ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment 2020 B
1. A client is prescribed spironolactone. Which of the following dietary instructions should the nurse include?
- A. Increase potassium-rich foods
- B. Limit sodium intake
- C. Avoid potassium supplements
- D. Increase protein intake
Correct answer: C
Rationale: The correct answer is to advise the client to avoid potassium supplements. Spironolactone is a potassium-sparing diuretic, meaning it helps the body retain potassium. Adding potassium supplements on top of this medication can lead to hyperkalemia, an elevated level of potassium in the blood, which can be dangerous. Choices A, B, and D are incorrect because increasing potassium-rich foods, limiting sodium intake, and increasing protein intake are not specifically related to the dietary considerations when taking spironolactone.
2. A nurse is teaching a client who has multiple sclerosis (MS) about strategies to reduce fatigue. Which of the following instructions should the nurse include?
- A. Exercise to the point of exhaustion
- B. Rest as needed throughout the day
- C. Avoid physical activity
- D. Exercise only once per week
Correct answer: B
Rationale: The correct instruction the nurse should include is to 'Rest as needed throughout the day.' Fatigue is a common symptom of multiple sclerosis (MS), and adequate rest is essential to manage it effectively. Resting as needed helps conserve energy and prevent fatigue from worsening. Choices A, C, and D are incorrect. 'Exercise to the point of exhaustion' is not recommended as it can lead to increased fatigue. 'Avoiding physical activity' entirely is not advisable as appropriate exercise can help maintain strength and energy levels. 'Exercising only once per week' may not be sufficient to combat fatigue and maintain overall well-being in clients with MS.
3. What motivates a nurse to perform tasks, whether at work or off duty?
- A. Personal motivation
- B. Facility policies
- C. Fear of reprisals
- D. Parental expectations
Correct answer: A
Rationale: Personal motivation is the driving force behind a nurse's actions, influencing their decisions and behaviors both during work hours and while off duty. It is an internal drive that compels them to act in a certain way, regardless of external factors such as facility policies, fear of reprisals, or parental expectations. While facility policies may guide their actions within the workplace, they do not address motivation. Fear of reprisals and parental expectations are external factors and are less likely to be the primary motivators for a nurse's actions.
4. In addition to active transport, which process is involved in absorbing food in the small intestine?
- A. pinocytosis
- B. excretion
- C. phagocytosis
- D. electrochemical diffusion
Correct answer: A
Rationale: The correct answer is pinocytosis. Pinocytosis is a process where cells in the small intestine absorb nutrients by engulfing them. This process is different from phagocytosis, which involves engulfing large particles, and excretion, which is the removal of waste products. Electrochemical diffusion is not directly involved in the absorption of food in the small intestine.
5. The nurse is assessing a postpartum client's fundus. Where should the nurse expect to find the fundus 24 hours after delivery?
- A. At the level of the umbilicus
- B. 1 cm above the symphysis pubis
- C. At the level of the xiphoid process
- D. 2 cm below the umbilicus
Correct answer: A
Rationale: After delivery, the fundus is expected to be at the level of the umbilicus 24 hours postpartum. This position indicates that the uterus is involuting properly. Assessing the fundal height helps monitor the progress of uterine involution and can identify any potential complications like postpartum hemorrhage.
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