ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment B Quizlet
1. A nurse is planning care for a client who has a latex allergy and is scheduled for surgery. Which of the following actions should the nurse take?
- A. Apply tape to the client’s skin before surgery.
- B. Ensure the surgical suite is well-ventilated.
- C. Wrap monitoring cords with stockinette.
- D. Schedule the surgery at the end of the day.
Correct answer: C
Rationale: The correct action the nurse should take is to wrap monitoring cords with stockinette. This measure ensures that the latex in the cords does not come into contact with the client’s skin, reducing the risk of an allergic reaction. Applying tape to the client’s skin before surgery (Choice A) may expose the client to latex if the tape contains latex. Ensuring the surgical suite is well-ventilated (Choice B) is important for overall safety but does not specifically address the client's latex allergy. Scheduling the surgery at the end of the day (Choice D) is not directly related to preventing latex exposure and allergic reactions.
2. 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.
3. A school nurse is providing care for students in an elementary education facility. What intervention by the nurse addresses the primary level of prevention?
- A. Monitor for signs of illness.
- B. Teach students about healthy food choices.
- C. Administer medication to students with chronic conditions.
- D. Monitor immunization compliance.
Correct answer: B
Rationale: The correct answer is B: Teach students about healthy food choices. Teaching healthy habits like proper nutrition is an example of primary prevention because it aims to prevent disease before it occurs. Choice A, monitoring for signs of illness, is more related to secondary prevention (early detection and treatment). Choice C, administering medication to students with chronic conditions, is a form of tertiary prevention (managing existing conditions to prevent complications). Choice D, monitoring immunization compliance, is also a form of primary prevention but focuses on preventing specific infectious diseases through immunization rather than general health promotion.
4. A nurse is teaching a client who is pregnant about the amniocentesis procedure. Which of the following statements should the nurse include in the teaching?
- A. You do not need to have a full bladder for the procedure
- B. You will not receive magnesium sulfate before the procedure
- C. The procedure will take longer than 30 minutes to complete
- D. You should report if you experience any contractions after the procedure
Correct answer: D
Rationale: The correct statement to include in the teaching about amniocentesis is that the client should report if they experience any contractions after the procedure. This is crucial because contractions could indicate preterm labor or other complications following the amniocentesis. Choices A and B are incorrect as a full bladder is not required for the procedure, and magnesium sulfate is not typically given before an amniocentesis. Choice C is incorrect as the procedure usually takes about 20-30 minutes to complete.
5. A client just received their first dose of lisinopril. Which of the following is an appropriate nursing intervention?
- A. Place the client on cardiac monitoring
- B. Monitor the client’s oxygen saturation
- C. Provide standby assistance when the client gets out of bed
- D. Encourage foods high in potassium
Correct answer: C
Rationale: The correct answer is to provide standby assistance when the client gets out of bed. Lisinopril can cause hypotension, especially after the first dose, which can lead to dizziness and falls. Standby assistance helps prevent potential injury. Placing the client on cardiac monitoring (choice A) or monitoring oxygen saturation (choice B) are not typically necessary after the first dose of lisinopril unless specific symptoms are present. Encouraging foods high in potassium (choice D) is not directly related to the immediate concern of postural hypotension associated with lisinopril.
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