ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment Form A
1. A client with severe preeclampsia is receiving magnesium sulfate intravenously. Which action should the nurse take when toxicity occurs?
- A. Position the client supine
- B. Prepare an IV bolus of dextrose 5%
- C. Administer calcium gluconate IV
- D. Administer methylergonovine IM
Correct answer: C
Rationale: When toxicity from magnesium sulfate occurs, the nurse should administer calcium gluconate IV as it is the antidote for magnesium sulfate toxicity. Positioning the client supine may not address the toxicity issue. Administering dextrose 5% is not the appropriate intervention for magnesium sulfate toxicity. Methylergonovine is used to manage postpartum hemorrhage and is not indicated for magnesium sulfate toxicity.
2. After Natasha's husband passed away two months ago, she has been overwhelmed with grief. When Natasha is subsequently diagnosed with major depressive disorder, her daughter, Nadia, makes which true statement?
- A. Depression often begins after a major loss. Losing dad was a major loss.
- B. Bereavement and depression are the same problem.
- C. Mourning is pathological and not normal behavior.
- D. Antidepressant medications will not help this type of depression.
Correct answer: A
Rationale: It is common for major depressive disorder to be triggered by significant life events, such as the sudden loss of a loved one. Therefore, Nadia's statement that 'Depression often begins after a major loss' is correct. Bereavement and major depressive disorder are related but distinct conditions, and while mourning can be intense, it is generally considered a normal response to loss. Antidepressant medications can be beneficial in treating depression, including cases triggered by a significant loss.
3. A healthcare professional is preparing to administer an intramuscular injection to a client. Which of the following actions should the healthcare professional take?
- A. Use a 1-inch needle.
- B. Stretch the skin at the injection site.
- C. Insert the needle at a 90-degree angle.
- D. Aspirate for blood return before injecting.
Correct answer: D
Rationale: Aspirating for blood return before injecting is a crucial step in administering intramuscular injections. This action ensures that the needle is not in a blood vessel, reducing the risk of injecting medication into a blood vessel, which can lead to potential complications. Choices A, B, and C are incorrect. Using a longer 1-inch needle is often necessary for intramuscular injections to reach the muscle tissue properly. Stretching the skin is not recommended as it can cause unnecessary pain and tissue damage. Inserting the needle at a 90-degree angle is the preferred method for intramuscular injections to ensure proper medication delivery.
4. A new parent is concerned because their newborn's stools are loose and yellow. The healthcare provider should explain that this is:
- A. A sign of dehydration
- B. A normal finding in breastfed infants
- C. Indicative of an infection
- D. Due to lactose intolerance
Correct answer: B
Rationale: Loose, yellow stools are a normal finding in breastfed infants. Breastfed infants often have loose, yellow stools due to the composition of breast milk. It is not typically a sign of dehydration, infection, or lactose intolerance in this context.
5. A 35-year-old woman presents with fatigue, weight gain, and cold intolerance. Laboratory tests reveal high TSH and low free T4 levels. What is the most likely diagnosis?
- A. Hypothyroidism
- B. Hyperthyroidism
- C. Thyroiditis
- D. Thyroid cancer
Correct answer: A
Rationale: The scenario describes a 35-year-old woman with symptoms of fatigue, weight gain, and cold intolerance along with high TSH and low free T4 levels. These findings are consistent with the diagnosis of hypothyroidism. In hypothyroidism, there is decreased thyroid hormone production leading to elevated TSH levels as the body tries to stimulate the thyroid to produce more hormone. The low free T4 levels indicate insufficient thyroid hormone in the blood, which can manifest as symptoms such as fatigue, weight gain, and cold intolerance.
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