Med-Surg ATI LVN or PN

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Sample questions from Med-Surg ATI LVN or PN

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift, report identifies four clients. Which client should the practical nurse report to the RN first?

   • A.A client with arthritis requesting an as-needed analgesic
   • B.A client with diabetes whose premeal blood glucose is 180 mg/dL
   • C.A client 2 hours after surgery who is newly restless and has an SpO2 of 88% on room air
   • D.A client with chronic heart failure who has gained 1 lb (0.45 kg) in 24 hours

   Rationale: New restlessness with oxygen saturation of 88% may indicate hypoxia and requires prompt reporting and action within facility protocol. A 1-lb weight gain, glucose of 180 mg/dL, and a request for analgesia warrant follow-up but are less urgent. The practical nurse reports the change rather than independently diagnosing or changing the plan of care.

2. 2.A client with heart failure is preparing for discharge. Which instructions should the practical nurse reinforce from the established teaching plan? Select all that apply.

   • A.Take prescribed medications as directed, even when you feel well.
   • B.Call the provider for a weight gain of 2 lb (0.9 kg) in a day or 5 lb (2.3 kg) in a week.
   • C.Weigh yourself each morning after urinating, using the same scale.
   • D.Use salt substitutes freely to season food.
   • E.Limit fluids only if your individualized plan specifies a restriction.

   Rationale: Daily weights under consistent conditions help detect fluid retention, and the specified weight gain should be reported. Prescribed medications should be taken as directed, and fluid limits should follow the client's individual instructions. Salt substitutes may contain potassium and should not be used freely without approval; the practical nurse reinforces, rather than independently establishes, the plan.

3. 3.The provider prescribes digoxin 0.125 mg orally for an older adult. The apical pulse counted for 1 minute is 54/min. What should the practical nurse do?

   • A.Ask the client to walk, then repeat the pulse.
   • B.Give the medication with food.
   • C.Give half the dose and recheck the pulse in 1 hour.
   • D.Hold the dose and report the pulse to the RN.

   Rationale: A pulse of 54/min is below the usual hold parameter for digoxin, so the practical nurse should withhold the dose and promptly report the finding according to facility policy. Giving the medication or independently reducing the dose is unsafe. Activity is not an appropriate way to evaluate bradycardia before administering the medication.

4. 4.In a long-term care facility, a resident with dementia repeatedly asks when a family member will visit. Which response is most therapeutic?

   • A.Your family member is coming after lunch. Would you like to look at your photo album while you wait?
   • B.You have asked that several times; try to remember what I told you.
   • C.You should stop worrying because nothing is wrong.
   • D.I will call your family member and ask them to come immediately.

   Answer and rationale are in the full material.

5. 5.A client with a new colostomy is practicing care with the practical nurse after the RN has provided initial teaching. Which actions indicate correct understanding? Select all that apply.

   • A.Report a dusky or black stoma to the health care team.
   • B.Clean the skin around the stoma gently and dry it before applying the barrier.
   • C.Cut the skin barrier opening slightly larger than the stoma.
   • D.Change the appliance only when it leaks, regardless of the schedule.
   • E.Empty the pouch when it is about one-third to one-half full.

   Answer and rationale are in the full material.