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PN ATI Capstone Proctored Comprehensive Assessment Form B
1. A client with chronic kidney disease is about to start hemodialysis. Which of the following instructions should the nurse include?
- A. Increase protein intake between dialysis sessions
- B. Reduce potassium intake
- C. Avoid iron supplements
- D. Expect weight gain after each dialysis session
Correct answer: B
Rationale: The correct answer is to instruct the client to reduce potassium intake. Clients with chronic kidney disease should limit potassium intake to prevent hyperkalemia, as the kidneys may struggle to remove excess potassium. Increasing protein intake between dialysis sessions (Choice A) is not recommended as it can increase urea production, adding to the workload of the kidneys. Avoiding iron supplements (Choice C) is not necessary unless iron levels are high. Expecting weight gain after each dialysis session (Choice D) is incorrect as patients typically experience weight loss due to fluid removal during dialysis.
2. A nurse is planning care for a client who has a chest tube. Which of the following actions should the nurse take to ensure proper functioning of the chest tube?
- A. Clamp the chest tube intermittently.
- B. Keep the drainage system below chest level.
- C. Empty the drainage chamber every 4 hours.
- D. Apply sterile gauze around the insertion site daily.
Correct answer: B
Rationale: To ensure proper functioning of a chest tube, the nurse should keep the drainage system below chest level. This position allows for proper drainage by gravity and prevents backflow into the pleural space. Clamping the chest tube intermittently can lead to a buildup of pressure and should be avoided. Emptying the drainage chamber every 4 hours is important but not directly related to maintaining the chest tube's function. Applying sterile gauze around the insertion site daily is essential for infection prevention but does not specifically ensure the proper functioning of the chest tube.
3. A client at risk for coronary artery disease seeks advice from a nurse. What should the nurse recommend to reduce the risk?
- A. Increase your intake of saturated fats.
- B. Exercise for 150 minutes per week.
- C. Take iron supplements daily.
- D. Limit fruits and vegetables in your diet.
Correct answer: B
Rationale: The correct recommendation to reduce the risk of coronary artery disease is to exercise for at least 150 minutes per week. Regular exercise is crucial in maintaining cardiovascular health and reducing the chances of developing heart disease. Increasing intake of saturated fats (Choice A) is counterproductive as it can raise cholesterol levels and contribute to arterial plaque formation. Taking iron supplements daily (Choice C) is not directly related to reducing the risk of coronary artery disease. Limiting fruits and vegetables in the diet (Choice D) is also not advisable, as they are essential components of a heart-healthy diet due to their high fiber and nutrient content.
4. A client who is 2 hours postpartum reports heavy bleeding and passing large clots. What is the nurse's priority action?
- A. Perform fundal massage
- B. Administer oxytocin IV
- C. Check vital signs
- D. Encourage the client to void
Correct answer: A
Rationale: The correct answer is A: Perform fundal massage. Fundal massage promotes uterine contractions, which is the initial action to reduce postpartum hemorrhage caused by uterine atony. Checking vital signs (choice C) is important but not the priority when active bleeding is present. Administering oxytocin IV (choice B) may be needed but is not the priority action. Encouraging the client to void (choice D) does not address the underlying issue of postpartum hemorrhage and should not be the priority.
5. A client with a new diagnosis of heart failure is prescribed furosemide. Which of the following instructions should the nurse include?
- A. Take the medication in the morning.
- B. Increase intake of potassium-rich foods.
- C. Report a decrease in urine output.
- D. Expect swelling in the lower extremities.
Correct answer: B
Rationale: The correct answer is to instruct the client to increase their intake of potassium-rich foods. Furosemide, a loop diuretic, can lead to potassium loss, which may cause hypokalemia. Increasing potassium intake can help prevent this electrolyte imbalance. Choice A is incorrect because furosemide is usually taken in the morning to prevent sleep disturbances due to increased urination. Choice C is incorrect because a decrease in urine output could indicate a problem and should be reported immediately. Choice D is incorrect because furosemide is used to reduce swelling in the body, including the lower extremities, so expecting swelling is not appropriate.
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