ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment 2020 B
1. A nurse is caring for a client with a new prescription for furosemide. Which of the following should the nurse monitor?
- A. Serum potassium levels
- B. Liver function
- C. Blood glucose levels
- D. Calcium levels
Correct answer: A
Rationale: Corrected Rationale: When a client is prescribed furosemide, the nurse should monitor serum potassium levels. Furosemide is a loop diuretic that can lead to potassium loss, potentially causing hypokalemia. Monitoring serum potassium levels is crucial to prevent complications such as cardiac dysrhythmias. Choices B, C, and D are incorrect because furosemide primarily affects potassium excretion rather than liver function, blood glucose levels, or calcium levels.
2. When teaching a client about the correct use of a cane, what should the nurse include?
- A. Ensure the cane has a rubber cap
- B. Hold the cane on the stronger side
- C. Flex the elbow slightly when using the cane
- D. Use a quad cane for increased support
Correct answer: B
Rationale: When using a cane, it should be held on the stronger side to provide optimal support and stability. This positioning allows the cane to bear weight effectively and helps in improving balance. Option A about ensuring the cane has a rubber cap is important for preventing slipping but is not directly related to the correct use of the cane. Option C, flexing the elbow slightly, is a general guideline and may vary depending on the individual's height and the type of cane being used. Option D suggesting the use of a quad cane for increased support is not necessary if a standard cane is sufficient for the client's needs.
3. A client has been prescribed metformin. What should be included in the teaching?
- A. It can cause weight gain
- B. Take it with food
- C. It is an insulin
- D. Monitor for hyperglycemia
Correct answer: B
Rationale: The correct answer is to take metformin with food. This is important to minimize gastrointestinal side effects and improve absorption. Choice A is incorrect as metformin is not typically associated with weight gain. Choice C is wrong as metformin is not an insulin but a medication that helps control blood sugar levels. Choice D is also incorrect as metformin is not known to cause hyperglycemia.
4. A nurse is assessing four clients for fluid balance. Which of the following clients is exhibiting manifestations of dehydration?
- A. A client who has a urine specific gravity of 1.010.
- B. A client who has a weight gain of 2.2 kg (2 lb) in 24 hr.
- C. A client who has a hematocrit of 45%.
- D. A client who has a temperature of 39°C (102°F).
Correct answer: D
Rationale: The correct answer is D because an elevated temperature is a common manifestation of dehydration. Choices A, B, and C are not indicative of dehydration. A urine specific gravity of 1.010 is within normal range, weight gain suggests fluid overload, and a hematocrit of 45% is also within normal limits and not specifically related to dehydration.
5. A nurse is caring for a client who has an indwelling urinary catheter. What should the nurse identify as a sign of catheter occlusion?
- A. Bladder distention
- B. Frequent urination
- C. Dark urine
- D. Increased thirst
Correct answer: A
Rationale: Bladder distention is the correct sign of catheter occlusion. When a catheter is occluded, the urine cannot drain properly, leading to the buildup of urine in the bladder and subsequent distention. Frequent urination, dark urine, and increased thirst are not typical signs of catheter occlusion. Frequent urination can be a sign of conditions like urinary tract infection, dark urine may indicate dehydration or other issues, and increased thirst can be related to various factors like diabetes or medication side effects.
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