ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment A
1. A nurse on an acute med-surgical unit is performing assessments on a group of clients. Which is the highest priority?
- A. Client with surgical hypoparathyroidism and positive Trousseau's sign
- B. Client with Clostridium difficile and acute diarrhea
- C. Client with acute kidney injury and low urine specific gravity
- D. Client with oral cancer and reports a sore on his gums
Correct answer: A
Rationale: The correct answer is A. A positive Trousseau's sign indicates hypocalcemia, which can lead to life-threatening complications like tetany or laryngospasm, making it the highest priority. Choices B, C, and D, while important, do not pose immediate life-threatening risks compared to the potential complications of severe hypocalcemia seen in a client with surgical hypoparathyroidism and a positive Trousseau's sign.
2. Which therapeutic intervention is most appropriate for a patient diagnosed with dissociative amnesia?
- A. Cognitive-behavioral therapy
- B. Hypnotherapy
- C. Electroconvulsive therapy
- D. Pharmacotherapy
Correct answer: B
Rationale: Hypnotherapy is the most appropriate therapeutic intervention for a patient diagnosed with dissociative amnesia. This approach aims to help the patient recover lost memories in a controlled environment, allowing them to process and integrate their memories effectively. Hypnotherapy can assist in uncovering and addressing the underlying issues contributing to dissociative amnesia. Cognitive-behavioral therapy focuses on changing negative patterns of thinking or behavior and may not directly address memory recovery. Electroconvulsive therapy is typically used for severe depression or certain mental disorders, not dissociative amnesia. Pharmacotherapy involves medication and is not the primary intervention for dissociative amnesia.
3. A nurse is teaching a client who has peripheral arterial disease (PAD) about exercise recommendations. Which of the following instructions should the nurse include?
- A. Exercise to the point of pain
- B. Stop exercising if pain occurs
- C. Exercise only once per week
- D. Avoid walking to prevent pain
Correct answer: B
Rationale: The correct instruction the nurse should include is to 'Stop exercising if pain occurs.' In peripheral arterial disease (PAD), it is crucial to avoid exercising to the point of pain as this may worsen the condition and lead to complications. Exercising to the point of pain can result in inadequate blood flow to the extremities, causing further damage. By stopping exercise if pain occurs, the client can prevent exacerbating their condition. Choices A, C, and D are incorrect because exercising to the point of pain, limiting exercise to once per week, and avoiding walking altogether are not recommended strategies for managing PAD and could potentially harm the client.
4. What instruction should be provided to a client with a history of myocardial infarction (MI) who is prescribed nitroglycerin?
- A. Take nitroglycerin with food to avoid stomach upset.
- B. Store nitroglycerin tablets in a dark, glass container.
- C. Swallow nitroglycerin tablets whole without chewing.
- D. Discontinue the medication if a headache occurs.
Correct answer: B
Rationale: Nitroglycerin is a medication that should be stored in a dark, glass container to protect it from light and moisture. Exposure to light and moisture can reduce its effectiveness. Storing it in a dark, glass container helps maintain the medication's stability and potency, ensuring that it remains safe and effective for use in emergencies, such as angina attacks.
5. A healthcare professional is educating a client with osteoporosis about dietary management. Which of the following foods should the professional recommend?
- A. Green beans
- B. Fortified cereal
- C. Red meat
- D. White bread
Correct answer: B
Rationale: Fortified cereal is the correct answer as it is an excellent choice for individuals with osteoporosis due to its high calcium and vitamin D content, both essential nutrients for bone health. These nutrients help in maintaining bone density and strength, which is crucial for individuals with osteoporosis. Green beans (choice A) do not provide as much calcium and vitamin D as fortified cereal. Red meat (choice C) is a good source of protein but is not as rich in calcium and vitamin D compared to fortified cereal. White bread (choice D) lacks the essential nutrients needed for bone health, making it a less suitable choice for individuals with osteoporosis.
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