ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment 2020 A with NGN
1. A nurse is assessing a client who has Parkinson's disease. Which of the following manifestations should the nurse expect?
- A. Pruritus
- B. Hypertension
- C. Bradykinesia
- D. Xerostomia
Correct answer: C
Rationale: The correct answer is C: Bradykinesia. Bradykinesia, which refers to slowness of movement, is a characteristic symptom of Parkinson's disease. Other common manifestations in Parkinson's disease include tremors, muscle rigidity, orthostatic hypotension, and drooling. Pruritus (choice A) is unrelated to Parkinson's disease. While hypertension (choice B) can coexist with Parkinson's disease due to autonomic dysfunction, it is not a specific hallmark manifestation. Xerostomia (choice D) is not a primary symptom associated with Parkinson's disease.
2. A nurse on the medical-surgical unit is receiving reports on four clients. Which of the following clients should the nurse assess first?
- A. A client who is receiving warfarin and has an INR of 3.3
- B. A client who has acute kidney injury, creatinine 4 mg/dL, and BUN 52 mg/dL
- C. A client who had an NG tube inserted 6 hours ago and has abdominal distention
- D. A client who is 4 hours postoperative following a thyroidectomy and reports fullness in the throat
Correct answer: D
Rationale: The client who is 4 hours postoperative following a thyroidectomy and reports fullness in the throat should be assessed first. This client may be experiencing airway obstruction due to hematoma or swelling, making it a priority. Options A, B, and C have concerning findings as well, but airway compromise takes precedence over other issues.
3. A client in labor has an epidural for pain control. Which of the following clinical manifestations is an adverse effect of epidural anesthesia?
- A. Polyuria
- B. Hypertension
- C. Pruritus
- D. Dry mouth
Correct answer: C
Rationale: Pruritus is a common adverse effect of epidural anesthesia, often due to the opioids administered with the epidural. It presents as itching on the skin and can cause significant discomfort to the client. Polyuria (excessive urination) and dry mouth are not typical adverse effects of epidural anesthesia. Hypertension is not commonly associated with epidural anesthesia; in fact, hypotension is a more frequent complication due to sympathetic blockade. Therefore, the correct answer is pruritus (choice C), as it is a known adverse effect of epidural anesthesia.
4. A nurse is preparing to administer a dose of losartan. Which of the following should the nurse assess first?
- A. Blood pressure
- B. Heart rate
- C. Serum potassium
- D. Liver function
Correct answer: A
Rationale: The correct answer is to assess blood pressure first. Losartan is an angiotensin receptor blocker used to lower blood pressure. Assessing the patient's blood pressure before administering losartan is crucial to ensure it is not already too low, which could lead to hypotension. Assessing heart rate (choice B) is important but not the priority when administering losartan. Serum potassium levels (choice C) and liver function (choice D) are also important assessments, but they are not the primary concern before administering losartan.
5. A client is in the transition phase of labor. Which of the following actions should the nurse take?
- A. Assist the client to void every 3 hours
- B. Monitor contractions every 30 minutes
- C. Place the client in a lithotomy position
- D. Encourage the client to use a pant-blow breathing pattern
Correct answer: D
Rationale: Encouraging the client to use a pant-blow breathing pattern is crucial during the transition phase of labor. This phase is characterized by intense contractions and emotional responses. Pant-blow breathing helps manage pain and anxiety, providing comfort and support to the client. Voiding every 3 hours is not specific to the transition phase and may not address immediate needs. Monitoring contractions every 30 minutes is important but may not be as directly beneficial as focusing on coping mechanisms like breathing techniques. Placing the client in a lithotomy position is generally not recommended during the transition phase as it can impede progress and comfort.
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