporting client is not themselves
          - G. Smoking marijuana to clear their mind
          - H. Witnessing the death of their parents and sibling

Rationale for Findings:

• C. Nightmares are indicative of acute stress disorder or PTSD.

• F. Changes in behavior reported by a peer require psychosocial evaluation.

• G. Marijuana use as coping needs intervention due to potential substance dependence.

• H. History of trauma increases risk for psychological distress and requires mental health follow-up.

Client Case 2: Outpatient Shoulder Injury

• A nurse is assisting a client in an outpatient setting for a shoulder injury:
    - Vital Signs
      - 1900:
        - Temperature: 37° C (98.6° F)
        - Heart rate: 101/min
        - Respiratory rate: 20/min
        - Blood pressure: 128/85 mm Hg
        - Oxygen saturation: 100% on room air
    - Medical Plan
      - Plan: Moderate sedation for shoulder reduction.
    - Administered Medication
      - Propofol 40 mg IV, Fentanyl 100 mcg IV, Midazolam 2.5 mg IV
    - Findings Indicating Immediate Actions
      - Decreased respiratory rate (10/min), low blood pressure (80/51 mm Hg), and dropping oxygen saturation (87% on 2 L/min).

• Correct Actions Recommended:
    - Administer naloxone
    - Administer supplemental oxygen 10 L/min via face mask

Rationale for Actions:

• Naloxone counteracts opioid overdose (Fentanyl).

• Increasing oxygen via a face mask corrects hypoxemia.

Client Case 3: Immobility Assessment

• A home care nurse identifies five complications for a client immobilized due to advancing multiple sclerosis:
    - Findings for Assessment
      - Temperature: 36.8° C (98.2° F)
      - Heart rate: 80/min
      - Respiratory rate: 20/min
      - Blood pressure: 116/76 mm Hg
    - Complications:
      - B. Atelectasis
      - D. Urinary stasis
      - E. Pressure ulcer
      - G. Contractures
      - H. Calcium resorption

Rationale for Findings:

• Atelectasis: Reduced lung expansion due to immobility.

• Urinary Stasis: Risk due to inability to void completely.

• Pressure Ulcer: Continuous pressure from immobility.

• Contractures: Decreased range of motion leads to muscle shortening.

• Calcium Resorption: Imbalance due to immobility.

Client Case 4: Post-Operative Care

• A nurse assists a post-operative client:
      - Findings after IV fluid error:
          - Priority: collect data on the client to assess for fluid overload or related complications.
          - Notify the provider after assessment.
          - Complete an incident report as an administrative follow-up.

Rationale: Immediate patient assessment is critical to troubleshoot fluid errors before administrative measures.

Client Case 5: Labor and Delivery

• A nurse is assisting following an epidural:
    - Essential Interventions:
       - A. Monitor fetal heart rate
       - B. Place client in left lateral position
       - E. Assist with ampicillin IV administration

• Contraindicated:
    - C. Decrease IV flow rate; IV fluids should be maintained after an epidural.
    - D. Request ephedrine only if hypotension develops.

Client Case 6: Dysphagia Management

• Recommended interventions include:
      - Elevate the head of client's bed to at least 90° during meals.
      - Encourage small, frequent meals to aid swallowing.
      - Avoid distractions that could impact concentration on eating.

Client Case 7: Medication Adverse Effects

• Observed patient adverse effects after administering hydromorphone include:
      - C. Urinary retention; opioids can cause decreased bladder tone and retention issues.

Rationale: Correct understanding of opioid effects and monitoring of urinary output is necessary for safety.

Client Case 8: Teaching for Post-Radiation Care

• Instruct clients undergoing neck radiation to:
      - Eat small, frequent meals to prevent mucositis-related discomfort
      - Avoid skin contact with extreme temperatures, including cold.

Client Case 9: Clostridium Difficile Isolation

• Recommended precautions:
      - Use contact precautions, including washing hands with soap and water post-care, not alcohol rubs. Avoid unnecessary items in the patient's room.

Client Case 10: Discharge Teaching for Acute Care

• Effective discharge instructions after thyroid-related surgeries:
      - Clients should maintain a high-protein diet for recovery.
      - Importance of monitoring for signs of hemorrhage and infection.
      - Avoid exposure of the surgical area to extreme conditions.

Client Case 11: Managing IV Infiltration

• Immediate action for infiltration:
      - Stop the infusion immediately to prevent tissue damage.
      - Elevate the affected extremity and apply warm compresses post-assessment.

Rationale: Early intervention can reduce complications from infiltrations.

Summary of Key Points

• Prioritization of client needs based on symptoms and findings.

• Importance of thorough monitoring and patient education in various scenarios.

• Recognizing critical signs and timely action regarding medication administration and therapeutic interventions.