ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment B Quizlet
1. A nurse is assessing a client who is receiving chemotherapy and has stomatitis. Which of the following findings should the nurse expect?
- A. Dry, cracked lips
- B. Bleeding gums
- C. Foul-smelling breath
- D. Red, open sores in the mouth
Correct answer: D
Rationale: The correct answer is D: Red, open sores in the mouth. Stomatitis, a common side effect of chemotherapy, presents with red, open sores in the mouth, which can be painful and increase the risk of infection. Choices A, B, and C are incorrect because stomatitis typically does not manifest as dry, cracked lips, bleeding gums, or foul-smelling breath.
2. A healthcare professional is preparing to administer an IM injection to a 4-month-old infant. Which of the following injection sites should the healthcare professional use?
- A. Ventrogluteal
- B. Deltoid
- C. Dorsogluteal
- D. Vastus lateralis
Correct answer: D
Rationale: The vastus lateralis is the preferred site for IM injections in infants under 1 year of age because it is well developed and easily accessible compared to other muscle groups. The ventrogluteal and deltoid sites are not typically used for infants due to muscle development and size. The dorsogluteal site is not recommended for infants or young children due to its proximity to major nerves and blood vessels.
3. A nurse is planning care for a client who has a new diagnosis of dysphagia. Which of the following foods should be included when initiating feeding?
- A. Beef broth
- B. Oatmeal
- C. Apple juice
- D. Toast
Correct answer: B
Rationale: Oatmeal is a soft, easy-to-swallow food, making it appropriate for clients with dysphagia, as it minimizes the risk of aspiration compared to liquids or hard foods. Beef broth (Choice A) is a liquid and may pose a risk of aspiration. Apple juice (Choice C) is a liquid and can also be a choking hazard for individuals with dysphagia. Toast (Choice D) is a hard food that may be difficult for a client with dysphagia to swallow safely.
4. A client with a history of renal failure is being cared for by a nurse. Which of the following should the nurse monitor?
- A. Fluid intake
- B. Electrolyte levels
- C. Blood pressure
- D. Both B and C
Correct answer: D
Rationale: Clients with renal failure are at risk for electrolyte imbalances and hypertension. Monitoring electrolyte levels is crucial because renal failure can lead to imbalances in sodium, potassium, and other electrolytes. Blood pressure monitoring is essential as hypertension is a common complication of renal failure. Therefore, both electrolyte levels and blood pressure should be closely monitored to detect and manage any abnormalities. Fluid intake, while important, is not specific to renal failure monitoring and is not the priority in this case.
5. A nurse is preparing to teach a client about the management of hypoglycemia. Which sign should the nurse instruct the client to monitor for?
- A. Diaphoresis
- B. Polyuria
- C. Abdominal pain
- D. Thirst
Correct answer: A
Rationale: The correct answer is A: Diaphoresis. Diaphoresis, which refers to excessive sweating, is a classic symptom of hypoglycemia. Instructing the client to monitor for diaphoresis is crucial as it can help them recognize and address hypoglycemic events promptly. Polyuria (excessive urination), abdominal pain, and thirst are not typical signs of hypoglycemia. Polyuria is more commonly associated with conditions like diabetes mellitus, while abdominal pain and thirst are not specific indicators of low blood sugar levels.
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