ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment B Quizlet
1. A nurse is caring for a client who has a urinary tract infection (UTI) and is prescribed ciprofloxacin. Which of the following client statements indicates a need for further teaching?
- A. I will stop taking the medication when I feel better.
- B. I will avoid caffeine while taking this medication.
- C. I will wear sunscreen when going outside.
- D. I will drink plenty of fluids while on this medication.
Correct answer: A
Rationale: Clients should be instructed to complete the entire course of antibiotics, even if they start feeling better, to prevent antibiotic resistance and recurrence of infection.
2. A nurse is caring for a client who is 2 hours postpartum following a vaginal birth. The client reports heavy bleeding and passing large clots. What is the priority action for the nurse to take?
- A. Administer oxytocin IV
- B. Perform fundal massage
- C. Check vital signs
- D. Encourage the client to void
Correct answer: B
Rationale: Performing fundal massage is the priority action to take in this situation. Fundal massage helps stimulate uterine contractions, which can reduce postpartum bleeding. Uterine atony, the most common cause of early postpartum hemorrhage, can be addressed effectively through fundal massage. Administering oxytocin IV, although important, should come after initiating fundal massage. Checking vital signs is also crucial but not the immediate priority. Encouraging the client to void does not directly address the heavy bleeding and passing of large clots; hence, it is not the priority action.
3. When teaching a client about the use of trazodone, what should be included?
- A. It can cause sedation
- B. It is a stimulant
- C. It has no side effects
- D. It should be taken with food
Correct answer: A
Rationale: The correct answer is A. Trazodone can cause sedation, so clients should be cautioned about activities requiring alertness, like driving. Choice B is incorrect because trazodone is not a stimulant; it is actually a sedating antidepressant. Choice C is incorrect as all medications have potential side effects. Choice D is not specifically indicated for trazodone; the client should follow the prescribing healthcare provider's instructions regarding food intake.
4. A nurse is completing an admission assessment for a client who has hearing loss. What action should the nurse take?
- A. Speak loudly to the client
- B. Use written communication to assist with communication
- C. Avoid eye contact while speaking
- D. Use sign language without an interpreter
Correct answer: B
Rationale: The correct action for the nurse to take when assessing a client with hearing loss is to use written communication. This method helps ensure effective communication and that the client understands the information being conveyed. Speaking loudly may not be helpful and can be perceived as rude. Avoiding eye contact can hinder communication and appear disrespectful. Using sign language without an interpreter may not be appropriate if the client does not understand sign language.
5. What is the first action when a client who is admitted with schizophrenia reports hearing voices telling them to harm themselves?
- A. Administer antipsychotic medication
- B. Ask the client what the voices are saying
- C. Distract the client with another activity
- D. Call the healthcare provider
Correct answer: B
Rationale: The correct first action when a client with schizophrenia reports hearing voices telling them to harm themselves is to ask the client what the voices are saying. This is important to assess the content of the hallucinations and determine if there is any immediate danger or suicidal intent. Administering antipsychotic medication without knowing the content of the voices or the level of danger could be inappropriate and potentially harmful. Distracting the client with another activity may not address the underlying issue of the hallucinations commanding harm. Calling the healthcare provider can be done after assessing the situation and gathering information from the client.
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