a nurse is admitting a client at 38 weeks gestation with a history of herpes simplex virus 2 which of the following questions is most appropriate to a
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ATI LPN

PN ATI Capstone Proctored Comprehensive Assessment Form B

1. A client at 38 weeks gestation with a history of herpes simplex virus 2 is being admitted. Which of the following questions is most appropriate to ask the client?

Correct answer: B

Rationale: The most appropriate question to ask a client with a history of herpes simplex virus 2 at 38 weeks gestation is whether they have any active lesions. Active herpes lesions during labor can necessitate a cesarean delivery to prevent neonatal transmission. Asking about ruptured membranes (choice A), beta strep status (choice C), or contraction timing (choice D) is important but not the priority when managing a client with a history of herpes simplex virus 2 due to the high risk of neonatal transmission.

2. A nurse is providing teaching for a client who has a new prescription for sertraline. Which of the following statements by the client indicates understanding?

Correct answer: C

Rationale: The correct answer is C: 'I may experience difficulty sleeping while taking this medication.' Sertraline can cause insomnia, especially when first starting the medication, so the client should be aware of this potential side effect. Choices A, B, and D are incorrect because feeling better immediately, increased urination, and decreasing sodium intake are not commonly associated side effects of sertraline.

3. A healthcare professional is preparing to administer a dose of warfarin. Which of the following actions should the healthcare professional take?

Correct answer: A

Rationale: Corrected Rationale: When administering warfarin, it is crucial to verify the patient's INR levels. INR monitoring is essential to ensure that the patient is receiving the correct dose of warfarin for their condition and to minimize the risk of bleeding. Choices B, C, and D are incorrect because administering warfarin with food, monitoring blood glucose levels, and assessing liver function are not directly related to the safe administration and monitoring of warfarin therapy.

4. A community nurse is instructing a group of high school students about the transmission of hepatitis A. Which mode of transmission should the nurse include in the teaching?

Correct answer: C

Rationale: The correct answer is C: Fecal-oral. Hepatitis A is primarily transmitted through the fecal-oral route, often from consuming contaminated food or water. Choice A, sexual contact, is not a typical mode of transmission for hepatitis A. Choice B, airborne droplets, is more characteristic of diseases like influenza or tuberculosis. Choice D, bloodborne transmission, is more relevant to hepatitis B and C, not hepatitis A.

5. A client with a history of seizures is being cared for by a nurse. Which of the following interventions should the nurse prioritize?

Correct answer: A

Rationale: The nurse should prioritize ensuring the environment is safe for a client with a history of seizures. This intervention is crucial to prevent injury during a seizure. Administering medications as prescribed is important but ensuring a safe environment takes precedence to prevent harm. Monitoring for signs of infection and educating the client about triggers are also essential aspects of care but are not the priority when considering the immediate safety of the client during a seizure.

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