ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment 2020 B
1. A nurse is providing education on the use of calcium carbonate. Which of the following should be included?
- A. It can cause hypocalcemia
- B. Monitor for constipation
- C. It can be taken anytime
- D. It is a prescription medication
Correct answer: B
Rationale: The correct answer is B: 'Monitor for constipation.' Calcium carbonate can cause constipation as a side effect. Educating clients on dietary adjustments, such as increasing fluid intake and fiber consumption, can help alleviate this issue. Choice A is incorrect because calcium carbonate supplementation is used to treat hypocalcemia, not cause it. Choice C is incorrect because calcium carbonate should be taken with food for optimal absorption. Choice D is incorrect because calcium carbonate is available over the counter, not as a prescription medication.
2. A nurse is preparing to perform closed intermittent bladder irrigation for a client following a transurethral resection of the prostate (TURP). Which of the following actions is appropriate by the nurse?
- A. Aspirate the irrigation solution from the bladder
- B. Insert the tip of the irrigation syringe into the catheter opening
- C. Apply sterile gloves
- D. Open the flow clamp to the irrigating fluid infusion tubing
Correct answer: C
Rationale: The correct action for the nurse to take before performing a closed intermittent bladder irrigation is to apply sterile gloves. Sterile gloves help maintain asepsis, reduce the risk of infection, and ensure patient safety during the procedure. Aspirating the irrigation solution from the bladder (Choice A) is not a standard step in closed intermittent bladder irrigation. Inserting the tip of the irrigation syringe into the catheter opening (Choice B) can introduce contaminants into the system. Opening the flow clamp to the irrigating fluid infusion tubing (Choice D) should only be done after ensuring all equipment is ready and the nurse is gloved to maintain sterility.
3. A nurse is caring for a client who has congestive heart failure and is taking digoxin. The client reports nausea and refuses to eat breakfast. Which of the following actions should the nurse take first?
- A. Encourage the client to eat the toast on the breakfast tray
- B. Administer an antiemetic
- C. Inform the client's provider
- D. Check the client's apical pulse
Correct answer: D
Rationale: The correct answer is to check the client's apical pulse first. Nausea can be a sign of digoxin toxicity, and assessing the client's heart rate is crucial in this situation. Administering an antiemetic or encouraging the client to eat should come after ensuring the client's safety. While informing the provider is important, the immediate concern is to assess for potential digoxin toxicity by checking the client's apical pulse.
4. A nurse is caring for a client with celiac disease. Which food should be removed from the meal tray?
- A. Cornbread
- B. Mashed potatoes
- C. Lentils
- D. Tortillas
Correct answer: D
Rationale: The correct answer is D, Tortillas. Clients with celiac disease should avoid gluten, which is often found in tortillas. Cornbread, mashed potatoes, and lentils are gluten-free options, making them safe for individuals with celiac disease. Therefore, the other choices (A, B, and C) do not need to be removed from the meal tray.
5. A nurse is admitted to a psychiatric unit and fails to follow her medication regimen. What does this behavior indicate?
- A. Early cognitive impairment
- B. Lack of motivation
- C. Lack of health literacy
- D. Worsening health state
Correct answer: C
Rationale: The correct answer is C, 'Lack of health literacy.' The nurse's inability to follow the medication regimen suggests she may lack health literacy, meaning she may not fully understand how to manage her own health care. Choice A, 'Early cognitive impairment,' is not supported by the information provided in the question as there is no mention of cognitive decline. Choice B, 'Lack of motivation,' is less likely as the behavior is more indicative of a knowledge deficit rather than a lack of drive. Choice D, 'Worsening health state,' is also less likely as the behavior described does not directly imply a worsening health condition but rather a misunderstanding or lack of knowledge on managing health.
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