ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment Form B
1. A client has been prescribed ferrous sulfate. Which instruction should the nurse provide to the client?
- A. Avoid strawberries, citrus fruits, and melon to improve absorption
- B. Take with fluids other than coffee or tea
- C. Take on a full stomach
- D. Double the dose if you miss a dose one day
Correct answer: B
Rationale: The correct instruction the nurse should provide to a client prescribed ferrous sulfate is to take it with fluids other than coffee or tea. Coffee and tea can inhibit iron absorption. Therefore, choices A, C, and D are incorrect. Avoiding strawberries, citrus fruits, and melon is not necessary for improving absorption of ferrous sulfate, taking it on a full stomach is not recommended, and doubling the dose if a dose is missed can lead to an overdose.
2. A client wearing an arm cast reports numb fingers. Which of the following actions should the nurse take first?
- A. Place the arm in a dependent position
- B. Administer pain medication
- C. Check the client's circulation
- D. Apply a warm compress to the fingers
Correct answer: C
Rationale: The correct answer is to check the client's circulation. Numbness in the fingers may indicate compromised circulation or nerve damage. By assessing the circulation first, the nurse can ensure that the cast is not too tight, which could be cutting off blood flow. Option A is incorrect because placing the arm in a dependent position may worsen circulation issues. Option B is incorrect as administering pain medication does not address the underlying cause of numbness. Option D is incorrect as applying a warm compress could mask circulation issues and is not the priority in this situation.
3. A healthcare professional is assessing a client for signs of hyperglycemia. Which of the following findings should the healthcare professional look for?
- A. Increased thirst
- B. Weight gain
- C. Decreased urination
- D. Fatigue
Correct answer: A
Rationale: Increased thirst is a classic symptom of hyperglycemia due to the body trying to eliminate excess glucose through urine, leading to dehydration and increased thirst. Weight gain, decreased urination, and fatigue are not typical signs of hyperglycemia. Weight gain is more commonly associated with conditions like hypothyroidism or fluid retention. Decreased urination is not a typical symptom of hyperglycemia, as high blood sugar levels usually lead to increased urination. Fatigue can be a symptom of hyperglycemia, but it is not as specific or characteristic as increased thirst.
4. A nurse reviewing a patient’s care plan notes a goal of 'Patient will ambulate 50 feet three times in the hallway today.' Which domain of Bloom’s taxonomy is this goal in?
- A. Affective domain
- B. Physical domain
- C. Psychomotor domain
- D. Cognitive domain
Correct answer: C
Rationale: The psychomotor domain involves physical activity and motor skills, such as ambulation, making it the correct domain for this goal. Choices A, B, and D are incorrect: Affective domain focuses on emotions and attitudes, physical domain is not a recognized domain in Bloom's taxonomy, and cognitive domain pertains to knowledge and intellectual skills, none of which directly relate to the physical act of ambulation.
5. A nurse is caring for a client in active labor. The nurse notes variable decelerations in the fetal heart rate. Which of the following is the priority nursing action?
- A. Administer oxygen
- B. Reposition the client
- C. Prepare for delivery
- D. Increase IV fluids
Correct answer: B
Rationale: The correct answer is to reposition the client. Variable decelerations are often caused by umbilical cord compression. Repositioning the client can help alleviate pressure on the cord and improve fetal oxygenation. Administering oxygen may be necessary in some situations, but repositioning the client takes precedence to address the underlying cause of variable decelerations. While preparing for delivery is important, addressing the immediate concern of variable decelerations by repositioning the client is the priority. Increasing IV fluids is not the priority in this situation as it does not directly address the cause of variable decelerations.
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