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PN ATI Capstone Proctored Comprehensive Assessment Form A
1. A healthcare professional is teaching a client about reducing the risk of urinary tract infections (UTIs). Which factor increases the risk of UTI?
- A. Wearing underwear with a cotton crotch
- B. Wiping from front to back
- C. Using perfumed toilet paper
- D. Urinating after intercourse
Correct answer: C
Rationale: Using perfumed toilet paper can irritate the urinary tract and increase the risk of UTI, so it should be avoided. Wearing underwear with a cotton crotch (Choice A) is a preventive measure as cotton allows for better air circulation and reduces moisture, lowering the risk of UTIs. Wiping from front to back (Choice B) helps prevent the introduction of bacteria from the anal region to the urinary tract. Urinating after intercourse (Choice D) can help flush out bacteria introduced during sexual activity, thereby reducing the risk of UTIs.
2. A nurse is caring for a client with end-stage osteoporosis who is experiencing severe pain and a respiratory rate of 14/min. Which medication should the nurse prioritize?
- A. Promethazine
- B. Hydromorphone
- C. Ketorolac
- D. Amitriptyline
Correct answer: B
Rationale: In this situation, the nurse should prioritize administering Hydromorphone (choice B), an opioid analgesic, to manage the severe pain effectively. Opioids are the first-line treatment for severe pain, especially in end-stage conditions like osteoporosis. Promethazine (choice A) is an antihistamine and antiemetic, not a potent analgesic. Ketorolac (choice C) is a nonsteroidal anti-inflammatory drug (NSAID) that may not provide sufficient pain relief in severe cases. Amitriptyline (choice D) is a tricyclic antidepressant used for neuropathic pain and depression, but it is not the first choice for managing severe pain in this scenario.
3. A client with mild persistent asthma is being taught about montelukast by a nurse. Which statement by the client indicates understanding?
- A. I will use this for asthma attacks.
- B. I should take this before exercise.
- C. This medication will decrease swelling and mucus production.
- D. I can stop this medication after 10 days.
Correct answer: C
Rationale: The correct answer is C: 'This medication will decrease swelling and mucus production.' Montelukast is a leukotriene receptor antagonist that works by reducing swelling and mucus production in the airways, helping to manage asthma symptoms in the long term. Choices A, B, and D are incorrect because montelukast is not used for immediate relief during asthma attacks, pre-exercise prophylaxis, or short-term treatment; instead, it is taken regularly for asthma control.
4. A client is receiving magnesium sulfate for preeclampsia. Which finding indicates magnesium toxicity?
- A. Respiratory rate of 12/min
- B. Diminished deep tendon reflexes
- C. Urine output 40 mL/hr
- D. Systolic blood pressure of 140 mm Hg
Correct answer: B
Rationale: Diminished deep tendon reflexes are a sign of magnesium toxicity. Magnesium sulfate can depress the central nervous system, leading to decreased reflexes. Respiratory rate of 12/min, urine output 40 mL/hr, and systolic blood pressure of 140 mm Hg are not specific findings of magnesium toxicity. Respiratory depression, oliguria, and hypotension are more concerning signs that require immediate attention.
5. A nurse is preparing to administer 2.5 mL of medication intramuscularly to an adult client. Which site is safest for the nurse to use?
- A. Ventrogluteal
- B. Dorsogluteal
- C. Vastus lateralis
- D. Rectus femoris
Correct answer: A
Rationale: The correct answer is 'Ventrogluteal.' The ventrogluteal site is recommended for intramuscular injections in adults because it is free of major blood vessels and nerves, reducing the risk of injury or complications. Choice B, 'Dorsogluteal,' is not recommended due to the proximity of the sciatic nerve and major blood vessels. Choices C and D, 'Vastus lateralis' and 'Rectus femoris,' are sites commonly used for intramuscular injections but are more suitable for pediatric or specific population groups, not typically for adults.
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