ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment Form B
1. A client who has osteoporosis is being discharged with a new prescription for alendronate. Which of the following instructions should the nurse provide?
- A. Take the medication at bedtime.
- B. Take the medication with a full glass of water.
- C. Take the medication with food.
- D. Lie down for 30 minutes after taking the medication.
Correct answer: B
Rationale: The correct answer is to take the medication with a full glass of water. Alendronate should be taken with a full glass of water to prevent esophageal irritation. Additionally, the client should remain upright for 30 minutes after taking it to prevent potential adverse effects. Choice A is incorrect because alendronate should not be taken at bedtime, but rather in the morning on an empty stomach. Choice C is incorrect because alendronate should be taken on an empty stomach, not with food. Choice D is incorrect because the client should remain upright, not lie down, for 30 minutes after taking the medication.
2. When teaching about safety risks for adolescents, what should be included?
- A. Adolescents are more likely to follow rules
- B. Peer influence to participate in high-risk behaviors can lead to injury
- C. Most injuries occur during sports activities
- D. Adolescents are aware of the dangers of substance use
Correct answer: B
Rationale: When educating about safety risks for adolescents, it is crucial to address the impact of peer influence on engaging in high-risk behaviors, which can result in injuries. Choice A is incorrect because adolescents are known to sometimes take risks and not always follow rules. Choice C is incorrect as injuries among adolescents can also happen outside of sports activities. Choice D is incorrect as adolescents may not always be fully aware of the dangers of substance use.
3. A nurse is planning care for a client who has a new diagnosis of deep vein thrombosis (DVT). Which action should the nurse take?
- A. Massage the affected extremity
- B. Elevate the affected leg
- C. Apply cold packs to the affected leg
- D. Keep the leg dependent to increase circulation
Correct answer: B
Rationale: Elevating the leg promotes venous return and reduces swelling, which is crucial for clients with DVT. Massaging the affected extremity can dislodge the clot and worsen the condition. Applying cold packs can cause vasoconstriction, potentially increasing the risk of clot formation. Keeping the leg dependent can impede circulation and increase the risk of clot migration.
4. A nurse is caring for a client with a stage 2 pressure ulcer. Define the characteristics of the ulcer.
- A. Intact skin with nonblanchable redness (Stage 1)
- B. Full-thickness tissue loss with subQ damage (Stage 3)
- C. Partial-thickness skin loss involving the epidermis and dermis
- D. Full-thickness tissue loss with damage to muscle or bone (Stage 4)
Correct answer: C
Rationale: The correct answer is C. Stage 2 ulcers involve partial-thickness skin loss with visible and superficial damage, which may appear as an abrasion, blister, or shallow crater. Choice A describes a Stage 1 pressure ulcer characterized by intact skin with nonblanchable redness. Choice B describes a Stage 3 pressure ulcer with full-thickness tissue loss and damage to the subcutaneous tissue. Choice D is indicative of a Stage 4 pressure ulcer, involving full-thickness tissue loss with damage extending to muscle or bone.
5. A nurse is caring for a client with a history of hypertension. Which of the following should the nurse monitor?
- A. Fluid intake
- B. Blood pressure
- C. Serum potassium levels
- D. Weight
Correct answer: B
Rationale: The correct answer is B: Blood pressure. When caring for a client with a history of hypertension, monitoring blood pressure is crucial as it allows the nurse to assess the effectiveness of management and adjust treatment if necessary. Monitoring fluid intake (Choice A) is important for conditions like heart failure, but in hypertension, the focus is primarily on blood pressure. Monitoring serum potassium levels (Choice C) is relevant in clients taking certain medications like diuretics, and weight (Choice D) is important for overall health assessment but is not the primary parameter to monitor in hypertension.
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