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PN ATI Capstone Proctored Comprehensive Assessment Form A
1. A healthcare provider is reviewing a prescription for doxazosin with a client. Which instruction should the healthcare provider provide?
- A. Decrease caloric intake to reduce weight gain
- B. Increase dietary fiber to prevent constipation
- C. Rise slowly when sitting up
- D. Take this medication each morning
Correct answer: C
Rationale: The correct instruction for a client prescribed with doxazosin is to rise slowly when sitting up. Doxazosin can cause orthostatic hypotension, leading to dizziness upon sudden position changes. Instructing the client to rise slowly helps prevent this side effect. Choices A, B, and D are incorrect because they are not directly related to the potential side effects or administration of doxazosin.
2. A nurse is assessing a client with pericarditis. Which of the following findings is the priority for the nurse to report?
- A. Paradoxical pulse
- B. Dependent edema
- C. Pericardial friction rub
- D. Substernal chest pain
Correct answer: A
Rationale: A paradoxical pulse is a sign of cardiac tamponade, a life-threatening complication of pericarditis that requires immediate intervention. It results from decreased cardiac output due to increased pressure in the pericardial sac. Reporting this finding promptly allows for timely treatment to prevent further deterioration. Dependent edema and substernal chest pain are common in pericarditis but are not as urgent as a paradoxical pulse. A pericardial friction rub is a classic finding in pericarditis and indicates inflammation but is not as critical as a paradoxical pulse.
3. A client is being taught how to use a PCA pump postoperatively. Which statement indicates understanding?
- A. I should wait until the pain is severe before using the PCA pump.
- B. My family can press the button for me when I'm asleep.
- C. I will press the button when I start to feel pain.
- D. I will only press the button once per hour.
Correct answer: C
Rationale: The correct answer is C because the client should press the PCA pump button when they start to feel pain. This approach helps maintain pain control effectively. Choice A is incorrect because waiting for the pain to become severe before using the PCA pump can lead to inadequate pain management. Choice B is incorrect because only the client should operate the PCA pump to ensure the correct dosage is administered. Choice D is incorrect because the client should press the button as needed when experiencing pain, rather than limiting its use to once per hour.
4. A nurse is caring for a client who is 38 weeks pregnant and has a history of herpes simplex virus 2. Which question is most appropriate for the nurse to ask?
- A. Have your membranes ruptured?
- B. How far apart are your contractions?
- C. Do you have any active lesions?
- D. Are you positive for beta strep?
Correct answer: C
Rationale: The most appropriate question for the nurse to ask is whether the client has any active herpes lesions. This is crucial because the presence of active lesions can necessitate a cesarean section to prevent transmission of the virus to the newborn. Asking about membrane rupture (choice A) is important but not directly related to the client's herpes simplex virus 2 status. Inquiring about the frequency of contractions (choice B) is relevant for assessing labor progression but does not address the immediate concern of herpes transmission. Asking about being positive for beta strep (choice D) is important for determining the need for prophylactic antibiotics during labor, but it is not directly related to the client's herpes simplex virus 2 status.
5. A nurse is caring for a client with a history of heroin use who is intoxicated. Which finding should the nurse expect?
- A. Constricted pupils
- B. Dilated pupils
- C. Increased reflexes
- D. Elevated blood pressure
Correct answer: A
Rationale: The correct answer is A: Constricted pupils. Constricted pupils are a classic sign of opioid intoxication, including heroin. Opioids like heroin cause the pupils to constrict due to their effect on the autonomic nervous system. Dilated pupils, increased reflexes, and elevated blood pressure are not typically associated with opioid intoxication but may be seen with other substances or conditions.
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