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PN ATI Capstone Proctored Comprehensive Assessment 2020 A with NGN
1. A nurse is caring for a client prescribed the HMG CoA reductase inhibitor, atorvastatin. Which of the following should be monitored while this medication is prescribed?
- A. Liver function test
- B. Renal function test
- C. Hearing screenings
- D. Visual acuity screenings
Correct answer: A
Rationale: Corrected Rationale: Atorvastatin, an HMG CoA reductase inhibitor, can lead to hepatotoxicity. Therefore, monitoring liver function through regular tests is essential. Baseline liver function should be assessed, followed by tests at 12 weeks after starting therapy and periodically thereafter. This monitoring helps detect early signs of liver damage, including jaundice, nausea, and dark urine. Incorrect Choices Rationale: B) Renal function test is not directly affected by atorvastatin. C) Hearing screenings and D) Visual acuity screenings are not indicated for monitoring while on atorvastatin therapy.
2. A nurse is preparing to administer a pneumococcal vaccine. Which of the following should the nurse verify?
- A. Client's allergy to eggs
- B. Client's current medications
- C. Client's vaccination history
- D. Client's blood pressure
Correct answer: C
Rationale: The correct answer is C: Client's vaccination history. Before administering a pneumococcal vaccine, the nurse should verify the client's vaccination history to ensure they are due for the vaccine. Verifying the vaccination history helps prevent unnecessary vaccinations and ensures that the client receives the appropriate immunization at the right time. Choices A, B, and D are not directly related to the administration of the pneumococcal vaccine. Checking for allergies to eggs may be important for other vaccines, but it is not specifically relevant to pneumococcal vaccination. The client's current medications and blood pressure are important for general health assessment but are not directly related to verifying the need for a pneumococcal vaccine.
3. A nurse is planning to discharge a client who has quadriplegia to his home. The nurse suggests that the family might need respite care services. When a family member asks how respite care can help, which response should the nurse provide?
- A. Respite care provides medical support to the client.
- B. Respite care assists with financial planning for the client’s needs.
- C. Respite care provides long-term housing.
- D. Respite care allows the primary caregiver time away from day-to-day care responsibilities.
Correct answer: D
Rationale: The correct answer is D. Respite care is designed to give primary caregivers temporary relief from the responsibilities of care, allowing them to take a break. Choice A is incorrect because respite care is not primarily focused on providing medical support to the client. Choice B is incorrect as respite care does not specifically assist with financial planning for the client's needs. Choice C is incorrect as respite care does not provide long-term housing, but rather short-term relief for caregivers.
4. While in the cafeteria, a nurse overhears two APs discussing a hospitalized patient. What action should the nurse take?
- A. Report the incident to the supervisor.
- B. Join the conversation to intervene.
- C. Quietly tell the APs that this is not appropriate.
- D. Ignore the conversation.
Correct answer: C
Rationale: The correct action for the nurse to take in this situation is to choose option C: 'Quietly tell the APs that this is not appropriate.' The nurse should immediately and discreetly address the situation, reminding the APs that discussing patient information in public areas violates confidentiality. Reporting the incident to the supervisor (option A) may be necessary if the behavior continues. Joining the conversation to intervene (option B) may escalate the situation and compromise patient confidentiality. Ignoring the conversation (option D) does not address the violation or prevent it from recurring.
5. A nurse is caring for a client with chronic obstructive pulmonary disease (COPD). Which of the following should the nurse assess for?
- A. Respiratory rate
- B. Chest pain
- C. Use of accessory muscles
- D. Oxygen saturation
Correct answer: C
Rationale: In a client with COPD, the nurse should assess for the use of accessory muscles. This is important because COPD can lead to increased work of breathing, causing the client to engage accessory muscles to help with respiration. Assessing for the use of accessory muscles provides crucial information about the client's respiratory effort. Respiratory rate (Choice A) is a standard assessment parameter but may not specifically indicate the severity of COPD. Chest pain (Choice B) is not typically associated with COPD unless there are complicating factors. Oxygen saturation (Choice D) is essential to monitor in COPD clients, but assessing for the use of accessory muscles takes priority as it directly reflects the client's respiratory status in COPD.
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