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 nurse is planning to delegate client assignments to the assistive personnel. Which of the following tasks is appropriate for the nurse to delegate?
- A. Adjust the flow rate of the client’s oxygen tank
- B. Collect a urine sample
- C. Measure the client’s pain level
- D. Monitor blood glucose levels
Correct answer: B
Rationale: The correct answer is B: Collect a urine sample. Delegating this task to assistive personnel is appropriate as it falls within their scope of practice. Tasks like adjusting the flow rate of oxygen tanks, measuring pain levels, and monitoring blood glucose levels require clinical judgment and should be performed by a nurse. It is important for nurses to delegate tasks that align with the competencies of assistive personnel to ensure safe and effective patient care.
3. A client is being taught about the use of levothyroxine. Which of the following should be included in the teaching?
- A. Take it with food
- B. Take it at the same time every day
- C. It can be stopped suddenly
- D. Monitor for hyperglycemia
Correct answer: B
Rationale: The correct answer is B: 'Take it at the same time every day.' It is important to take levothyroxine consistently at the same time each day to maintain stable thyroid hormone levels. Choice A is incorrect as levothyroxine should be taken on an empty stomach for better absorption. Choice C is incorrect because stopping levothyroxine suddenly can lead to adverse effects due to sudden changes in hormone levels. Choice D is also incorrect as hyperglycemia is not a common side effect associated with levothyroxine.
4. A nurse is providing teaching to a client who has chronic kidney disease. Which of the following client statements indicates an understanding of the teaching?
- A. I will decrease my intake of foods that are high in phosphorus
- B. I will increase my intake of foods that are high in potassium
- C. I will decrease my intake of foods that are high in iron
- D. I will increase my intake of calcium supplements
Correct answer: A
Rationale: The correct answer is A. Clients with chronic kidney disease should limit their intake of phosphorus because high phosphorus levels can lead to bone disease and cardiovascular problems. Increasing foods high in potassium (choice B) is not recommended as it can be harmful to individuals with kidney disease. Decreasing intake of foods high in iron (choice C) is not specifically indicated for chronic kidney disease. Increasing calcium supplements (choice D) may not be necessary and can potentially lead to hypercalcemia in individuals with kidney disease.
5. A nurse is preparing to administer a dose of digoxin. Which of the following should the nurse do first?
- A. Assess blood pressure
- B. Check heart rate
- C. Monitor potassium levels
- D. Review the medication order
Correct answer: B
Rationale: The correct answer is to check the heart rate first before administering digoxin. Digoxin is a medication that directly affects the heart, so it is crucial to ensure that the heart rate is within the appropriate range before giving the dose. If the heart rate is below 60 bpm, administering digoxin could lead to toxicity. Assessing blood pressure (Choice A) is important but not the first priority when preparing to administer digoxin. Monitoring potassium levels (Choice C) is also crucial for patients on digoxin, but it is not the initial step. Reviewing the medication order (Choice D) is necessary but can be done after checking the heart rate.
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