ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment Form A
1. A nurse is teaching a client who is lactose intolerant about dietary choices. Which food should the nurse recommend to increase calcium intake?
- A. Spinach
- B. Peanut butter
- C. Ground beef
- D. Carrots
Correct answer: A
Rationale: The correct answer is A: Spinach. Spinach is rich in calcium, making it a suitable choice for individuals with lactose intolerance who need to avoid dairy products. Peanut butter, ground beef, and carrots are not significant sources of calcium compared to spinach, and therefore, not the best recommendation for increasing calcium intake in lactose-intolerant individuals.
2. A nurse is assessing a client for signs of hypokalemia. Which of the following findings should the nurse look for?
- A. Muscle weakness
- B. Weight gain
- C. Elevated blood pressure
- D. Increased thirst
Correct answer: A
Rationale: Muscle weakness is a classic sign of hypokalemia. Potassium plays a crucial role in muscle function, and low potassium levels can lead to muscle weakness. Weight gain, elevated blood pressure, and increased thirst are not typically associated with hypokalemia. Weight gain can be seen in conditions like fluid retention, elevated blood pressure can result from various causes, and increased thirst may be a symptom of conditions like diabetes.
3. A client with a history of seizures is being cared for by a nurse. Which of the following interventions should the nurse prioritize?
- A. Ensure the environment is safe
- B. Administer medications as prescribed
- C. Monitor for signs of infection
- D. Educate the client about triggers
Correct answer: A
Rationale: The nurse should prioritize ensuring the environment is safe for a client with a history of seizures. This intervention is crucial to prevent injury during a seizure. Administering medications as prescribed is important but ensuring a safe environment takes precedence to prevent harm. Monitoring for signs of infection and educating the client about triggers are also essential aspects of care but are not the priority when considering the immediate safety of the client during a seizure.
4. A nurse is assessing a client who was brought to the psychiatric emergency services by law enforcement. The client has disorganized, incoherent speech with loose associations and religious content. The nurse should recognize these signs and symptoms as consistent with which of the following?
- A. Alzheimer's disease
- B. Schizophrenia
- C. Substance intoxication
- D. Depression
Correct answer: B
Rationale: The correct answer is B: Schizophrenia. Disorganized speech, loose associations, and religious delusions are characteristic symptoms of schizophrenia. In this scenario, the client's presentation aligns with positive symptoms of schizophrenia, indicating a severe mental disorder requiring immediate attention. Choice A, Alzheimer's disease, primarily involves cognitive decline and memory impairment, not disorganized speech or religious content. Choice C, Substance intoxication, may present with altered mental status but typically lacks the persistent pattern of symptoms seen in schizophrenia. Choice D, Depression, is associated with a different set of symptoms such as low mood, anhedonia, and changes in appetite or sleep, rather than disorganized speech and loose associations.
5. A nurse is caring for a client who has an indwelling urinary catheter. What should the nurse identify as a catheter occlusion?
- A. Pain during urination
- B. Bladder distention
- C. Cloudy urine
- D. Blood in the catheter tube
Correct answer: B
Rationale: The correct answer is B: Bladder distention. Bladder distention indicates that the bladder is full and there is impaired elimination, which could be caused by catheter occlusion. Pain during urination (choice A) is not typically associated with catheter occlusion but may indicate a urinary tract infection. Cloudy urine (choice C) can be a sign of infection but is not specific to catheter occlusion. Blood in the catheter tube (choice D) may indicate trauma during catheter insertion but is not a typical finding in catheter occlusion.
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