ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment A
1. A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40mg daily, but the client reports she has been taking extra doses to promote weight loss. Which of the following indicates she is dehydrated?
- A. Urine specific gravity of 1.035
- B. Urine specific gravity of 444
- C. Urine specific gravity of 2000
- D. Urine specific gravity of 1111.1
Correct answer: A
Rationale: A urine specific gravity greater than 1.030 indicates dehydration. In this case, a urine specific gravity of 1.035 suggests concentrated urine, indicating dehydration. Choices B, C, and D have values that are not within the normal range for urine specific gravity and do not indicate dehydration. A urine specific gravity of 444, 2000, or 1111.1 are not physiologically possible values and are therefore incorrect.
2. A client at 28 weeks of gestation is experiencing preterm labor. Which of the following medications should the nurse plan to administer?
- A. Oxytocin
- B. Nifedipine
- C. Dinoprostone
- D. Misoprostol
Correct answer: B
Rationale: Nifedipine is the correct choice because it is a calcium channel blocker that helps relax the uterus and stop preterm labor. Oxytocin (Choice A) is used to induce labor, not to stop preterm labor. Dinoprostone (Choice C) and Misoprostol (Choice D) are prostaglandins used to induce labor and ripen the cervix, not to stop preterm labor.
3. A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the client reports she has been taking extra doses to promote weight loss. Which of the following indicates she is dehydrated?
- A. Urine specific gravity of 1.035
- B. Oliguria
- C. Increased urine concentration
- D. Dry mucous membranes
Correct answer: A
Rationale: The correct answer is A: Urine specific gravity of 1.035. A urine specific gravity greater than 1.030 indicates dehydration as the kidneys conserve water in response to dehydration. Choice B, oliguria, refers to decreased urine output, which can be a sign of dehydration but is not specific to it. Choice C, increased urine concentration, is a general term and does not directly indicate dehydration. Choice D, dry mucous membranes, can be a sign of dehydration but is not as specific as a urine specific gravity greater than 1.030.
4. A nurse is preparing to administer lactated Ringer's (LR) 1,000 mL IV to infuse over 8 hr. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number).
- A. 21 gtt/min
- B. 20 gtt/min
- C. 25 gtt/min
- D. 18 gtt/min
Correct answer: A
Rationale: To calculate the IV infusion rate in gtt/min: 1000 mL / 480 min × 10 gtt/mL = 20.83 ≈ 21 gtt/min. Therefore, the correct answer is A. Choice B (20 gtt/min) is incorrect because the calculation results in 20.83 gtt/min, rounded to 21. Choices C (25 gtt/min) and D (18 gtt/min) are incorrect as they are not the closest whole number approximation to the calculated value.
5. A healthcare professional is planning to administer diltiazem via IV bolus to a client who has atrial fibrillation. When assessing the client, the healthcare professional should recognize that which of the following findings is a contraindication to the administration of diltiazem?
- A. Hypotension
- B. Tachycardia
- C. Decreased level of consciousness
- D. History of diuretic use
Correct answer: A
Rationale: Diltiazem, a calcium channel blocker, can cause hypotension. Administering it to a client who already has hypotension could exacerbate this condition. Therefore, hypotension is a contraindication to the administration of diltiazem. Incorrect Choices: B) Tachycardia is not a contraindication for administering diltiazem in atrial fibrillation as it is commonly used to control the heart rate. C) Decreased level of consciousness may require evaluation but is not a direct contraindication to diltiazem administration. D) History of diuretic use is not a contraindication if the client is not currently experiencing hypotension.
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