ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment A
1. A nurse is assessing a client who was brought to the psychiatric emergency services by law enforcement. The client has disorganized, incoherent speech with loose associations and religious content. The nurse should recognize these signs and symptoms as consistent with which of the following?
- A. Alzheimer's disease
- B. Schizophrenia
- C. Substance intoxication
- D. Depression
Correct answer: B
Rationale: The correct answer is B: Schizophrenia. Disorganized speech, loose associations, and religious delusions are characteristic symptoms of schizophrenia. In this scenario, the client's presentation aligns with positive symptoms of schizophrenia, indicating a severe mental disorder requiring immediate attention. Choice A, Alzheimer's disease, primarily involves cognitive decline and memory impairment, not disorganized speech or religious content. Choice C, Substance intoxication, may present with altered mental status but typically lacks the persistent pattern of symptoms seen in schizophrenia. Choice D, Depression, is associated with a different set of symptoms such as low mood, anhedonia, and changes in appetite or sleep, rather than disorganized speech and loose associations.
2. A 65-year-old client is taking methylprednisolone. What pharmacological action should the nurse expect with this therapy?
- A. Suppression of beta2 receptors.
- B. Suppression of airway mucus production.
- C. Fortification of bones.
- D. Suppression of candidiasis.
Correct answer: B
Rationale: The correct answer is B: 'Suppression of airway mucus production.' Methylprednisolone, a corticosteroid, is known to suppress airway mucus production. While corticosteroids can enhance the responsiveness of beta2 receptors, they are not directly involved in the suppression of these receptors (Choice A). Corticosteroids can lead to adverse effects such as bone loss, rather than fortification of bones (Choice C). They can also increase the risk of infections like candidiasis but do not directly suppress it (Choice D). Therefore, the most expected pharmacological action of methylprednisolone therapy is the suppression of airway mucus production.
3. A nurse is developing discharge care plans for a client who has osteoporosis. To prevent injury, the nurse should instruct the client to:
- A. Perform weight-bearing exercises
- B. Avoid crossing the legs beyond the midline
- C. Avoid sitting in one position for prolonged periods
- D. Splint the affected area
Correct answer: A
Rationale: The correct answer is A: Perform weight-bearing exercises. Weight-bearing exercises strengthen bones and help prevent fractures, which is crucial for clients with osteoporosis. Choices B, C, and D are incorrect. Avoiding crossing the legs beyond the midline and avoiding sitting in one position for prolonged periods are general recommendations for preventing musculoskeletal issues but are not specific to osteoporosis. Splinting the affected area is not a standard practice for managing osteoporosis and preventing fractures.
4. A healthcare professional is teaching a client about reducing the risk of urinary tract infections (UTIs). Which factor increases the risk of UTI?
- A. Wearing underwear with a cotton crotch
- B. Wiping from front to back
- C. Using perfumed toilet paper
- D. Urinating after intercourse
Correct answer: C
Rationale: Using perfumed toilet paper can irritate the urinary tract and increase the risk of UTI, so it should be avoided. Wearing underwear with a cotton crotch (Choice A) is a preventive measure as cotton allows for better air circulation and reduces moisture, lowering the risk of UTIs. Wiping from front to back (Choice B) helps prevent the introduction of bacteria from the anal region to the urinary tract. Urinating after intercourse (Choice D) can help flush out bacteria introduced during sexual activity, thereby reducing the risk of UTIs.
5. A nurse is caring for a client prescribed gabapentin. Which of the following should the nurse monitor?
- A. Liver function tests
- B. Renal function
- C. Blood glucose levels
- D. Cardiac rhythm
Correct answer: B
Rationale: The correct answer is B: Renal function. Gabapentin is primarily eliminated by the kidneys, so monitoring renal function is essential to ensure the drug is being cleared effectively from the body. Monitoring liver function tests (choice A) is not a priority for gabapentin as it is not primarily metabolized by the liver. Blood glucose levels (choice C) are not directly impacted by gabapentin. Cardiac rhythm (choice D) monitoring is not typically necessary for clients on gabapentin unless they have pre-existing cardiac conditions that may be exacerbated by the medication.
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