ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment A
1. A client with hepatic encephalopathy is being educated about their diet by a nurse. Which of the following food selections indicates that the client understands the teaching?
- A. A sandwich and a milkshake
- B. Rice with black beans
- C. Cottage cheese and tuna on lettuce
- D. A three-egg omelet with low-sodium ham
Correct answer: B
Rationale: The correct answer is B: Rice with black beans. Clients with hepatic encephalopathy should limit protein intake to prevent the buildup of ammonia. Plant-based proteins are preferred over animal-based proteins in this condition. Rice with black beans provides a good balance of nutrients and is a suitable choice for a client with hepatic encephalopathy. Choices A, C, and D are incorrect because they contain animal-based proteins, which should be limited in clients with hepatic encephalopathy.
2. A nurse is caring for a client who has been taking haloperidol for several years. Which of the following assessment findings should the nurse recognize as a long-term side effect of this medication?
- A. Lip-smacking
- B. Agranulocytosis
- C. Clang association
- D. Alopecia
Correct answer: A
Rationale: Lip-smacking is a symptom of tardive dyskinesia, a long-term side effect of antipsychotic medications like haloperidol, characterized by involuntary movements of the face and jaw. Agranulocytosis (Choice B) is a rare but serious side effect of some medications, characterized by a dangerously low white blood cell count. Clang association (Choice C) is a thought disorder characterized by the association of words based on sound rather than meaning. Alopecia (Choice D) refers to hair loss, which is not a known long-term side effect of haloperidol.
3. A nurse is planning care for a client with a sealed radiation implant. Which intervention should the nurse implement?
- A. Remove dirty linens after double-bagging them
- B. Wear a dosimeter badge in the client’s room
- C. Limit visitors to 1 hour per day
- D. Ensure family remains 3 feet away from the client
Correct answer: B
Rationale: The nurse should wear a dosimeter badge to monitor radiation exposure when caring for a client with a sealed radiation implant.
4. A nurse is caring for a client who has been prescribed methadone. Which of the following client statements 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 I’m taking this medication.
- D. I’ll change positions slowly, especially when standing.
Correct answer: B
Rationale: The correct answer is B because methadone typically causes sedation and respiratory depression, not trouble sleeping. The statement about trouble sleeping indicates a need for further teaching. Choices A, C, and D are incorrect because understanding that methadone slows breathing, avoiding alcohol while taking the medication, and changing positions slowly to prevent dizziness are all appropriate client statements when prescribed methadone.
5. A home health nurse is providing teaching to a patient who has a new diagnosis of a gastric ulcer and a new prescription for sucralfate oral suspension. What statement by the patient indicates an understanding of the teaching?
- A. I will take this medicine with meals.
- B. I will take this medicine right before bed.
- C. I will take this medicine 1 hour before meals and at bedtime.
- D. I will take this medicine only when I have symptoms.
Correct answer: C
Rationale: The correct answer is C because sucralfate should be taken on an empty stomach, 1 hour before meals, and at bedtime to coat the ulcer and protect it from stomach acid. Choice A is incorrect because taking it with meals may reduce its effectiveness. Choice B is incorrect as it should not be taken right before bed. Choice D is incorrect as sucralfate should be taken regularly as prescribed, not just when symptoms occur.
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