ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment A
1. A client with chronic kidney failure and an AV fistula for hemodialysis is prescribed epoetin alfa. Which of the following therapeutic effects should the nurse include in the teaching?
- A. Reduces blood pressure
- B. Inhibits clotting of fistula
- C. Promotes RBC production
- D. Stimulates growth of neutrophils
Correct answer: C
Rationale: The correct answer is C: Promotes RBC production. Epoetin alfa stimulates erythropoiesis (red blood cell production) to treat anemia associated with chronic kidney failure. This helps in increasing the hemoglobin levels and improving oxygen-carrying capacity. Choices A, B, and D are incorrect as epoetin alfa does not have direct effects on reducing blood pressure, inhibiting clotting of the fistula, or stimulating the growth of neutrophils.
2. A client with rheumatoid arthritis is prescribed long-term prednisone therapy. What adverse effect should the client monitor for according to the nurse's instruction?
- A. Stress fractures
- B. Orthostatic hypotension
- C. Gingival ulcerations
- D. Weight loss
Correct answer: A
Rationale: The correct answer is A: Stress fractures. Long-term prednisone therapy can lead to osteoporosis, which increases the risk of stress fractures. Option B, orthostatic hypotension, is not a common adverse effect associated with prednisone use. Option C, gingival ulcerations, is more commonly associated with conditions like periodontal disease or poor oral hygiene rather than prednisone therapy. Option D, weight loss, is not a typical adverse effect of prednisone; in fact, weight gain is more common due to prednisone's impact on metabolism.
3. A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse should anticipate a prescription for which of the following medications?
- A. Methimazole
- B. Somatropin
- C. Levothyroxine
- D. Propylthiouracil
Correct answer: C
Rationale: Levothyroxine is the correct answer. In this scenario, the client's elevated TSH and decreased T3 and T4 levels indicate hypothyroidism, a condition where the thyroid gland does not produce enough hormones. Levothyroxine is a synthetic form of thyroid hormone that is used to replace or supplement the body's naturally produced thyroid hormones. Methimazole and Propylthiouracil are used to treat hyperthyroidism by reducing the production of thyroid hormones. Somatropin is a growth hormone used to treat growth hormone deficiency and other conditions unrelated to thyroid disorders.
4. A healthcare professional is reviewing the laboratory results for a client who has a prescription for filgrastim. The healthcare professional should recognize that an increase in which of the following values indicates a therapeutic effect of this medication?
- A. Erythrocyte count
- B. Neutrophil count
- C. Lymphocyte count
- D. Thrombocyte count
Correct answer: B
Rationale: Filgrastim is a medication used to stimulate the production of neutrophils in patients with neutropenia. Neutrophils are a type of white blood cell that plays a crucial role in fighting off infections. Therefore, an increase in neutrophil count would indicate a therapeutic effect of filgrastim. The other options, such as erythrocyte count (red blood cells), lymphocyte count, and thrombocyte count (platelets), are not directly affected by filgrastim and would not indicate a therapeutic effect of this medication.
5. A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects?
- A. Antiestrogenic
- B. Antimicrobial
- C. Androgenic
- D. Anti-inflammatory
Correct answer: A
Rationale: Tamoxifen is an antiestrogen medication used primarily in the treatment and prevention of breast cancer. It works by blocking the effects of estrogen in the breast tissue, thereby acting as an antiestrogenic agent. This makes choice A the correct answer. Choice B, antimicrobial, is incorrect as tamoxifen does not possess antimicrobial properties and is not used to treat infections. Choice C, androgenic, is incorrect as tamoxifen has antiestrogenic effects, not androgenic effects. Choice D, anti-inflammatory, is incorrect as tamoxifen's main therapeutic action is antiestrogenic rather than anti-inflammatory.