ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment 2020 B
1. A healthcare provider is preparing to administer a dose of levothyroxine. Which of the following should the healthcare provider do?
- A. Give it with food
- B. Assess the patient's heart rate
- C. Administer it in the evening
- D. Give it with calcium supplements
Correct answer: B
Rationale: The correct answer is to assess the patient's heart rate. Levothyroxine is a thyroid hormone replacement medication that can increase metabolism. One of the potential side effects of levothyroxine is tachycardia (rapid heart rate). Therefore, it is essential for the healthcare provider to assess the patient's heart rate before administering the medication to monitor for any signs of tachycardia. Giving levothyroxine with food may affect its absorption, so it is typically recommended to administer it on an empty stomach. Administering it in the evening is not necessary unless specifically prescribed by the healthcare provider, and giving it with calcium supplements can interfere with the absorption of levothyroxine.
2. A client has an NG tube that needs irrigation every 8 hours. Which solution should be used to irrigate the tube to maintain fluid and electrolyte balance?
- A. Tap water
- B. Sterile water
- C. 0.9% sodium chloride
- D. 0.45% sodium chloride
Correct answer: C
Rationale: The correct answer is 0.9% sodium chloride. This solution is isotonic and helps maintain electrolyte balance during irrigation, preventing fluid and electrolyte imbalances. Tap water (choice A) may cause electrolyte imbalances due to its hypotonic nature. Sterile water (choice B) is hypotonic and can lead to electrolyte disturbances. 0.45% sodium chloride (choice D) is hypotonic and may also disrupt electrolyte balance when used for irrigation.
3. When assessing a client reporting severe pain in the right lower quadrant of the abdomen, which sign would most likely indicate appendicitis?
- A. Rebound tenderness at McBurney's point.
- B. Positive Murphy's sign.
- C. Rovsing's sign.
- D. Cullen's sign.
Correct answer: A
Rationale: Rebound tenderness at McBurney's point is a classic sign of appendicitis. This sign indicates peritoneal irritation, a common feature of appendicitis. McBurney's point is located in the right lower quadrant of the abdomen and is a focal point for assessing tenderness. Positive Murphy's sign is associated with cholecystitis, not appendicitis. Rovsing's sign is elicited by palpation of the left lower quadrant resulting in pain in the right lower quadrant, also suggestive of appendicitis. Cullen's sign is associated with acute pancreatitis and manifests as periumbilical ecchymosis.
4. The nurse is assisting in the care of a client with a history of chronic obstructive pulmonary disease (COPD) who is on oxygen therapy. Which action should the nurse take to ensure the client's safety?
- A. Set the oxygen flow rate to 4 liters per minute.
- B. Remove oxygen while the client is eating.
- C. Ensure the client wears a nasal cannula instead of a face mask.
- D. Maintain the oxygen flow rate at the lowest level that relieves hypoxia.
Correct answer: D
Rationale: For clients with COPD, too much oxygen can suppress their drive to breathe, leading to hypoventilation. Therefore, the nurse should maintain the oxygen flow rate at the lowest level that relieves hypoxia to prevent complications while ensuring adequate oxygenation. Setting the oxygen flow rate too high (Choice A) can be detrimental for the client with COPD. Removing oxygen while the client is eating (Choice B) can compromise oxygenation, which is essential even during meals. While nasal cannulas are commonly used, the choice of oxygen delivery device depends on the client's needs; there may be situations where a face mask (Choice C) is more appropriate.
5. Which component of fat can be used to make glucose through gluconeogenesis?
- A. Glycogen
- B. Fatty acids
- C. Glycerol
- D. Monoglyceride
Correct answer: C
Rationale: The correct answer is 'Glycerol.' Glycerol, a component of fat, can be converted into glucose through gluconeogenesis. Glycogen (Choice A) is a polysaccharide stored in animals, not a component of fat. Fatty acids (Choice B) are used primarily for energy production through beta-oxidation, not for gluconeogenesis. Monoglyceride (Choice D) is a molecule formed during fat digestion, but it is not the component of fat that can be used to make glucose.
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