ATI LPN
PN ATI Capstone Maternal Newborn
1. A client is in active labor and is receiving an epidural for pain relief. Which of the following should the nurse monitor as the priority?
- A. Fetal heart rate
- B. Client's blood pressure
- C. Client's respiratory rate
- D. Client's pain level
Correct answer: B
Rationale: The most common side effect of an epidural is hypotension, which can compromise placental perfusion. Monitoring the client's blood pressure is the priority to ensure maternal and fetal well-being. Fetal heart rate is important but monitoring the client's blood pressure takes precedence due to the risk of hypotension. Respiratory rate and pain level monitoring are also important but not the priority in this scenario.
2. A healthcare professional is preparing to administer a dose of hydrocodone. Which of the following should the healthcare professional assess first?
- A. Respiratory rate
- B. Blood pressure
- C. Pain level
- D. Heart rate
Correct answer: A
Rationale: When administering hydrocodone, a healthcare professional should assess the respiratory rate first because hydrocodone is an opioid that can lead to respiratory depression. Monitoring the respiratory rate helps to detect any signs of respiratory distress or depression early on. Assessing blood pressure, pain level, or heart rate is also important but not the priority when administering hydrocodone, as the risk of respiratory depression is a more critical concern.
3. A nurse is caring for a client who has mild anxiety. Which of the following findings should the nurse expect?
- A. Feelings of dread
- B. Rapid speech
- C. Purposeless activity
- D. Heightened perceptual field
Correct answer: D
Rationale: In mild anxiety, the client is expected to have a heightened perceptual field. This means that their perception is increased, enhancing their awareness and ability to concentrate. Feelings of dread (Choice A) are more common in moderate to severe anxiety. Rapid speech (Choice B) and purposeless activity (Choice C) are more indicative of moderate to severe anxiety where the individual may exhibit signs of agitation and restlessness.
4. A healthcare professional is assessing a client for signs of anemia. Which of the following findings should the healthcare professional expect?
- A. Increased energy levels
- B. Pale skin
- C. Elevated blood pressure
- D. Decreased heart rate
Correct answer: B
Rationale: Pale skin is a common sign of anemia due to reduced hemoglobin levels, leading to decreased oxygen delivery to tissues. This results in skin pallor. Choices A, C, and D are incorrect. Anemia typically causes fatigue and decreased energy levels (not increased), low blood pressure (not elevated), and tachycardia (increased heart rate) to compensate for the decreased oxygen-carrying capacity of the blood.
5. A healthcare provider is assessing a client who has a heart rate of 40/min. The client is diaphoretic and has chest pain. Which of the following medications should the healthcare provider plan to administer?
- A. Lidocaine
- B. Adenosine
- C. Atropine
- D. Verapamil
Correct answer: C
Rationale: The client presents with bradycardia, diaphoresis, and chest pain, indicating reduced cardiac output. Atropine is the appropriate choice as it increases heart rate by blocking the parasympathetic nervous system. Lidocaine is used for ventricular arrhythmias, Adenosine for supraventricular tachycardia, and Verapamil for controlling heart rate in atrial fibrillation or atrial flutter. These medications are not suitable for the client's current presentation.
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