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PN ATI Capstone Proctored Comprehensive Assessment 2020 B
1. A client has been prescribed metoclopramide. Which of the following should the nurse include in client education regarding this medication?
- A. Notify your provider if you experience restlessness or spasms of the face or neck.
- B. Take the medication only if you feel nauseous.
- C. Avoid drinking any fluids while taking this medication.
- D. Take the medication on an empty stomach.
Correct answer: A
Rationale: The correct answer is A: 'Notify your provider if you experience restlessness or spasms of the face or neck.' Metoclopramide can cause extrapyramidal symptoms, such as restlessness and muscle spasms, particularly of the face and neck. These symptoms should be reported to the provider immediately. Choice B is incorrect because metoclopramide is not meant to be taken only when feeling nauseous; it is used to treat nausea and vomiting. Choice C is incorrect because it is important to stay hydrated while taking metoclopramide. Choice D is incorrect because metoclopramide is usually taken before meals to improve gastric emptying, not necessarily on an empty stomach.
2. A nurse is caring for a client with encephalopathy secondary to liver failure. The client has been prescribed a high-calorie, low-protein diet. Which of the following meal selections is appropriate for this client?
- A. Scrambled eggs, bacon, and pancakes
- B. Grilled cheese sandwich, potato chips, chocolate pudding
- C. Steak, French fries, corn
- D. Chicken breast, mashed potatoes, spinach
Correct answer: D
Rationale: The correct answer is D: Chicken breast provides a low-fat protein source, and mashed potatoes and spinach provide high-calorie nutrients suitable for managing liver failure. Option A (Scrambled eggs, bacon, and pancakes) is high in protein, which is not suitable for a low-protein diet. Option B (Grilled cheese sandwich, potato chips, chocolate pudding) contains high protein and may not be appropriate for the client. Option C (Steak, French fries, corn) is high in protein and fat, which are not recommended for this client's dietary requirements.
3. A nurse is caring for a client with a new prescription for furosemide. Which of the following should the nurse monitor?
- A. Serum potassium levels
- B. Liver function
- C. Blood glucose levels
- D. Calcium levels
Correct answer: A
Rationale: Corrected Rationale: When a client is prescribed furosemide, the nurse should monitor serum potassium levels. Furosemide is a loop diuretic that can lead to potassium loss, potentially causing hypokalemia. Monitoring serum potassium levels is crucial to prevent complications such as cardiac dysrhythmias. Choices B, C, and D are incorrect because furosemide primarily affects potassium excretion rather than liver function, blood glucose levels, or calcium levels.
4. A charge nurse is discussing HIPAA with a newly licensed nurse. Which action should the charge nurse include in the teaching as an example of a HIPAA violation?
- A. Faxing a patient’s discharge summary to the pharmacy.
- B. Emailing the patient’s positive hepatitis results from an unencrypted server.
- C. Discussing the patient’s care plan during bedside rounds.
- D. Placing the patient’s chart in a secure location at the nurse’s station.
Correct answer: B
Rationale: Emailing patient information from an unencrypted server violates HIPAA because it exposes sensitive health information to potential breaches. Choice A is not a violation as long as the fax is sent to the correct recipient. Choice C is not a violation if the discussion is done discreetly and within an appropriate setting. Choice D is a recommended practice to ensure patient information is kept secure.
5. A nurse is assessing four clients for fluid balance. Which of the following clients is exhibiting manifestations of dehydration?
- A. A client who has a urine specific gravity of 1.010.
- B. A client who has a weight gain of 2.2 kg (2 lb) in 24 hr.
- C. A client who has a hematocrit of 45%.
- D. A client who has a temperature of 39°C (102°F).
Correct answer: D
Rationale: The correct answer is D because an elevated temperature is a common manifestation of dehydration. Choices A, B, and C are not indicative of dehydration. A urine specific gravity of 1.010 is within normal range, weight gain suggests fluid overload, and a hematocrit of 45% is also within normal limits and not specifically related to dehydration.
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