ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment Form A
1. A postpartum client with AB negative blood whose newborn is B positive requires what intervention?
- A. Administer Rh immune globulin within 72 hours of delivery
- B. Administer Rh immune globulin at the 6-week postpartum visit
- C. No Rh immune globulin is needed since this is the second pregnancy
- D. Both mother and baby need Rh immune globulin
Correct answer: A
Rationale: The correct intervention is to administer Rh immune globulin within 72 hours of delivery. This is essential to prevent the mother from forming antibodies against Rh-positive blood, which could cause complications in future pregnancies. Choice B is incorrect as the administration should be immediate postpartum. Choice C is incorrect as Rh immune globulin is needed for each Rh-incompatible pregnancy. Choice D is incorrect as only the mother, who is Rh-negative, needs Rh immune globulin.
2. A nurse in a provider's office is assessing a client who reports a decrease in the effectiveness of their arthritis medication. Which of the following client information should the nurse identify as a contributing factor?
- A. The client has a history of recurring bowel inflammation.
- B. The client has recently increased their exercise regimen.
- C. The client is taking herbal supplements.
- D. The client is experiencing increased stress.
Correct answer: A
Rationale: The correct answer is A. Recurring bowel inflammation can decrease gastrointestinal motility, affecting the absorption of oral medications. This can lead to decreased effectiveness of the arthritis medication. Choice B is incorrect because increasing exercise would not typically impact the absorption of arthritis medication. Choice C is incorrect as herbal supplements may not directly affect the absorption of conventional arthritis medication. Choice D is also incorrect as stress, while it can impact overall health, is less likely to directly affect the effectiveness of arthritis medication compared to gastrointestinal issues.
3. A nurse is checking laboratory results for a client. Which of the following laboratory findings indicates hypervolemia?
- A. Serum sodium 138 mEq/L
- B. Urine specific gravity 1.001
- C. Serum calcium 10 mg/dL
- D. Urine pH 6
Correct answer: B
Rationale: The correct answer is B. A urine specific gravity of 1.001 is low and indicates dilute urine, which is a sign of fluid overload (hypervolemia). Choice A, serum sodium 138 mEq/L, is within the normal range and does not indicate hypervolemia. Choice C, serum calcium 10 mg/dL, is not typically used to diagnose hypervolemia. Choice D, urine pH 6, is also not a specific indicator of hypervolemia.
4. A healthcare professional is supervising a newly licensed colleague who is preparing to administer an intramuscular injection. Which of the following actions by the newly licensed colleague requires intervention?
- A. Selecting a 25-gauge needle
- B. Administering the injection at a 45° angle
- C. Using the ventrogluteal site for the injection
- D. Aspirating for blood return before injecting the medication
Correct answer: B
Rationale: The correct answer is B. Administering an intramuscular injection at a 90° angle is essential for proper medication delivery into the muscle tissue. Injecting at a 45° angle is incorrect for intramuscular injections and is typically used for subcutaneous injections where the needle is inserted into the fatty tissue layer beneath the skin. Choice A is correct as selecting a 25-gauge needle is appropriate for an intramuscular injection. Choice C is also correct as the ventrogluteal site is a suitable site for intramuscular injections. Choice D is correct as aspirating for blood return is a necessary step to ensure the needle is not in a blood vessel before injecting the medication.
5. In calculating the crude death rate of your municipality, with a total population of about 18,000 last year, there were 94 deaths. Among the deceased, 20 died due to heart diseases, and 32 were aged 50 years or older. What is the crude death rate?
- A. 4.1/1000
- B. 5.2/1000
- C. 6.3/1000
- D. 7.3/1000
Correct answer: B
Rationale: To calculate the crude death rate, divide the total number of deaths (94) by the total population (18,000) and then multiply by 1,000. This gives a crude death rate of 5.2 deaths per 1,000 population.
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