ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment 2020 B
1. A nurse is assessing four clients for fluid balance. Which of the following clients is exhibiting manifestations of dehydration?
- A. A client who has a urine specific gravity of 1.010.
- B. A client who has a weight gain of 2.2 kg (2 lb) in 24 hr.
- C. A client who has a hematocrit of 45%.
- D. A client who has a temperature of 39°C (102°F).
Correct answer: D
Rationale: The correct answer is D because an elevated temperature is a common manifestation of dehydration. Choices A, B, and C are not indicative of dehydration. A urine specific gravity of 1.010 is within normal range, weight gain suggests fluid overload, and a hematocrit of 45% is also within normal limits and not specifically related to dehydration.
2. A client who is at 40 weeks gestation and in active labor has 6 cm of cervical dilation and 100% cervical effacement. The client's blood pressure reading is 82/52 mm Hg. Which of the following nursing interventions should the nurse perform?
- A. Prepare for a cesarean birth.
- B. Assist the client to an upright position.
- C. Prepare for an immediate vaginal delivery.
- D. Assist the client to turn onto her side.
Correct answer: D
Rationale: Turning the client onto her side is the appropriate nursing intervention in this scenario. This position can help improve blood pressure by enhancing venous return, which may aid in increasing perfusion to vital organs. It can also alleviate pressure on the inferior vena cava, promoting better circulation and supporting blood pressure stabilization during labor. Choices A, B, and C are incorrect. A cesarean birth is not indicated based on the information provided. Assisting the client to an upright position may worsen her blood pressure due to decreased venous return. Lastly, there is no indication for an immediate vaginal delivery solely based on the client's blood pressure reading.
3. What are the signs and symptoms of a potential infection?
- A. Fever, chills, and increased heart rate
- B. Increased white blood cell count and fever
- C. Shortness of breath and confusion
- D. Sweating and low blood pressure
Correct answer: A
Rationale: The correct answer is A: Fever, chills, and increased heart rate are classic signs of an infection. These symptoms indicate the body's response to an invading pathogen. Choice B, 'Increased white blood cell count and fever,' is not a primary symptom that a person would typically notice themselves, and white blood cell count needs to be tested. Choice C, 'Shortness of breath and confusion,' may indicate other conditions like heart or lung issues rather than a general infection. Choice D, 'Sweating and low blood pressure,' are not specific to infections and can be caused by various factors like heat or dehydration.
4. A nurse in a provider’s office is interviewing a client who is requesting an oral contraceptive. Which of the following findings in the client’s history is a contraindication to the use of combination oral contraceptives?
- A. Thyroid disease
- B. Allergy to penicillin
- C. Impaired liver function
- D. Abnormal blood glucose
Correct answer: C
Rationale: Impaired liver function is a contraindication to combination oral contraceptives. The liver metabolizes hormones, and any impairment can affect the metabolism of hormones, potentially leading to imbalances or toxicity. Thyroid disease, allergy to penicillin, and abnormal blood glucose levels are not contraindications to combination oral contraceptives.
5. How should a healthcare professional care for a patient with a central venous catheter?
- A. Monitor for infection and change the dressing regularly
- B. Ensure the catheter is patent and flush as needed
- C. Educate the patient on self-care and proper hygiene
- D. Monitor blood glucose levels and administer IV fluids
Correct answer: A
Rationale: Corrected Rationale: Regular monitoring for infection and dressing changes are essential aspects of caring for a patient with a central venous catheter. Infections are a significant risk with these catheters, so vigilant monitoring and timely dressing changes help prevent complications. Choice B is important too, but ensuring catheter patency and flushing are more focused on maintaining the functionality of the catheter rather than infection prevention. Choice C is also important for patient education, but the immediate concern for a healthcare professional is monitoring and preventing infections related to the catheter. Choice D is not directly related to the care of a central venous catheter.
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