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PN ATI Capstone Proctored Comprehensive Assessment 2020 B with NGN
1. A healthcare professional is preparing to administer a dose of potassium chloride. Which of the following actions should the healthcare professional take?
- A. Administer rapidly
- B. Dilute the medication before administration
- C. Give it as a bolus
- D. Administer it intramuscularly
Correct answer: B
Rationale: The correct action when administering potassium chloride is to dilute the medication before administration. Potassium chloride is a highly concentrated solution that can cause irritation and potential complications if not properly diluted. Administering it rapidly (choice A) can lead to adverse effects. Giving it as a bolus (choice C) or administering it intramuscularly (choice D) are inappropriate routes for potassium chloride administration and can result in harm to the patient.
2. A nurse is caring for a client who is at 38 weeks of gestation and is experiencing continuous abdominal pain and vaginal bleeding. The client has a history of cocaine use. The nurse should identify that the client is likely experiencing which of the following complications?
- A. Abruptio placentae
- B. Hydatidiform mole
- C. Preterm labor
- D. Placenta previa
Correct answer: A
Rationale: Continuous abdominal pain and vaginal bleeding in a client with a history of cocaine use suggest abruptio placentae, where the placenta detaches from the uterus prematurely, posing serious risks to both mother and fetus. Hydatidiform mole is characterized by abnormal trophoblastic tissue growth, not continuous pain and bleeding. Preterm labor is premature contractions leading to birth before 37 weeks gestation. Placenta previa involves the placenta partially or completely covering the cervix, presenting with painless vaginal bleeding.
3. A nurse is preparing to administer a dose of losartan. Which of the following should the nurse assess first?
- A. Blood pressure
- B. Heart rate
- C. Serum potassium
- D. Liver function
Correct answer: A
Rationale: The correct answer is to assess blood pressure first. Losartan is an angiotensin receptor blocker used to lower blood pressure. Assessing the patient's blood pressure before administering losartan is crucial to ensure it is not already too low, which could lead to hypotension. Assessing heart rate (choice B) is important but not the priority when administering losartan. Serum potassium levels (choice C) and liver function (choice D) are also important assessments, but they are not the primary concern before administering losartan.
4. A client is prescribed spironolactone. Which of the following dietary instructions should the nurse include?
- A. Increase potassium-rich foods
- B. Limit sodium intake
- C. Avoid potassium supplements
- D. Increase protein intake
Correct answer: C
Rationale: The correct answer is to advise the client to avoid potassium supplements. Spironolactone is a potassium-sparing diuretic, meaning it helps the body retain potassium. Adding potassium supplements on top of this medication can lead to hyperkalemia, an elevated level of potassium in the blood, which can be dangerous. Choices A, B, and D are incorrect because increasing potassium-rich foods, limiting sodium intake, and increasing protein intake are not specifically related to the dietary considerations when taking spironolactone.
5. A healthcare professional is assessing a client for signs of infection. Which of the following findings should the healthcare professional look for?
- A. Increased energy
- B. Fever
- C. Improved appetite
- D. Stable weight
Correct answer: B
Rationale: Corrected Question: A healthcare professional is assessing a client for signs of infection. The correct answer is 'Fever.' Fever is a common sign of infection and indicates an immune response to an invading pathogen. Increased energy (Choice A) is not typically associated with infection, as the body often feels fatigued when fighting an infection. Improved appetite (Choice C) and stable weight (Choice D) are not specific signs of infection and may not necessarily indicate the presence of an infectious process. Therefore, the healthcare professional should focus on monitoring for fever as a key indicator of infection.
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