ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment Form B
1. A client with diabetes mellitus is receiving education on foot care. Which of the following instructions should the nurse include?
- A. Apply lotion between the toes.
- B. Cut toenails straight across.
- C. Use a heating pad to warm the feet.
- D. Soak feet in warm water daily.
Correct answer: B
Rationale: The correct answer is B: Cut toenails straight across. This instruction is vital for clients with diabetes as it helps prevent ingrown toenails and infections, reducing the risk of foot ulcers. Applying lotion between the toes (choice A) should be avoided as it can create a moist environment prone to fungal infections. Using a heating pad (choice C) can lead to burns or injuries due to reduced sensation common in diabetes. Soaking feet in warm water daily (choice D) can also increase the risk of skin breakdown and should be avoided.
2. Which of the following would increase a client's risk of ovarian cancer?
- A. History of fibroids
- B. Early menopause
- C. Endometriosis
- D. Polycystic ovary syndrome
Correct answer: C
Rationale: The correct answer is C, Endometriosis. Endometriosis is associated with an increased risk of developing ovarian cancer due to chronic inflammation and hormonal imbalances. The exact cause is not fully understood, but women with endometriosis should be monitored closely. Choices A, B, and D are incorrect as they are not directly linked to an increased risk of ovarian cancer. Fibroids, early menopause, and polycystic ovary syndrome do not have a known direct correlation with ovarian cancer risk.
3. A client is being treated with thiazide diuretics. What should the nurse monitor regularly?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hyponatremia
- D. Hypoglycemia
Correct answer: B
Rationale: Thiazide diuretics are known to cause hypokalemia by increasing potassium excretion in the urine. Therefore, the nurse should monitor the client for low potassium levels. Hyperkalemia (Choice A) is not typically associated with thiazide diuretics. Hyponatremia (Choice C) is more commonly linked with thiazide diuretics due to increased sodium excretion. Hypoglycemia (Choice D) is not a usual concern when a client is receiving thiazide diuretics.
4. A nurse is reviewing the laboratory results for a client who is at 29 weeks of gestation. Which of the following results should the nurse report to the provider?
- A. WBC count 11,000/mm³
- B. Hgb 11.2 g/dL
- C. Hct 34%
- D. Platelets 140,000/mm³
Correct answer: D
Rationale: A platelet count of 140,000/mm³ is at the lower end of the normal range but can be concerning in pregnancy, especially if there are signs of thrombocytopenia or bleeding. Thrombocytopenia in pregnancy can lead to complications such as bleeding during childbirth or excessive bleeding postpartum. The other laboratory values mentioned are within normal ranges for pregnancy and do not typically raise immediate concerns. High WBC counts can be a normal response to pregnancy, hemoglobin levels around 11.2 g/dL and hematocrit levels around 34% are also considered normal in the third trimester.
5. A nurse is assessing a 2-hour-old newborn for cold stress. Which of the following findings should the nurse expect?
- A. Respiratory rate of 60/min
- B. Jitteriness of the hands
- C. Diaphoresis
- D. Bounding peripheral pulses
Correct answer: B
Rationale: The correct answer is B: Jitteriness of the hands. Jitteriness is a key sign of cold stress in a newborn, indicating the need for immediate warming measures. A respiratory rate of 60/min may not be directly indicative of cold stress. Diaphoresis (excessive sweating) and bounding peripheral pulses are not typical findings associated with cold stress in newborns.
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