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PN ATI Capstone Proctored Comprehensive Assessment Form A
1. A nurse is assessing a client with suspected myocardial infarction. Which finding should the nurse report to the provider?
- A. Pain radiating to the left arm
- B. Pain relieved by rest
- C. Pain worsened with breathing
- D. Pain relieved by antacids
Correct answer: A
Rationale: The correct answer is A: Pain radiating to the left arm. This is a classic symptom of myocardial infarction and indicates possible heart involvement. Reporting this finding to the provider is crucial for prompt evaluation and intervention. Choices B, C, and D are incorrect. Pain relieved by rest, pain worsened with breathing, and pain relieved by antacids are not typical symptoms of myocardial infarction. These findings do not raise the same level of concern as pain radiating to the left arm and are less indicative of cardiac involvement.
2. A healthcare provider is reviewing a client’s care plan. Which of the following goals is most appropriate?
- A. Client will inject insulin twice daily
- B. Client will keep appointments with the healthcare provider for 6 months
- C. Client's A1c will be 5% within one year
- D. Client's blood glucose will stay between 60-120 mg/dL
Correct answer: C
Rationale: The correct answer is C. A1c is a key indicator of long-term diabetes management, reflecting average blood sugar levels over the past 2-3 months. Achieving a target A1c of 5% indicates good control of blood sugar levels and reduces the risk of diabetes-related complications. Choices A, B, and D are not as appropriate as they focus on short-term tasks or individual blood glucose readings, rather than long-term management and outcomes.
3. A nurse is reviewing a prescription for doxazosin with a client. Which instruction should the nurse include?
- A. Decrease caloric intake to reduce weight gain
- B. Increase dietary fiber to prevent constipation
- C. Rise slowly when sitting up
- D. Take this medication each morning
Correct answer: C
Rationale: The correct answer is C: 'Rise slowly when sitting up.' Doxazosin can cause orthostatic hypotension, a sudden drop in blood pressure when standing up, leading to dizziness or fainting. Instructing the client to rise slowly helps prevent this adverse effect. Choices A, B, and D are incorrect. A decrease in caloric intake to reduce weight gain, an increase in dietary fiber to prevent constipation, and taking the medication each morning are not specific instructions related to managing the side effects of doxazosin.
4. A nurse is caring for a client 4 hours postoperative following a thyroidectomy. The client reports fullness in the throat. What should the nurse assess for?
- A. Hypocalcemia
- B. Hemorrhage
- C. Hypoxia
- D. Hypothyroidism
Correct answer: B
Rationale: In this scenario, the correct answer is B: Hemorrhage. Fullness in the throat post-thyroidectomy can indicate postoperative bleeding, a critical complication that requires immediate assessment and intervention. Choice A, Hypocalcemia, is incorrect because it does not typically present with fullness in the throat. Choice C, Hypoxia, is not directly related to the symptom described and is not the primary concern in this situation. Choice D, Hypothyroidism, is also incorrect as it is a long-term condition and unlikely to manifest suddenly 4 hours postoperatively with throat fullness.
5. While assessing four clients, which client data should be reported to the provider?
- A. Client with pleurisy who reports a pain level of 6 out of 10 when coughing
- B. Client with 110 mL of serosanguineous fluid from a JP drain
- C. Client 4 hours postoperative with a heart rate of 98 bpm
- D. Client undergoing chemotherapy with an absolute neutrophil count of 75/mm³
Correct answer: D
Rationale: An absolute neutrophil count of 75/mm³ is critically low and places the client at high risk for infection, necessitating immediate intervention. Neutropenia increases susceptibility to infections, making it essential to report this finding promptly. The other options, such as pain level in pleurisy, drainage amount from a drain, and heart rate postoperatively, are important but do not indicate an immediate life-threatening condition that requires urgent provider notification.
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