ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment Form B
1. A client is prescribed digoxin for heart failure. Which of the following should the nurse monitor to evaluate the effectiveness of the medication?
- A. Respiratory rate
- B. Blood pressure
- C. Apical pulse
- D. Urine output
Correct answer: C
Rationale: The correct answer is C: Apical pulse. Digoxin's primary effect is to strengthen the force of the heart's contractions and slow the heart rate. Monitoring the apical pulse is crucial in evaluating the effectiveness of digoxin as it helps assess the medication's impact on the heart's function. Option A, respiratory rate, is not directly related to digoxin's mechanism of action and is not the most appropriate parameter to monitor for this medication. Option B, blood pressure, while important, may not be as sensitive as the apical pulse in assessing the effectiveness of digoxin. Option D, urine output, is more indicative of kidney function and fluid balance, rather than the direct effectiveness of digoxin in heart failure.
2. Which of the following statements regarding pediatric anatomy is correct?
- A. The child's trachea is more rigid and less prone to collapse.
- B. The occiput is proportionately larger when compared to an adult.
- C. Airway obstruction is common in children due to their large uvula.
- D. Relative to the overall size of the airway, a child's epiglottis is smaller.
Correct answer: B
Rationale: The occiput, the back part of the head, is proportionately larger in children compared to adults, which can have implications for airway management techniques. This anatomical difference is important to consider when providing care to pediatric patients, especially during airway interventions.
3. A client who is at 42 weeks gestation and in labor asks the nurse what to expect because the baby is postmature. Which of the following statements should the nurse make?
- A. Your baby will have excess baby fat.
- B. Your baby will have flat areola without breast buds.
- C. Your baby's heels will easily move to his ears.
- D. Your baby's skin will have a leathery appearance.
Correct answer: D
Rationale: The correct answer is D: 'Your baby's skin will have a leathery appearance.' Postmature infants, born after 42 weeks of gestation, may have a leathery appearance of the skin due to prolonged exposure to amniotic fluid. This occurs as the protective vernix caseosa is shed, and the skin loses its protective covering, leading to a wrinkled and dry appearance. Choices A, B, and C are incorrect. Excess baby fat is not a typical characteristic of postmature infants. Flat areola without breast buds and the ability of the baby's heels to easily move to his ears are not associated with postmaturity.
4. In the emergency department, a nurse is performing triage for multiple clients following a disaster in the community. To which of the following types of injuries should the nurse assign the highest priority?
- A. Below-the-knee amputation.
- B. 10 cm (4 in) laceration.
- C. Fractured tibia.
- D. 95% full-thickness body burn.
Correct answer: A
Rationale: A below-the-knee amputation requires immediate attention due to the risk of hemorrhage and shock, making it the highest priority. This type of injury can lead to significant blood loss and impaired perfusion, which can be life-threatening if not addressed promptly. While a 10 cm laceration, a fractured tibia, and a 95% full-thickness body burn are serious injuries requiring urgent care, they do not pose the same immediate threat to life as a below-the-knee amputation. The laceration may require suturing to control bleeding and prevent infection, the fractured tibia needs stabilization to prevent further damage and pain, and the burn necessitates immediate management to prevent complications, but they are not as acutely life-threatening as the amputation.
5. After the baby's head delivers, how is it usually tilted?
- A. with the face up.
- B. anteriorly, with the chin up.
- C. posteriorly, to one side.
- D. posteriorly, face down.
Correct answer: C
Rationale: After the baby's head delivers, it is typically tilted posteriorly to one side to help facilitate the delivery of the shoulders. This positioning is important for the safe and smooth delivery of the baby.
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