ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment Form B
1. A nurse is caring for a client with Alzheimer’s disease. Which action should the nurse include in the plan of care to support the client’s cognitive function?
- A. Place a daily calendar in the kitchen
- B. Replace buttoned clothing with zippered items
- C. Replace the carpet with hardwood floors
- D. Create variation in the daily routine
Correct answer: A
Rationale: Placing a daily calendar in the kitchen is essential to help clients with Alzheimer's stay oriented to time and maintain cognitive function. It supports their ability to recall the day, date, and upcoming events, promoting a sense of control over their environment. Choices B, C, and D do not directly target cognitive function support in clients with Alzheimer's disease. While replacing buttoned clothing with zippered items may aid in dressing independently, changing the flooring or introducing variation in the daily routine does not specifically address cognitive function support.
2. A client is being taught about the use of metformin. Which of the following should be included?
- A. It is taken with food
- B. It can cause hyperglycemia
- C. It should be taken once daily
- D. It is an injectable medication
Correct answer: A
Rationale: Corrected Rationale: Metformin should be taken with food to minimize gastrointestinal side effects. Choice A is the correct answer as taking metformin with meals can help reduce the likelihood of experiencing gastrointestinal side effects like diarrhea and nausea, which are common side effects of metformin. Choice B is incorrect because metformin actually helps lower blood sugar levels and does not cause hyperglycemia. Choice C is incorrect as metformin is usually taken twice or even three times a day, not just once daily. Choice D is incorrect because metformin is an oral medication, not an injectable one.
3. A healthcare provider is providing education on the use of clozapine. Which of the following should be included?
- A. Monitor for agranulocytosis
- B. It is a first-line treatment
- C. It can cause significant weight loss
- D. It has no risk for metabolic syndrome
Correct answer: A
Rationale: Correct Answer: A nurse should include monitoring for agranulocytosis when educating a patient about clozapine. Clozapine is known to cause agranulocytosis, a potentially life-threatening decrease in white blood cells. This adverse effect requires close monitoring to detect it early. Choices B, C, and D are incorrect because clozapine is not a first-line treatment for most conditions, it is more commonly associated with weight gain rather than weight loss, and it is known to have a risk for metabolic syndrome.
4. A nurse is developing a plan of care for a newborn who has hyperbilirubinemia and a prescription for phototherapy. Which of the following interventions should the nurse include?
- A. Check the newborn's temperature every 4 hours
- B. Apply moisturizing lotion to the newborn's skin every 4 hours
- C. Give the newborn 1 oz of glucose water every 4 hours
- D. Reposition the newborn every 2 to 3 hours
Correct answer: D
Rationale: Repositioning the newborn every 2 to 3 hours during phototherapy is important to expose all areas of the skin to light and facilitate the breakdown of bilirubin. Checking the newborn's temperature is important, but it should be done more frequently, such as every 4 hours, to monitor for any signs of overheating or hypothermia. Applying moisturizing lotion is not indicated during phototherapy as it may interfere with the treatment. Giving glucose water is not necessary for the management of hyperbilirubinemia.
5. A nurse is assessing a client who has schizophrenia and is experiencing negative symptoms. Which of the following findings should the nurse expect?
- A. Hallucinations
- B. Delusions
- C. Flat affect
- D. Paranoia
Correct answer: C
Rationale: The correct answer is C: Flat affect. Negative symptoms of schizophrenia involve deficits in normal emotional responses or other thought processes. These symptoms include a flat affect (reduced emotional expression), social withdrawal, and avolition (lack of motivation). Hallucinations and delusions are characteristic of positive symptoms, which involve the presence of abnormal behaviors or experiences. Paranoia is more associated with delusions rather than negative symptoms.
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