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PN ATI Capstone Proctored Comprehensive Assessment Form B
1. A nurse is assessing a client with chronic kidney disease. Which laboratory value would indicate the need for hemodialysis?
- A. Glomerular filtration rate (GFR) of 14 mL/min
- B. BUN 16 mg/dL
- C. Serum magnesium 1.8 mg/dL
- D. Serum phosphorus 4.0 mg/dL
Correct answer: A
Rationale: A GFR of 14 mL/min indicates significant kidney damage and a severe decrease in kidney function. This level of GFR typically indicates the need for hemodialysis to help the kidneys perform their function adequately. BUN, serum magnesium, and serum phosphorus levels are important in assessing kidney function and managing chronic kidney disease but do not specifically indicate the need for hemodialysis. Therefore, choices B, C, and D are incorrect.
2. A nurse is teaching a client with gestational diabetes about blood sugar control. Which of the following statements indicates understanding?
- A. I should test my blood sugar before each meal.
- B. I can eat any foods as long as I take my insulin.
- C. I should avoid all carbohydrates in my diet.
- D. I will only need to monitor my blood sugar at bedtime.
Correct answer: A
Rationale: The correct answer is A: 'I should test my blood sugar before each meal.' Monitoring blood sugar before meals is crucial for managing gestational diabetes as it helps in understanding how different foods affect blood sugar levels and adjusting insulin doses accordingly. Choice B is incorrect as food choices should be monitored carefully, not just relying on insulin. Choice C is incorrect because while it is important to manage carbohydrate intake, completely avoiding all carbohydrates is not recommended. Choice D is incorrect as blood sugar monitoring throughout the day is essential, not just at bedtime, to ensure proper control and management of gestational diabetes.
3. 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.
4. A client diagnosed with pneumonia is receiving oxygen therapy at 4 L/min via nasal cannula. Which of the following interventions is most important?
- A. Encourage fluid intake.
- B. Monitor oxygen saturation levels.
- C. Change the oxygen tubing daily.
- D. Assist with frequent position changes.
Correct answer: B
Rationale: Monitoring oxygen saturation levels is the most important intervention in this scenario. It ensures that the client is receiving adequate oxygenation, which is crucial for a client with pneumonia. By monitoring saturation levels, the nurse can promptly identify any oxygenation issues and adjust the oxygen delivery if necessary. Encouraging fluid intake, changing oxygen tubing daily, and assisting with frequent position changes are also important aspects of care for a client with pneumonia, but they are not as critical as monitoring oxygen saturation levels in ensuring immediate respiratory support.
5. A client has been prescribed ferrous sulfate. Which instruction should the nurse provide to the client?
- A. Avoid strawberries, citrus fruits, and melon to improve absorption
- B. Take with fluids other than coffee or tea
- C. Take on a full stomach
- D. Double the dose if you miss a dose one day
Correct answer: B
Rationale: The correct instruction the nurse should provide to a client prescribed ferrous sulfate is to take it with fluids other than coffee or tea. Coffee and tea can inhibit iron absorption. Therefore, choices A, C, and D are incorrect. Avoiding strawberries, citrus fruits, and melon is not necessary for improving absorption of ferrous sulfate, taking it on a full stomach is not recommended, and doubling the dose if a dose is missed can lead to an overdose.
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