ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment B Quizlet
1. A nurse is providing teaching about breastfeeding to a client who is postpartum. Which of the following instructions should the nurse include?
- A. Wash your nipples with soap after each feeding.
- B. Place your baby to your breast for 5 minutes every 4 hours.
- C. Ensure your newborn has at least six wet diapers per day.
- D. Give your newborn 30 mL of water between feedings.
Correct answer: C
Rationale: The correct answer is C: 'Ensure your newborn has at least six wet diapers per day.' Six or more wet diapers per day is an indicator that the newborn is receiving adequate breast milk, making this an important part of breastfeeding education. Choice A is incorrect because washing nipples with soap after each feeding can lead to dryness and cracking. Choice B is incorrect as babies should nurse on demand rather than on a strict schedule of 5 minutes every 4 hours. Choice D is incorrect as giving water to a newborn between feedings is not recommended and can interfere with breastfeeding.
2. A nurse is teaching a client about the use of pantoprazole. Which of the following should be included?
- A. It should be taken on an empty stomach
- B. It reduces stomach acid production
- C. It can cause headache
- D. It should not be used with other antacids
Correct answer: C
Rationale: The correct information to include when teaching a client about pantoprazole is that it can cause headaches. Option A is incorrect because pantoprazole is usually taken before meals. Option B is not necessary information for the client to know. Option D is not directly related to the side effects of pantoprazole.
3. A client newly prescribed sertraline is being taught by a nurse. Which statement by the client indicates understanding?
- A. I should take this medication with meals.
- B. I might have trouble sleeping when I start this medication.
- C. I should avoid drinking orange juice.
- D. I will feel better immediately after starting the medication.
Correct answer: B
Rationale: Choice B, 'I might have trouble sleeping when I start this medication,' indicates understanding because insomnia is a common side effect of sertraline, especially when initiating the medication. This statement shows the client comprehends a potential adverse effect and is prepared for it. Choices A, C, and D are incorrect. Taking sertraline with or without meals does not significantly affect its efficacy. There is no specific contraindication about drinking orange juice while on sertraline. Feeling better immediately after starting the medication is unlikely as sertraline usually takes some time to exert its therapeutic effects.
4. A nurse is reviewing information about advance directives with a newly admitted client. Which statement by the client indicates an understanding of the teaching?
- A. My family can make decisions if I am unable to.
- B. I have a living will that outlines my wishes when I am unable to make a decision.
- C. I can write down my wishes, but they aren't legally binding.
- D. I don't need to worry about this until I’m critically ill.
Correct answer: B
Rationale: Choice B is the correct answer because having a living will is a legal document that outlines a client's wishes when they are unable to make decisions, indicating a good understanding of advance directives. Choice A is incorrect because it doesn't mention a specific document like a living will. Choice C is incorrect because advance directives, like a living will, can be legally binding. Choice D is incorrect because planning for advance directives should ideally be done before a person becomes critically ill.
5. A client with schizophrenia is experiencing auditory hallucinations. Which of the following actions should the nurse take first?
- A. Encourage the client to listen to music
- B. Ask the client what the voices are saying
- C. Provide the client with a distraction
- D. Administer an antipsychotic medication
Correct answer: B
Rationale: Asking the client what the voices are saying is the priority action as it helps assess the content of the hallucinations. This assessment is crucial to determine if the client is at risk of harm to themselves or others. Encouraging the client to listen to music or providing a distraction may not address the underlying issues related to the hallucinations. Administering antipsychotic medication, although important, should come after a thorough assessment of the hallucinations to ensure the right medication and dosage are provided.
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