ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 B
1. A healthcare provider is caring for a client who has heart failure and is prescribed enalapril. The provider should monitor the client for which of the following adverse effects?
- A. Hypertension
- B. Hypokalemia
- C. Hyperglycemia
- D. Hyperkalemia
Correct answer: D
Rationale: Corrected Question: When a client with heart failure is prescribed enalapril, monitoring for hyperkalemia is essential. Enalapril is an angiotensin-converting enzyme (ACE) inhibitor that can lead to an increase in potassium levels in the blood. This adverse effect can be serious and potentially life-threatening. Choices A, B, and C are incorrect because enalapril does not typically cause hypertension, hypokalemia, or hyperglycemia as adverse effects. It's essential for healthcare providers to be vigilant in monitoring potassium levels when clients are on ACE inhibitors like enalapril.
2. A client is administering insulin. Which statement by the client shows proper understanding of insulin administration?
- A. I will inject insulin into my thigh before exercise
- B. I will skip meals to lower blood sugar
- C. I will store my insulin in the freezer
- D. I will rotate injection sites for insulin administration
Correct answer: D
Rationale: The correct answer is D because rotating injection sites prevents tissue damage and ensures better absorption of insulin. Option A is incorrect as injecting insulin into the thigh before exercise can lead to hypoglycemia. Option B is incorrect as skipping meals can cause blood sugar levels to drop dangerously low. Option C is incorrect as insulin should not be stored in the freezer as it can alter its effectiveness.
3. A nurse is teaching an older adult client who reports constipation. Which of the following instructions should the nurse include in the teaching?
- A. Increase dietary intake of raw vegetables
- B. Limit activity
- C. Drink four to five glasses of water daily
- D. Bear down hard when defecating
Correct answer: C
Rationale: The correct instruction the nurse should include is to advise the client to drink four to five glasses of water daily. Increasing water intake helps alleviate constipation by softening stool and increasing bowel movements. Choice A, increasing dietary intake of raw vegetables, can be helpful in preventing constipation but may not be sufficient as the sole intervention for someone already experiencing constipation. Choice B, limiting activity, can worsen constipation as physical activity helps stimulate bowel movements. Choice D, bearing down hard when defecating, can lead to other issues like hemorrhoids and should be avoided.
4. How does a healthcare professional assess a patient's fluid balance, and what signs indicate fluid overload?
- A. Checking lung sounds for crackles
- B. Checking for signs of orthopnea
- C. Monitoring intake and output, and checking for edema
- D. Measuring daily weight
Correct answer: C
Rationale: The correct answer is monitoring intake and output and checking for edema. Monitoring intake and output provides information about fluid balance in the body, while checking for edema helps assess for fluid overload. Lung sounds and signs of orthopnea are more indicative of respiratory issues rather than fluid balance. Daily weight measurement is useful to assess fluid status, but it alone may not provide a comprehensive evaluation of fluid balance.
5. A healthcare professional is reviewing the lab results of a client with liver disease. Which finding requires immediate intervention?
- A. Elevated bilirubin levels
- B. Low albumin levels
- C. Elevated ammonia levels
- D. Low hemoglobin levels
Correct answer: C
Rationale: Elevated ammonia levels in a client with liver disease can lead to hepatic encephalopathy, requiring immediate intervention. Ammonia is a neurotoxin that can cause cognitive impairment and altered mental status. Elevated bilirubin levels (Choice A) are common in liver disease but do not require immediate intervention. Low albumin levels (Choice B) and low hemoglobin levels (Choice D) are also common in liver disease but do not pose an immediate threat compared to elevated ammonia levels.
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