ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment A
1. 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.
2. A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the client reports she has been taking extra doses to promote weight loss. Which of the following indicates she is dehydrated?
- A. Urine specific gravity of 1.035
- B. Oliguria, increased urine concentration, and an increase in urine specific gravity greater than 1.030
- C. Polyuria
- D. Hypotension
Correct answer: B
Rationale: Oliguria (reduced urine output), increased urine concentration, and a urine specific gravity greater than 1.030 are indicative of dehydration, particularly in clients using diuretics excessively. Choice A is incorrect because a urine specific gravity of 1.035 is high, indicating concentrated urine but not specifically dehydration. Choice C, polyuria, refers to increased urine output and is not consistent with dehydration. Choice D, hypotension, is a sign of fluid volume deficit but is not specific to dehydration as described in the scenario.
3. A client receiving chemotherapy is experiencing neutropenia. Which of the following should the nurse include in this client's education?
- A. Track oral temperature weekly
- B. Gardening is a good form of mild exercise
- C. Avoid crowded events
- D. Eat plenty of fresh fruits and vegetables
Correct answer: C
Rationale: Clients with neutropenia have a weakened immune system, making them susceptible to infections. Avoiding crowded events helps reduce the risk of exposure to pathogens, thereby minimizing the chance of infections. Tracking oral temperature is important for detecting fever early, which is a sign of infection and requires immediate medical attention. While gardening can be a good form of exercise, clients with neutropenia should avoid it due to the risk of exposure to bacteria and fungi present in soil. Eating fresh fruits and vegetables is generally encouraged for overall health but may carry a risk of bacterial contamination, which could be harmful to a client with neutropenia.
4. A nurse is caring for a client receiving heparin. Which of the following should the nurse monitor?
- A. INR levels
- B. APTT levels
- C. Blood glucose levels
- D. Liver function tests
Correct answer: B
Rationale: Heparin therapy requires monitoring of activated partial thromboplastin time (APTT) to ensure therapeutic levels. APTT reflects the intrinsic pathway of the clotting cascade and is used to assess the effectiveness and safety of heparin therapy. Monitoring INR levels is more relevant for assessing warfarin therapy, not heparin. Blood glucose levels are monitored for clients with diabetes or those on medications affecting glucose levels. Liver function tests are used to assess liver health and are not directly related to monitoring heparin therapy.
5. A healthcare professional is completing a nutritional assessment on a client and measures body mass index (BMI). Which of the following readings correlates with a BMI of an overweight client?
- A. 18.5
- B. 24.9
- C. 25
- D. 32
Correct answer: C
Rationale: A BMI of 25-29.9 is considered overweight. Therefore, a BMI of 25 correlates with an overweight client. A BMI of 18.5-24.9 indicates a healthy weight. Choices A, B, and D are incorrect as they fall into the healthy weight or obese categories, not overweight.
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