ATI LPN
PN ATI Capstone Maternal Newborn
1. A nurse is teaching the parent of a newborn about car seat safety. Which of the following statements should the nurse make?
- A. You should keep the car seat rear-facing until your baby is at least 2 years old.
- B. Position the retainer clip over the upper part of your baby's abdomen.
- C. You should place your baby in the car seat with a slight recline.
- D. Place the shoulder harness straps in the slots at or below your baby's shoulders.
Correct answer: A
Rationale: The correct answer is A. The car seat should remain rear-facing until the baby is at least 2 years old to ensure maximum safety in the event of a collision. This position helps protect the infant’s head, neck, and spine. Choice B is incorrect because the retainer clip should be positioned at armpit level on the baby, not over the upper part of the abdomen. Choice C is incorrect as the baby should be placed in the car seat with a slight recline, not at a 90-degree angle. Choice D is incorrect as the shoulder harness straps should be at or below the baby's shoulders, not above, to ensure proper fit and safety.
2. A nurse is caring for a client who has been prescribed methadone. Which of the following client statements indicates a need for further teaching?
- A. I understand methadone slows my breathing.
- B. I understand methadone may cause me to have trouble sleeping.
- C. I will avoid alcohol while I’m taking this medication.
- D. I’ll change positions slowly, especially when standing.
Correct answer: B
Rationale: The correct answer is B because methadone typically causes sedation and respiratory depression, not trouble sleeping. The statement about trouble sleeping indicates a need for further teaching. Choices A, C, and D are incorrect because understanding that methadone slows breathing, avoiding alcohol while taking the medication, and changing positions slowly to prevent dizziness are all appropriate client statements when prescribed methadone.
3. A nurse is caring for a client with a recent diagnosis of myasthenia gravis. Which of the following medications should the nurse expect to administer?
- A. Methotrexate
- B. Pyridostigmine
- C. Baclofen
- D. Atropine
Correct answer: B
Rationale: Pyridostigmine is the drug of choice for treating myasthenia gravis because it enhances communication between nerves and muscles by inhibiting acetylcholinesterase. Methotrexate (choice A) is not indicated for myasthenia gravis but is used in conditions like rheumatoid arthritis. Baclofen (choice C) is a muscle relaxant used for conditions like spasticity. Atropine (choice D) is not typically used in myasthenia gravis as it can worsen muscle weakness.
4. 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.
5. A nurse is preparing to administer a dose of enalapril. Which of the following should the nurse assess first?
- A. Heart rate
- B. Blood pressure
- C. Serum creatinine
- D. Potassium levels
Correct answer: B
Rationale: The correct answer is to assess blood pressure first. Enalapril is an ACE inhibitor commonly used to manage hypertension. It is crucial to evaluate the patient's blood pressure before administering enalapril to ensure it is within safe limits. Assessing other parameters like heart rate, serum creatinine, and potassium levels is also important but assessing blood pressure takes precedence due to the medication's mechanism of action and potential effects on blood pressure regulation.
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