ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment A
1. A nurse is planning care for a client who has a sealed radiation implant and is to remain in the hospital for one week. Which of the following should the nurse include in the plan of care?
- A. Remove dirty linens from the room after double-bagging them
- B. Wear a dosimeter film badge while in the client’s room
- C. Limit each visitor to one hour per day
- D. Ensure family members remain at least 3 feet from the client
Correct answer: B
Rationale: The correct answer is to wear a dosimeter film badge while in the client's room. Wearing a dosimeter helps monitor the cumulative radiation exposure of healthcare workers, ensuring their safety during care. Removing dirty linens, limiting visitor time, and maintaining a distance from the client are not directly related to radiation safety measures and are not necessary in this scenario.
2. A nurse is providing discharge teaching for a client newly prescribed methadone. Which statement indicates a need for further teaching?
- A. I understand methadone slows my breathing.
- B. I understand methadone may cause me to have trouble sleeping.
- C. I will avoid alcohol while taking this medication.
- D. I’ll change positions slowly to prevent dizziness.
Correct answer: B
Rationale: The correct answer is B. Trouble sleeping is not a typical side effect of methadone; the nurse should clarify this misunderstanding. Choices A, C, and D are all correct statements regarding methadone. Methadone can indeed slow breathing, so it is important for the client to be aware of this effect. Avoiding alcohol while taking methadone is crucial due to the increased risk of central nervous system depression when alcohol is combined with methadone. Additionally, changing positions slowly can help prevent dizziness, which can be a side effect of methadone.
3. A nurse is preparing to feed a newly admitted client with dysphagia. Which of the following actions should the nurse take?
- A. Instruct the client to lift their chin when swallowing
- B. Discourage the client from coughing during feedings
- C. Sit at or below the client’s eye level during feedings
- D. Talk with the client during feedings
Correct answer: C
Rationale: The correct answer is C. Sitting at or below the client’s eye level is important when feeding a client with dysphagia. This position allows the nurse to closely observe the client for any signs of difficulty with swallowing, which can help prevent aspiration. Instructing the client to lift their chin when swallowing (choice A) is not recommended for clients with dysphagia as it can increase the risk of aspiration. Discouraging the client from coughing during feedings (choice B) is also not correct, as coughing may be a protective mechanism to prevent aspiration. Talking with the client during feedings (choice D) may distract the client and interfere with their ability to focus on swallowing safely.
4. When teaching about safety risks for adolescents, what should be included?
- A. Adolescents are more likely to follow rules
- B. Peer influence to participate in high-risk behaviors can lead to injury
- C. Most injuries occur during sports activities
- D. Adolescents are aware of the dangers of substance use
Correct answer: B
Rationale: When educating about safety risks for adolescents, it is crucial to address the impact of peer influence on engaging in high-risk behaviors, which can result in injuries. Choice A is incorrect because adolescents are known to sometimes take risks and not always follow rules. Choice C is incorrect as injuries among adolescents can also happen outside of sports activities. Choice D is incorrect as adolescents may not always be fully aware of the dangers of substance use.
5. A healthcare professional is teaching a client about the use of methotrexate. Which of the following should be included?
- A. It is a pain reliever
- B. Monitor for signs of infection
- C. It can be taken without food
- D. It is safe to use during pregnancy
Correct answer: B
Rationale: The correct answer is B: 'Monitor for signs of infection.' Methotrexate can suppress the immune system, making the client more susceptible to infections. Educating the client to monitor for signs of infection is crucial for early detection and management. Choice A is incorrect because methotrexate is not a pain reliever; it is commonly used to treat conditions like cancer, rheumatoid arthritis, and psoriasis. Choice C is incorrect because methotrexate is usually recommended to be taken with food to reduce gastrointestinal side effects. Choice D is incorrect because methotrexate is known to be harmful during pregnancy and should not be used by pregnant individuals as it can cause birth defects.
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