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PN ATI Capstone Proctored Comprehensive Assessment 2020 A with NGN
1. A client has been prescribed albuterol. Which of the following is a priority adverse effect the nurse should monitor?
- A. Tachycardia
- B. Bradycardia
- C. Dizziness
- D. Hypertension
Correct answer: A
Rationale: Corrected Rationale: Albuterol, a beta-2 adrenergic agonist, can lead to tachycardia due to its stimulant effect on beta-2 receptors in the heart. Monitoring for tachycardia is crucial as it can be a sign of excessive sympathetic stimulation and may lead to severe complications. Bradycardia, dizziness, and hypertension are less likely adverse effects of albuterol, making them lower priority for monitoring in this context.
2. A nurse is assessing a client with pancreatitis. Which of the following findings should the nurse look for?
- A. Increased appetite
- B. Abdominal pain
- C. Weight gain
- D. Elevated blood pressure
Correct answer: B
Rationale: The correct answer is B: Abdominal pain. Abdominal pain, often severe, is a hallmark sign of pancreatitis. Other common symptoms include nausea, vomiting, and tenderness in the abdomen. Choices A, C, and D are incorrect because increased appetite, weight gain, and elevated blood pressure are not typically associated with pancreatitis. Therefore, the nurse should primarily focus on assessing for abdominal pain in a client with suspected pancreatitis.
3. A nurse is caring for a client prescribed hydroxychloroquine. Which of the following should the nurse monitor?
- A. Liver function tests
- B. Eye exams
- C. Blood glucose levels
- D. Complete blood count
Correct answer: B
Rationale: The correct answer is B: Eye exams. Hydroxychloroquine can cause retinal damage, making it essential for the nurse to monitor the client's eyes regularly for any changes. Monitoring liver function tests (choice A), blood glucose levels (choice C), or complete blood count (choice D) are not directly associated with the potential side effects of hydroxychloroquine.
4. A nurse is caring for an older adult client with delirium. Which intervention will most effectively reduce the client's risk for falls?
- A. Using a night-light
- B. Demonstrating how to use the call light
- C. Placing the bedside table in close proximity
- D. Hourly rounding by the nurse
Correct answer: D
Rationale: Hourly rounding by the nurse is the most effective intervention to reduce the risk of falls in older adult clients with delirium. This intervention ensures that the nurse regularly checks on the client, assesses their needs, and assists them with any activities, thereby minimizing the chances of falls. Using a night-light (choice A) may help improve visibility but does not provide continuous assistance and monitoring. Demonstrating how to use the call light (choice B) is important but may not prevent falls directly. Placing the bedside table in close proximity (choice C) is helpful for convenience but does not address the continuous monitoring and assistance needed to prevent falls in this case.
5. A nurse is caring for a client prescribed the HMG CoA reductase inhibitor, atorvastatin. Which of the following should be monitored while this medication is prescribed?
- A. Liver function test
- B. Renal function test
- C. Hearing screenings
- D. Visual acuity screenings
Correct answer: A
Rationale: Corrected Rationale: Atorvastatin, an HMG CoA reductase inhibitor, can lead to hepatotoxicity. Therefore, monitoring liver function through regular tests is essential. Baseline liver function should be assessed, followed by tests at 12 weeks after starting therapy and periodically thereafter. This monitoring helps detect early signs of liver damage, including jaundice, nausea, and dark urine. Incorrect Choices Rationale: B) Renal function test is not directly affected by atorvastatin. C) Hearing screenings and D) Visual acuity screenings are not indicated for monitoring while on atorvastatin therapy.
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