ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment B Quizlet
1. A nurse is planning to administer an injection of morphine to a client. Which of the following actions should the nurse take to ensure client safety?
- A. Instruct the client to take a deep breath during administration.
- B. Administer the medication over 30 seconds.
- C. Verify the client’s pain level.
- D. Have naloxone available in case of respiratory depression.
Correct answer: D
Rationale: The correct answer is to have naloxone available in case of respiratory depression. Morphine is an opioid that can lead to respiratory depression, especially in higher doses. Naloxone is the antidote for opioid overdose and should be readily accessible when administering morphine to reverse respiratory depression if it occurs. Instructing the client to take a deep breath during administration (choice A) is not directly related to ensuring safety in this scenario. Administering the medication over 30 seconds (choice B) may help with the comfort of the client but does not address the potential risk of respiratory depression. Verifying the client's pain level (choice C) is important but not the primary action to ensure safety when administering morphine.
2. A client with chronic kidney disease is being educated by a nurse about managing their condition. Which of the following statements shows an understanding of the teaching?
- A. I will need to take an iron supplement.
- B. I will consume foods high in phosphorus.
- C. I will reduce my intake of carbohydrates.
- D. I will monitor my blood glucose level daily.
Correct answer: A
Rationale: The correct answer is A. Clients with chronic kidney disease often develop anemia due to reduced erythropoietin production, leading to decreased red blood cell production. Iron supplementation is frequently required to enhance red blood cell production. Choices B, C, and D are incorrect because in chronic kidney disease, there is a need to restrict phosphorus intake, control carbohydrate intake for blood sugar management, and monitor electrolytes and fluid balance rather than blood glucose levels.
3. A nurse is preparing to administer a dose of escitalopram. Which of the following should the nurse assess first?
- A. Mood changes
- B. Blood pressure
- C. Heart rate
- D. Liver function
Correct answer: A
Rationale: The correct answer is to assess for mood changes. When administering escitalopram, it is crucial to evaluate mood changes first because the medication may take some time to demonstrate its full effects on the patient's mood. Assessing blood pressure, heart rate, or liver function is not the priority when administering escitalopram, as these parameters are not directly impacted acutely by this medication.
4. A nurse is providing teaching for a client who has a new prescription for sertraline. Which of the following statements by the client indicates understanding?
- A. I will feel better immediately after starting this medication.
- B. I can expect to urinate frequently while taking this medication.
- C. I may experience difficulty sleeping while taking this medication.
- D. I should decrease my sodium intake while taking this medication.
Correct answer: C
Rationale: The correct answer is C: 'I may experience difficulty sleeping while taking this medication.' Sertraline can cause insomnia, especially when first starting the medication, so the client should be aware of this potential side effect. Choices A, B, and D are incorrect because feeling better immediately, increased urination, and decreasing sodium intake are not commonly associated side effects of sertraline.
5. A nurse is assessing a client with pneumonia. Which of the following findings should the nurse expect?
- A. Bradycardia
- B. Increased respiratory rate
- C. Decreased temperature
- D. Elevated blood pressure
Correct answer: B
Rationale: The correct answer is B: Increased respiratory rate. In pneumonia, the body tries to compensate for the reduced ability to oxygenate the blood by increasing the respiratory rate. This helps to improve oxygen exchange. Bradycardia (Choice A) is not typically associated with pneumonia, as an increased heart rate is more common due to the stress on the body. Decreased temperature (Choice C) is not a typical finding in pneumonia, as infections usually cause a fever. Elevated blood pressure (Choice D) is not a common finding in pneumonia unless there are complications such as sepsis.
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