ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment 2020 A with NGN
1. What can cause a low pulse oximetry reading?
- A. Hyperthermia
- B. Increased hemoglobin level
- C. Inadequate peripheral circulation
- D. Low altitudes
Correct answer: C
Rationale: Inadequate peripheral circulation can cause a low pulse oximetry reading by limiting blood flow to the area being measured, leading to inaccurate oxygen saturation readings. Hyperthermia (choice A) is an elevated body temperature and does not directly affect pulse oximetry readings. An increased hemoglobin level (choice B) would actually lead to higher oxygen-carrying capacity in the blood, resulting in normal or increased pulse oximetry readings. Low altitudes (choice D) typically do not cause low pulse oximetry readings unless there are other underlying conditions affecting oxygen levels.
2. When assessing a client with a small bowel obstruction, what finding should a nurse expect?
- A. Significant abdominal distention
- B. Large bowel movements
- C. High-pitched bowel sounds
- D. Copious vomiting
Correct answer: C
Rationale: High-pitched bowel sounds are often heard early in a small bowel obstruction due to increased peristalsis as the bowel tries to overcome the blockage. Choices A, B, and D are incorrect. Abdominal distention is more commonly associated with large bowel obstructions, while large bowel movements and copious vomiting are not typical findings in small bowel obstructions.
3. A nurse is receiving a report on four clients. Which of the following clients should the nurse assess first?
- A. A client who has an ileal conduit and mucus in the pouch
- B. Client with arteriovenous fistula with additional vibration palpated
- C. A client with chronic kidney disease and cloudy dialysate outflow
- D. A client with transurethral resection of the prostate with red-tinged urine
Correct answer: C
Rationale: The nurse should assess the client with chronic kidney disease and cloudy dialysate outflow first because cloudy dialysate outflow suggests peritonitis, a serious complication of peritoneal dialysis that requires immediate intervention. Assessing and addressing peritonitis promptly is crucial to prevent further complications and ensure the client's safety. Choices A, B, and D present important findings that require attention but are not as urgent as peritonitis, which can quickly escalate and endanger the client's health.
4. A nurse is caring for a client who is in labor and has a diagnosis of group B streptococcus ß-hemolytic infection. Which of the following medications should the nurse plan to administer?
- A. Ampicillin
- B. Azithromycin
- C. Ceftriaxone
- D. Acyclovir
Correct answer: A
Rationale: Ampicillin is the correct choice for treating group B streptococcus infections in pregnant women during labor to prevent neonatal infection. Group B streptococcus is commonly treated with penicillin or ampicillin; therefore, choices B, C, and D are incorrect. Azithromycin is not the first-line treatment for group B streptococcus. Ceftriaxone is not the preferred antibiotic for this infection during labor. Acyclovir is an antiviral medication used for herpes simplex virus infections, not bacterial infections like group B streptococcus.
5. A nurse is caring for a client who had a stroke and is showing signs of dysphagia. Which of the following findings should the nurse recognize as an indication of this condition?
- A. Abnormal movements of the mouth
- B. Inability to stand without assistance
- C. Paralysis of the right arm
- D. Loss of appetite
Correct answer: A
Rationale: Abnormal movements of the mouth are a common indication of dysphagia, a condition that impairs swallowing function. In clients who have had a stroke, dysphagia can increase the risk of aspiration, leading to serious complications. Inability to stand without assistance (Choice B) is more indicative of motor deficits following a stroke rather than dysphagia. Paralysis of the right arm (Choice C) is a manifestation of hemiplegia, which is common in stroke but not directly related to dysphagia. Loss of appetite (Choice D) may occur in individuals with dysphagia but is not a direct indicator of the condition itself.
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