ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment 2020 A
1. When administering subcutaneous epinephrine for a client experiencing anaphylaxis, what adverse effect should the nurse monitor for?
- A. Hypotension
- B. Hyperthermia
- C. Hypoglycemia
- D. Tachycardia
Correct answer: D
Rationale: The correct adverse effect to monitor for when administering subcutaneous epinephrine for anaphylaxis is tachycardia. Epinephrine stimulates adrenergic receptors, leading to an increased heart rate (tachycardia). Hypotension (Choice A) is less likely due to the vasoconstrictive effects of epinephrine. Hyperthermia (Choice B) and hypoglycemia (Choice C) are not commonly associated with epinephrine administration for anaphylaxis.
2. What process is required for population-focused nursing practice?
- A. Community organizing
- B. Nursing process
- C. Community diagnosis
- D. Epidemiologic process
Correct answer: C
Rationale: Population-focused nursing practice involves identifying and addressing the health needs of a specific population group. Community diagnosis is a crucial process in population-focused nursing as it helps in understanding the health issues, concerns, and determinants within a community. Through community diagnosis, nurses can develop targeted interventions and strategies to promote the health and well-being of the population.
3. A recently widowed middle-aged female client presents to the psychiatric clinic for evaluation and tells the nurse that she has 'little reason to live.' She describes one previous suicidal gesture and admits to having a gun in her home. To maintain the client's confidentiality and to help ensure her safety, which action is best for the nurse to implement?
- A. Encourage the client to remove the gun from her possession.
- B. Notify the client's healthcare provider of the availability of the weapon.
- C. Contact a person of the client's choosing to remove the weapon from the home.
- D. Call the local police department and have the weapon removed from the home.
Correct answer: C
Rationale: In this scenario, it is crucial to maintain the client's confidentiality while ensuring her safety. Contacting a person chosen by the client to remove the weapon from her home is the best course of action. This approach respects the client's autonomy and helps reduce the risk of harm without involving external authorities unnecessarily.
4. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following actions should the nurse take?
- A. Administer the TPN through a peripheral IV catheter.
- B. Check the client's capillary blood glucose level every 4 hours.
- C. Heat the TPN solution to room temperature before administering.
- D. Weigh the client every 3 days.
Correct answer: B
Rationale: The correct answer is to check the client's capillary blood glucose level every 4 hours. Clients receiving TPN are at risk for hyperglycemia, so regular monitoring of blood glucose levels is essential to detect and manage hyperglycemia promptly. Administering TPN through a peripheral IV catheter (Choice A) is incorrect as TPN should be given through a central venous catheter to prevent complications. Heating the TPN solution to room temperature (Choice C) is unnecessary and not a standard practice. Weighing the client every 3 days (Choice D) is important for monitoring fluid status but is not the priority action when caring for a client receiving TPN.
5. The percentage of the total daily caloric intake for healthy persons that should be supplied by carbohydrate is:
- A. 10% to 35%.
- B. 20% to 35%.
- C. 40% to 55%.
- D. 45% to 65%.
Correct answer: D
Rationale: The correct answer is D: 45% to 65%. Carbohydrates should contribute between 45% to 65% of the total daily caloric intake for healthy individuals to maintain a balanced diet. Choices A, B, and C are incorrect because they suggest lower ranges, which may not provide sufficient energy from carbohydrates for overall health and well-being.