ATI RN
RN ATI Capstone Proctored Comprehensive Assessment Form A
1. A client with HIV-1 starting therapy with ritonavir and zidovudine asks why both medications are necessary. What explanation should the nurse provide?
- A. Taking two medications ensures a faster recovery.
- B. The medications work best together to improve your immune system.
- C. Taking the 2 medications together keeps you from becoming resistant to either of them.
- D. These medications target different parts of the virus.
Correct answer: C
Rationale: The correct answer is C because taking two medications together helps prevent the development of drug resistance in HIV treatment. Choice A is incorrect because the primary goal of combination therapy is not necessarily a faster recovery. Choice B is incorrect as the main purpose of combining medications in HIV treatment is to prevent resistance rather than improving the immune system. Choice D is incorrect because while it is true that the medications may target different parts of the virus, the main reason for using both together is to prevent resistance.
2. The patient with bipolar disorder is being treated with lithium and has a new prescription for captopril for hypertension. The combination of these two drugs makes which assessment particularly important?
- A. Potassium level
- B. Lithium level
- C. Creatinine level
- D. Blood pressure
Correct answer: B
Rationale: When captopril, an ACE inhibitor, is combined with lithium, it can lead to lithium accumulation. Therefore, monitoring lithium levels is crucial to prevent toxicity. While ACE inhibitors like captopril can cause hyperkalemia, renal insufficiency, and hypotension, the risk of these effects is not increased by the combination of lithium and captopril.
3. The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss?
- A. Poor appetite
- B. Reduction of edema
- C. Restriction to bed rest
- D. Increased potassium intake
Correct answer: B
Rationale: The weight loss is most likely due to the reduction of edema, as glomerulonephritis often causes fluid retention that resolves with treatment, leading to significant weight loss.
4. A client with asthma presents with bilateral wheezing, decreased pulse oxygen saturation, and suprasternal retraction on inhalation. Which actions should the nurse take? (SATA)
- A. Administer prescribed salmeterol (Serevent) inhaler.
- B. Assess the client for a tracheal deviation.
- C. Administer oxygen to maintain saturations above 94%.
- D. Perform peak expiratory flow measurements.
Correct answer: C
Rationale: Suprasternal retraction during inhalation suggests the client is using accessory muscles due to difficulty in moving air into the respiratory passages caused by airway narrowing. The presence of bilateral wheezing and decreased pulse oxygen saturation further support airway narrowing. In this situation, immediate intervention is necessary to improve oxygenation. Administering oxygen to maintain saturations above 94% is crucial to support oxygenation. While administering a rescue inhaler may be warranted, the priority in this scenario is ensuring adequate oxygenation to address the respiratory distress.
5. A client is being taught about measures to promote sleep for insomnia. Which client statement indicates understanding?
- A. I will take naps during the day to help me sleep at night
- B. I should drink caffeine to help me stay awake during the day
- C. I should reduce my fluid intake 2 hours before bedtime
- D. I should exercise right before bed to tire myself out
Correct answer: C
Rationale: The correct answer is C. By reducing fluid intake 2 hours before bedtime, the client can prevent nighttime awakenings to urinate, which promotes better sleep. Napping during the day (choice A) may interfere with nighttime sleep. Drinking caffeine (choice B) can disrupt sleep patterns. Exercising right before bed (choice D) can actually stimulate the body and make it harder to fall asleep.
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