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PN ATI Capstone Proctored Comprehensive Assessment Form B
1. A nurse is assessing a client who has a history of atrial fibrillation and is receiving warfarin. Which of the following laboratory values should the nurse monitor to determine the effectiveness of the warfarin?
- A. Platelet count
- B. International normalized ratio (INR)
- C. Bleeding time
- D. Partial thromboplastin time (PTT)
Correct answer: B
Rationale: The correct answer is B: International normalized ratio (INR). The INR is used to monitor the effectiveness of warfarin therapy. A higher INR indicates a longer time it takes for the blood to clot, which is desirable in patients receiving warfarin to prevent blood clots. Platelet count (Choice A) assesses the number of platelets in the blood and is not directly related to warfarin therapy. Bleeding time (Choice C) evaluates the time it takes for a person to stop bleeding after a standardized wound, but it is not specific to monitoring warfarin effectiveness. Partial thromboplastin time (PTT) (Choice D) is more commonly used to monitor heparin therapy, not warfarin.
2. A nurse is caring for a client with congestive heart failure. Which of the following prescriptions should the nurse anticipate?
- A. Call the provider if the respiratory rate is less than 18/min
- B. Administer a 500 mL IV bolus of 0.9% sodium chloride over 1 hour
- C. Administer enalapril 2.5 mg PO twice daily
- D. Call the provider if the client’s pulse rate is less than 80/min
Correct answer: C
Rationale: Enalapril, an ACE inhibitor, is commonly prescribed to manage hypertension and heart failure. It helps reduce the workload on the heart and prevent fluid retention. Options A, B, and D are incorrect. Option A focuses on a respiratory rate, which is not specific to heart failure management. Option B suggests administering a large IV bolus of fluid, which can worsen heart failure by increasing fluid volume. Option D addresses the pulse rate, which is not a typical parameter to monitor for heart failure specifically.
3. A healthcare professional is assessing a client in the PACU. Which finding indicates decreased cardiac output?
- A. Shivering
- B. Oliguria
- C. Bradypnea
- D. Constricted pupils
Correct answer: B
Rationale: The correct answer is B: Oliguria. Oliguria (low urine output) is a sign of decreased cardiac output because the kidneys are not receiving enough blood to produce an adequate amount of urine. Shivering (choice A) is a response to hypothermia or the body's attempt to generate heat. Bradypnea (choice C) refers to abnormally slow breathing rate and is not directly related to cardiac output. Constricted pupils (choice D) are more indicative of conditions affecting the nervous system or medications.
4. A client who has osteoporosis is being discharged with a new prescription for alendronate. Which of the following instructions should the nurse provide?
- A. Take the medication at bedtime.
- B. Take the medication with a full glass of water.
- C. Take the medication with food.
- D. Lie down for 30 minutes after taking the medication.
Correct answer: B
Rationale: The correct answer is to take the medication with a full glass of water. Alendronate should be taken with a full glass of water to prevent esophageal irritation. Additionally, the client should remain upright for 30 minutes after taking it to prevent potential adverse effects. Choice A is incorrect because alendronate should not be taken at bedtime, but rather in the morning on an empty stomach. Choice C is incorrect because alendronate should be taken on an empty stomach, not with food. Choice D is incorrect because the client should remain upright, not lie down, for 30 minutes after taking the medication.
5. A nurse is educating a patient about their new prescription for a statin medication. What should the nurse advise the patient to avoid while taking this medication?
- A. Drinking grapefruit juice
- B. Consuming high-protein meals
- C. Exercising regularly
- D. Taking the medication in the morning
Correct answer: A
Rationale: The correct answer is A: Drinking grapefruit juice. Grapefruit juice can increase the risk of statin toxicity by interfering with the enzyme that metabolizes statin medications, leading to higher drug levels in the body. This interaction can potentially cause adverse effects. Therefore, patients should be advised to avoid consuming grapefruit juice while taking statins. Choices B, C, and D are incorrect. Consuming high-protein meals, exercising regularly, and taking the medication in the morning are not contraindicated while on statin therapy. In fact, following a healthy diet, engaging in physical activity, and taking the medication at a consistent time each day can be beneficial for patients prescribed statins.
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