a nurse is performing a change of shift assessment on four clients which finding should the nurse report to the provider first a nurse is performing a change of shift assessment on four clients which finding should the nurse report to the provider first
Logo

Nursing Elites

ATI LPN

PN ATI Capstone Proctored Comprehensive Assessment Form B

1. During a change-of-shift assessment, a nurse is evaluating four clients. Which finding should the nurse report to the provider first?

Correct answer: B

Rationale: Lethargy and confusion in a client with gastroenteritis are concerning findings that may indicate severe dehydration or electrolyte imbalance, requiring immediate intervention. While the other options are important, they do not pose an immediate life-threatening risk compared to the altered mental status in a client with gastroenteritis.

2. A client with a history of hypertension is prescribed lisinopril (Prinivil). Which side effect should the nurse monitor for?

Correct answer: A

Rationale: The correct answer is A: Dry cough. Lisinopril is an ACE inhibitor, and a common side effect of ACE inhibitors is a dry cough. This occurs due to the accumulation of bradykinin in the lungs, leading to irritation and subsequent cough. It is important for the nurse to monitor the client for this side effect as it can affect adherence to the medication regimen. Weight gain, tachycardia, and hyperglycemia are not typically associated with lisinopril. Therefore, choices B, C, and D are incorrect.

3. When teaching a client who has a new prescription for metformin, which of the following instructions should the nurse include?

Correct answer: C

Rationale: The correct instruction for a client starting metformin is to increase fluid intake. This is crucial to prevent gastrointestinal discomfort, a common side effect of metformin. Adequate hydration helps reduce the risk of gastrointestinal upset and ensures the medication is well-tolerated. Option A is generally true for metformin but is not as essential as maintaining proper hydration. Option B is important but not directly related to starting metformin. Option D is incorrect as a metallic taste in the mouth is not typically associated with metformin.

4. A nurse is educating a patient about their new prescription for a statin medication. What should the nurse advise the patient to avoid while taking this medication?

Correct answer: A

Rationale: The correct answer is A: Drinking grapefruit juice. Grapefruit juice can increase the risk of statin toxicity by interfering with the enzyme that metabolizes statin medications, leading to higher drug levels in the body. This interaction can potentially cause adverse effects. Therefore, patients should be advised to avoid consuming grapefruit juice while taking statins. Choices B, C, and D are incorrect. Consuming high-protein meals, exercising regularly, and taking the medication in the morning are not contraindicated while on statin therapy. In fact, following a healthy diet, engaging in physical activity, and taking the medication at a consistent time each day can be beneficial for patients prescribed statins.

5. How should a healthcare provider manage a patient with dehydration?

Correct answer: D

Rationale: Dehydration management involves a comprehensive approach that includes monitoring fluid intake to assess the severity of dehydration, encouraging oral rehydration to replenish fluids orally if the patient can tolerate it, and administering IV fluids in severe cases where oral intake is insufficient. Choosing just one of these options may not address the diverse needs of patients with dehydration. Therefore, selecting 'All of the above' is the most appropriate response as it encompasses the various strategies required for effective dehydration management.

Similar Questions

A client who is receiving heparin therapy has an activated partial thromboplastin time (aPTT) of 90 seconds. What action should the nurse take?
A nurse is preparing to administer ampicillin 500 mg in 50 ml of dextrose 5% in water (D5W) to infuse over 15 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the nurse set the manual IV infusion to deliver? (Round to the nearest whole number)
When using the Ballard gestational assessment tool on a newborn, which of the following tests should be performed after the first hour of birth, allowing the newborn to recover from the stress of birth?
A nurse is caring for a client who is being discharged home following a cerebrovascular accident. Which of the following documents should the nurse plan to include with the discharge report?
A patient with obsessive-compulsive disorder (OCD) performs hand washing repeatedly. Which nursing intervention is most appropriate?

Access More Features

ATI Basic

  • 50,000 Questions with answers
  • All ATI courses Coverage
    • 30 days access @ $69.99

ATI Basic

  • 50,000 Questions with answers
  • All ATI courses Coverage
    • 90 days access @ $149.99