ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment 2020 A with NGN
1. A charge nurse is planning care for a group of patients on a med-surg unit. What task should the nurse delegate to an assistive personnel?
- A. Measure hourly urinary output for the postoperative patient.
- B. Administer medications to stable patients.
- C. Reinforce patient education.
- D. Initiate a care plan for a new patient.
Correct answer: A
Rationale: The correct answer is A because assistive personnel can be assigned to measure and document urinary output, a routine task within their scope of practice. Administering medications (choice B) requires a higher level of training and should be done by licensed nurses. Reinforcing patient education (choice C) involves providing information and ensuring patient understanding, which is typically done by licensed healthcare providers. Initiating a care plan (choice D) involves critical thinking and assessment skills, which are beyond the scope of practice for assistive personnel.
2. A nurse receives a change-of-shift report. Which of the following clients should the nurse attend to first?
- A. A client who reports tingling in the fingers following a thyroidectomy
- B. A client who has dark, foul-smelling urine with a urine output of 320 mL in the last 8 hr
- C. A client who is in a long leg cast and reports cool feet bilaterally
- D. A client who has a productive cough and an oral temperature of 36°C (96.8°F)
Correct answer: C
Rationale: The correct answer is C. Cool feet bilaterally in a client with a long leg cast may indicate compromised circulation, which is a medical emergency that requires immediate intervention. Choices A, B, and D do not present immediate life-threatening conditions. Tingling in the fingers following a thyroidectomy may indicate hypocalcemia but does not require immediate attention. Dark, foul-smelling urine with decreased urine output indicates a possible urinary tract infection or dehydration but can be addressed after attending to the client with compromised circulation. A productive cough and a normal oral temperature do not suggest an urgent condition compared to compromised circulation in a client with a long leg cast.
3. A nurse is sitting with the partner of a client who recently died. Which of the following actions should the nurse take to facilitate mourning?
- A. Encourage the partner to ask for help when needed
- B. Suggest the partner avoid discussing their feelings
- C. Recommend immediate return to daily activities
- D. Advise the partner to remain strong
Correct answer: A
Rationale: The correct action for the nurse to take to facilitate mourning is to encourage the partner to ask for help when needed. Grieving is a challenging process, and offering support and encouragement to seek help can be beneficial. Choice B is incorrect because avoiding discussing feelings can hinder the grieving process by suppressing emotions. Choice C is also incorrect as an immediate return to daily activities may not allow the partner to properly process their grief. Choice D is not the best approach as advising the partner to 'remain strong' may discourage the expression of emotions and seeking support, which are essential in the mourning process.
4. A nurse is assessing a client for potential drug interactions. Which of the following factors should the nurse consider?
- A. Client's diet
- B. Client's age
- C. Client's genetic background
- D. All of the above
Correct answer: D
Rationale: Correct! All of these factors should be considered when assessing a client for potential drug interactions. The client's diet can interact with certain medications, the client's age can affect metabolism and drug sensitivity, and genetic background can impact how the body processes medications. Therefore, it is essential for the nurse to take into account all these factors to ensure safe and effective drug therapy. Choices A, B, and C are incorrect because each of these factors alone can contribute to potential drug interactions, making it crucial to consider all of them together.
5. A healthcare professional is teaching a client about the use of methotrexate. Which of the following should be included?
- A. It is a pain reliever
- B. Monitor for signs of infection
- C. It can be taken without food
- D. It is safe to use during pregnancy
Correct answer: B
Rationale: The correct answer is B: 'Monitor for signs of infection.' Methotrexate can suppress the immune system, making the client more susceptible to infections. Educating the client to monitor for signs of infection is crucial for early detection and management. Choice A is incorrect because methotrexate is not a pain reliever; it is commonly used to treat conditions like cancer, rheumatoid arthritis, and psoriasis. Choice C is incorrect because methotrexate is usually recommended to be taken with food to reduce gastrointestinal side effects. Choice D is incorrect because methotrexate is known to be harmful during pregnancy and should not be used by pregnant individuals as it can cause birth defects.
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