ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 B with NGN
1. While caring for a client receiving morphine, what assessment is the priority for a nurse to conduct?
- A. Blood pressure
- B. Heart rate
- C. Respiratory rate
- D. Temperature
Correct answer: C
Rationale: The correct answer is monitoring the respiratory rate. Morphine can depress respiratory function, leading to respiratory depression or arrest. Therefore, closely monitoring the client's respiratory rate is crucial to detect any signs of respiratory distress. While blood pressure, heart rate, and temperature are important assessments, in this scenario, respiratory rate takes precedence due to the potential respiratory complications associated with morphine administration.
2. A client receiving chemotherapy with Methotrexate asks why Leucovorin is being given. Which of the following responses should the nurse use?
- A. Leucovorin reduces the risk of a transfusion reaction from Methotrexate.
- B. Leucovorin increases platelet production and prevents bleeding.
- C. Leucovorin potentiates the cytotoxic effects of Methotrexate.
- D. Leucovorin protects healthy cells from Methotrexate's toxic effects.
Correct answer: D
Rationale: Leucovorin, a folic acid derivative and an antagonist to Methotrexate, is given within 12 hours of high doses of Methotrexate to protect healthy cells from the toxic effects of Methotrexate. It helps to reduce the bone marrow suppression and gastrointestinal side effects caused by Methotrexate, supporting the client's overall well-being during chemotherapy treatment. Choices A, B, and C are incorrect because Leucovorin does not reduce the risk of a transfusion reaction from Methotrexate, increase platelet production, prevent bleeding, or potentiate the cytotoxic effects of Methotrexate. Instead, Leucovorin works by rescuing healthy cells from the toxic effects of Methotrexate.
3. A client with chronic kidney disease is being taught by a nurse about managing protein intake. Which of the following instructions should the nurse include?
- A. You should increase your intake of high-protein foods.
- B. You should limit your intake of high-protein foods.
- C. You should avoid all protein sources to prevent further kidney damage.
- D. You should increase your intake of animal protein.
Correct answer: B
Rationale: The correct answer is B: 'You should limit your intake of high-protein foods.' Clients with chronic kidney disease should restrict their intake of high-protein foods to lessen the workload on the kidneys and prevent further kidney damage. Option A is incorrect as increasing intake of high-protein foods can exacerbate the condition. Option C is incorrect as avoiding all protein sources is not advisable, as some proteins are essential for overall health. Option D is incorrect as increasing the intake of animal protein can put more strain on the kidneys due to the metabolites produced during protein breakdown.
4. What are protective factors? Give an example of one and explain how it can impact a person's later functioning.
- A. Protective factors are influences that modify a person's response to environmental stressors, making adverse consequences less likely.
- B. An example of a protective factor is having a warm and caring parent, which may lead to resilience.
- C. Protective factors usually lead to resilience, the ability to adapt successfully to stressful circumstances.
- D. Protective factors always prevent the development of psychopathology.
Correct answer: B
Rationale: Protective factors are influences that modify a person's response to environmental stressors, reducing the likelihood of adverse outcomes. An example of a protective factor is having a warm and caring parent, which can foster resilience in individuals. Resilience allows individuals to adapt successfully to stressful situations. Choice A is incorrect as protective factors do not always prevent adverse consequences but reduce their likelihood. Choice C is incorrect as resilience is the outcome of protective factors, not the other way around. Choice D is incorrect as while protective factors can reduce the risk of psychopathology, they do not always prevent its development.
5. A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?
- A. Lispro (Humalog)
- B. Glargine (Lantus)
- C. Detemir (Levemir)
- D. NPH (Humulin N)
Correct answer: A
Rationale: For mealtime coverage in intensive insulin therapy, rapid-acting insulins like Lispro (Humalog) are used. Lispro has a quick onset of action, making it suitable for covering the rise in blood sugar levels after meals. Glargine (Lantus), Detemir (Levemir), and NPH (Humulin N) are all long-acting insulins and are not appropriate for mealtime coverage as they do not act quickly enough to manage postprandial glucose spikes.
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