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PN ATI Capstone Proctored Comprehensive Assessment Form B
1. A nurse is preparing to administer a client's first dose of a new antibiotic. Which of the following is the priority nursing action?
- A. Assess the client's allergies.
- B. Monitor the client's vital signs.
- C. Inform the client of potential side effects.
- D. Obtain the client's informed consent.
Correct answer: A
Rationale: Assessing allergies before administering a new medication is crucial as it helps prevent potentially life-threatening allergic reactions like anaphylaxis. While monitoring vital signs and informing the client of side effects are important nursing actions, assessing allergies takes precedence to ensure the client's safety. Informed consent is necessary for the treatment process, but assessing allergies is the priority before administering any new medication.
2. A nurse is sitting with the partner of a client who recently died. Which of the following actions should the nurse take to facilitate mourning?
- A. Encourage the partner to ask for help when needed
- B. Suggest the partner avoid discussing their feelings
- C. Recommend immediate return to daily activities
- D. Advise the partner to remain strong
Correct answer: A
Rationale: The correct action for the nurse to take to facilitate mourning is to encourage the partner to ask for help when needed. Grieving is a challenging process, and offering support and encouragement to seek help can be beneficial. Choice B is incorrect because avoiding discussing feelings can hinder the grieving process by suppressing emotions. Choice C is also incorrect as an immediate return to daily activities may not allow the partner to properly process their grief. Choice D is not the best approach as advising the partner to 'remain strong' may discourage the expression of emotions and seeking support, which are essential in the mourning process.
3. When a nurse is interviewing a client who is requesting oral contraceptives, which finding in the client’s history is a contraindication to combined oral contraceptives?
- A. Thyroid disease
- B. Allergy to penicillin
- C. Impaired liver function
- D. Abnormal blood glucose levels
Correct answer: C
Rationale: The correct answer is C: Impaired liver function. Impaired liver function is a contraindication to the use of oral contraceptives because they are metabolized in the liver. Choices A, B, and D are incorrect. Thyroid disease, allergy to penicillin, and abnormal blood glucose levels are not contraindications to combined oral contraceptives.
4. A nurse is teaching a group of clients about stress management. Which of the following activities should the nurse recommend to reduce stress?
- A. Watching television
- B. Deep breathing exercises
- C. Drinking coffee
- D. Avoiding exercise
Correct answer: B
Rationale: Deep breathing exercises are effective in reducing stress by promoting relaxation and lowering heart rate, making them a recommended technique. Watching television may not actively reduce stress but can serve as a distraction. Drinking coffee, which contains caffeine, may increase anxiety levels. Avoiding exercise can lead to pent-up stress and tension rather than reducing it.
5. A client who has a new prescription for simvastatin is receiving teaching from a nurse. Which of the following client statements indicates an understanding of the teaching?
- A. I will take this medication in the morning.
- B. I should avoid drinking grapefruit juice while taking this medication.
- C. I should expect my cholesterol levels to increase initially.
- D. I will need to have my kidney function checked every 3 months.
Correct answer: B
Rationale: The correct answer is B. Grapefruit juice can increase the risk of toxicity with simvastatin, so clients should avoid consuming it while on the medication. Choice A is incorrect because the timing of medication administration should be based on healthcare provider instructions. Choice C is incorrect because simvastatin is prescribed to lower cholesterol levels. Choice D is incorrect as monitoring kidney function is not specifically related to simvastatin therapy.
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