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 a severe urinary tract infection (UTI) asks why both ciprofloxacin and phenazopyridine are needed. Which of the following responses should the nurse make?
- A. Phenazopyridine decreases adverse effects of ciprofloxacin.
- B. Combining phenazopyridine with ciprofloxacin shortens the course of therapy.
- C. The use of phenazopyridine allows for a lower dosage of ciprofloxacin.
- D. Ciprofloxacin treats the infection, and phenazopyridine treats pain.
Correct answer: D
Rationale: Ciprofloxacin is an antibiotic that treats the infection, while phenazopyridine is a urinary analgesic that relieves pain. Choice A is incorrect because phenazopyridine does not decrease adverse effects of ciprofloxacin; it primarily addresses pain. Choice B is incorrect because combining phenazopyridine with ciprofloxacin does not shorten the course of therapy; they serve different purposes. Choice C is incorrect because the use of phenazopyridine does not allow for a lower dosage of ciprofloxacin; they have independent roles in UTI management.
3. A nurse is providing discharge teaching to a client who has heart failure and a new prescription for digoxin 0.215 mg PO daily and furosemide 20 mg PO daily. Which of the following statements by the client indicates an understanding of the teaching?
- A. I know that blurred vision is something I will expect to happen while taking digoxin.
- B. I will measure my urine output each day and document it in my diary.
- C. I will skip a dose of my digoxin if my resting heart rate is below 72 beats per minute.
- D. I will eat fruits and vegetables that have high potassium content every day.
Correct answer: D
Rationale: Clients taking digoxin and furosemide are at risk for hypokalemia. Eating potassium-rich foods can help maintain normal potassium levels.
4. A nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication?
- A. Ecchymosis
- B. Jaundice
- C. Hypotension
- D. Hypokalemia
Correct answer: C
Rationale: The correct answer is C: Hypotension. Enalapril, an ACE inhibitor, can lead to hypotension, especially after the first dose. Choices A, B, and D are incorrect because enalapril is not typically associated with ecchymosis, jaundice, or hypokalemia as common adverse effects. Therefore, the nurse should primarily monitor the client for signs of hypotension.
5. A nurse is administering insulin glulisine 10 units subcutaneously at 0730 to an adolescent client who has type 1 diabetes mellitus. The nurse should anticipate the onset of action of the insulin at which of the following times?
- A. 0745
- B. 0700
- C. 0645
- D. 0457
Correct answer: A
Rationale: Insulin glulisine has a rapid onset of action, typically around 15 minutes. Therefore, the nurse should expect the onset around 0745. Choice A is correct as it aligns with the expected onset time. Choices B, C, and D are incorrect as they do not match the typical onset time of insulin glulisine.
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