ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment Form A
1. A nurse is planning care for a client who has chronic renal failure. Which action should the nurse include in the plan of care?
- A. Encourage increased fluid intake
- B. Restrict protein intake to the RDA
- C. Increase dietary potassium
- D. Encourage foods high in sodium
Correct answer: B
Rationale: The correct action the nurse should include in the plan of care for a client with chronic renal failure is to restrict protein intake to the RDA. This is important because limiting protein helps reduce the buildup of waste products that the kidneys are unable to efficiently excrete. Encouraging increased fluid intake (choice A) may further burden the kidneys, increasing the risk of fluid overload. Increasing dietary potassium (choice C) is not recommended in chronic renal failure as impaired kidneys have difficulty regulating potassium levels. Encouraging foods high in sodium (choice D) is also not appropriate as excessive sodium intake can lead to fluid retention and hypertension, which are detrimental in renal failure.
2. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following findings should the nurse report to the provider?
- A. Blood glucose level of 120 mg/dL
- B. White blood cell count of 8,000/mm³
- C. Temperature of 37.2°C (99°F)
- D. Daily weight increase of 0.45 kg (1 lb)
Correct answer: D
Rationale: The correct answer is D. A sudden weight increase may indicate fluid retention, a complication of TPN therapy that should be reported. Options A, B, and C are within normal ranges and do not directly relate to TPN therapy complications. A blood glucose level of 120 mg/dL is normal, a white blood cell count of 8,000/mm³ is within the normal range, and a temperature of 37.2°C (99°F) is also normal.
3. During a presentation on basic first aid, a nurse educator evaluates a newly licensed home health nurse's understanding of heat stroke. Which symptom indicates the client has heat stroke?
- A. Hypotension
- B. Bradycardia
- C. Clammy skin
- D. Bradypnea
Correct answer: A
Rationale: The correct answer is A: Hypotension. Heat stroke can lead to hypotension, which is low blood pressure. This is a common symptom of heat stroke and requires immediate intervention. Bradycardia (slow heart rate), clammy skin, and bradypnea (slow breathing) are not typically associated with heat stroke. In heat stroke, the body's temperature regulation system fails, leading to a rapid rise in body temperature, which can cause various symptoms including hypotension.
4. Which of the following is an early indicator that a client with a tracheostomy may require suctioning?
- A. Decreased respiratory rate
- B. Irritability
- C. Bradycardia
- D. Decreased oxygen saturation
Correct answer: B
Rationale: Irritability is an early indicator that suctioning is necessary for a client with a tracheostomy. Irritability can signal discomfort or difficulty breathing, which may be due to the need for suctioning to clear the airway. Decreased respiratory rate, bradycardia, and decreased oxygen saturation are not typically early indicators that suctioning is needed in a client with a tracheostomy. These symptoms may occur later if the airway is not cleared promptly.
5. A nurse is assessing a client who is taking amiodarone. Which of the following findings should the nurse report to the provider?
- A. Dry skin
- B. Weight loss
- C. Bradycardia
- D. Productive cough
Correct answer: D
Rationale: A productive cough can indicate pulmonary toxicity, a serious side effect of amiodarone, and should be reported. Dry skin is not typically associated with amiodarone use. Weight loss is a common side effect of amiodarone but not generally a cause for concern unless severe. Bradycardia is a known side effect of amiodarone and may not necessarily require immediate reporting unless symptomatic.
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