ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment Form B
1. What is an example of a culturally sensitive response from a healthcare provider when a patient mentions feeling uncomfortable with a treatment plan?
- A. Asking why they feel this way
- B. Explaining that the treatment is standard
- C. Inviting the patient to share concerns
- D. Offering alternative treatments
Correct answer: C
Rationale: Inviting the patient to share concerns is an example of a culturally sensitive response as it acknowledges the patient's feelings and provides a safe space for them to express their discomfort. This approach shows respect for the patient's cultural beliefs and values by valuing their perspective. Choice A, asking why they feel this way, can be perceived as confrontational and may not encourage open communication. Choice B, explaining that the treatment is standard, dismisses the patient's feelings and does not address their discomfort. Choice D, offering alternative treatments, may be premature without fully understanding the patient's concerns first.
2. A nurse is caring for a client 4 hours postoperative following a thyroidectomy. The client reports fullness in the throat. What should the nurse assess for?
- A. Hypocalcemia
- B. Hemorrhage
- C. Hypoxia
- D. Hypothyroidism
Correct answer: B
Rationale: In this scenario, the correct answer is B: Hemorrhage. Fullness in the throat post-thyroidectomy can indicate postoperative bleeding, a critical complication that requires immediate assessment and intervention. Choice A, Hypocalcemia, is incorrect because it does not typically present with fullness in the throat. Choice C, Hypoxia, is not directly related to the symptom described and is not the primary concern in this situation. Choice D, Hypothyroidism, is also incorrect as it is a long-term condition and unlikely to manifest suddenly 4 hours postoperatively with throat fullness.
3. A nurse is planning care for a client who has Alzheimer's disease and demonstrates confusion and wandering behavior. Which of the following should the nurse include in the plan of care?
- A. Place the client in seclusion when she is confused
- B. Request a prescription for PRN restraints when the client is wandering
- C. Dim the lighting in the client’s room
- D. Leave one side rail up on the client's bed
Correct answer: D
Rationale: The correct answer is to leave one side rail up on the client's bed. This action can help prevent falls while allowing the client to get up safely when needed, reducing the risk of injury from wandering. Placing the client in seclusion (Choice A) is not appropriate as it can lead to increased agitation and distress. Requesting restraints (Choice B) should be avoided as it can increase the risk of injuries and is not recommended for clients with Alzheimer's. Dimming the lighting (Choice C) may increase confusion and disorientation in clients with Alzheimer's disease.
4. A client with type 1 DM is being taught about hypoglycemia by a nurse. Which statement by the client indicates an understanding of the teaching?
- A. “Exercise decreases the risk of hypoglycemia.”
- B. “I should skip my insulin if I don't eat.”
- C. “I can drink 4 oz of regular soda if my blood sugar is low.”
- D. “Oral diabetic medications do not lead to hypoglycemia; only insulin does.”
Correct answer: C
Rationale: The correct answer is C because the client should have a quick-acting source of 15 g of carbohydrates to treat hypoglycemic episodes, such as 4 oz of regular soda. Choice A is incorrect because while exercise can help manage blood sugar levels, it can also increase the risk of hypoglycemia if not properly managed. Choice B is incorrect as skipping insulin when not eating can lead to hyperglycemia, not prevent hypoglycemia. Choice D is incorrect because certain oral diabetic medications can indeed cause hypoglycemia, not just insulin.
5. A nurse is preparing to administer a unit of packed RBCs to a client. Which of the following actions should the nurse take first?
- A. Administer an antihistamine prior to transfusion.
- B. Check the client’s vital signs.
- C. Verify the client’s identification with another nurse.
- D. Prime the IV tubing with normal saline.
Correct answer: C
Rationale: The correct first action the nurse should take when preparing to administer packed RBCs to a client is to verify the client’s identification with another nurse. This is crucial to ensure that the correct blood product is administered to the correct client, minimizing the risk of a transfusion reaction. Administering an antihistamine prior to transfusion (Choice A) is not the first priority and is not a standard practice. While checking the client’s vital signs (Choice B) is important, verifying the client’s identification takes precedence to prevent a critical error. Priming the IV tubing with normal saline (Choice D) is a necessary step in the process but should occur after verifying the client's identity.
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