ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment B Quizlet
1. A nurse is caring for a client in a mental health facility. The client’s daughter is crying and tells the nurse that she feels guilty for leaving her father in the hospital. Which of the following is an appropriate response?
- A. I’d like to know more about what’s bothering you.
- B. Why are you feeling this way?
- C. You did the right thing by bringing him here.
- D. I’m sure your father doesn’t blame you.
Correct answer: A
Rationale: The correct response is A: 'I’d like to know more about what’s bothering you.' Encouraging the daughter to express her feelings allows her to explore her emotions, which can be helpful in addressing her guilt and providing emotional support. Choice B is not as open-ended and may come across as confrontational. Choice C may invalidate the daughter's feelings of guilt by implying she shouldn't feel that way. Choice D assumes the father's emotions and may not address the daughter's feelings of guilt effectively.
2. A nurse is caring for a toddler diagnosed with respiratory syncytial virus (RSV). Which of the following actions should the nurse take?
- A. Use a designated stethoscope when caring for the toddler
- B. Wear an N95 respirator mask
- C. Remove the disposable gown after leaving the toddler’s room
- D. Place the toddler in a room with negative air pressure
Correct answer: A
Rationale: Using a designated stethoscope is the correct action when caring for a toddler diagnosed with RSV. This measure helps prevent the spread of infection to other clients by reducing the risk of contamination. Wearing an N95 respirator mask is not necessary for routine care of a toddler with RSV unless performing aerosol-generating procedures. Removing the disposable gown after leaving the toddler's room is important for infection control but not specific to RSV care. Placing the toddler in a room with negative air pressure is not a standard practice for managing RSV in toddlers.
3. A healthcare professional is preparing to administer a hepatitis B vaccine. Which of the following should the healthcare professional verify?
- A. Client's allergy to eggs
- B. Client's vaccination history
- C. Client's weight
- D. Client's blood pressure
Correct answer: B
Rationale: The correct answer is B: Client's vaccination history. Before administering the hepatitis B vaccine, it is essential to verify the client's vaccination history to ensure they are due for the vaccine. This helps in preventing unnecessary vaccinations and ensures the appropriate timing and dosage. Option A, the client's allergy to eggs, is not directly related to administering the hepatitis B vaccine. Option C, the client's weight, and option D, the client's blood pressure, are not factors that need to be specifically verified before administering the hepatitis B vaccine.
4. A nurse is caring for a client prescribed levetiracetam. Which of the following should the nurse monitor?
- A. Liver function
- B. Blood glucose levels
- C. Serum creatinine
- D. Blood pressure
Correct answer: C
Rationale: The correct answer is C: Serum creatinine. Levetiracetam requires monitoring of renal function, specifically serum creatinine levels, as it is primarily eliminated by the kidneys. Monitoring liver function (Choice A) is not necessary for levetiracetam. Blood glucose levels (Choice B) are typically not affected by levetiracetam. While monitoring blood pressure (Choice D) is important in general patient care, it is not specifically required for clients prescribed levetiracetam.
5. A nurse is caring for a client who has been receiving oxytocin IV for labor augmentation. The client's contractions are occurring every 2 minutes and lasting 90 seconds. What action should the nurse take?
- A. Decrease the oxytocin infusion
- B. Discontinue the oxytocin infusion
- C. Increase the IV fluid rate
- D. Apply an internal fetal monitor
Correct answer: B
Rationale: The correct action for the nurse to take in this situation is to discontinue the oxytocin infusion. The client is experiencing uterine hyperstimulation, as evidenced by contractions occurring every 2 minutes and lasting 90 seconds. Discontinuing the oxytocin is crucial to prevent fetal distress and uterine rupture. Increasing the IV fluid rate would not address the uterine hyperstimulation caused by oxytocin. Applying an internal fetal monitor is not the priority at this moment; first, the oxytocin infusion needs to be stopped to manage the uterine hyperstimulation effectively.
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