ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment A
1. A client with chronic kidney failure and an AV fistula for hemodialysis is prescribed epoetin alfa. Which of the following therapeutic effects should the nurse include in the teaching?
- A. Reduces blood pressure
- B. Inhibits clotting of fistula
- C. Promotes RBC production
- D. Stimulates growth of neutrophils
Correct answer: C
Rationale: The correct answer is C: Promotes RBC production. Epoetin alfa stimulates erythropoiesis (red blood cell production) to treat anemia associated with chronic kidney failure. This helps in increasing the hemoglobin levels and improving oxygen-carrying capacity. Choices A, B, and D are incorrect as epoetin alfa does not have direct effects on reducing blood pressure, inhibiting clotting of the fistula, or stimulating the growth of neutrophils.
2. A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following laboratory tests?
- A. Platelet count
- B. Electrolyte levels
- C. Thyroid function
- D. Liver function
Correct answer: D
Rationale: The correct answer is D: Liver function. Gemfibrozil can lead to hepatotoxicity, making it crucial to monitor liver function tests. Monitoring platelet count (choice A) is not specifically indicated for gemfibrozil. Electrolyte levels (choice B) and thyroid function (choice C) are not directly affected by gemfibrozil, so they are not the primary laboratory tests to monitor in this case.
3. A nurse is preparing to administer an enteral tube feeding through an NG tube at 250 mL over 4 hr. The nurse should set the pump to deliver how many mL/hr? (Round the answer to the nearest whole number)
- A. 63 mL/hr
- B. 36 mL/hr
- C. 78 mL/hr
- D. 90 mL/hr
Correct answer: A
Rationale: To calculate the rate for the enteral tube feeding, divide the total volume by the total time: 250 mL / 4 hr = 62.5 ≈ 63 mL/hr. Therefore, the nurse should set the pump to deliver 63 mL/hr. Choices B, C, and D are incorrect as they do not match the correct calculation result. B is too low, C is too high, and D is also too high based on the correct calculation.
4. A nurse is providing discharge teaching to a client who has heart failure and a new prescription for digoxin 0.215 mg PO daily and furosemide 20 mg PO daily. Which of the following statements by the client indicates an understanding of the teaching?
- A. I know that blurred vision is something I will expect to happen while taking digoxin.
- B. I will measure my urine output each day and document it in my diary.
- C. I will skip a dose of my digoxin if my resting heart rate is below 72 beats per minute.
- D. I will eat fruits and vegetables that have high potassium content every day.
Correct answer: D
Rationale: Clients taking digoxin and furosemide are at risk for hypokalemia. Eating potassium-rich foods can help maintain normal potassium levels.
5. A healthcare professional is reviewing the laboratory results for a client who has a prescription for filgrastim. The healthcare professional should recognize that an increase in which of the following values indicates a therapeutic effect of this medication?
- A. Erythrocyte count
- B. Neutrophil count
- C. Lymphocyte count
- D. Thrombocyte count
Correct answer: B
Rationale: Filgrastim is a medication used to stimulate the production of neutrophils in patients with neutropenia. Neutrophils are a type of white blood cell that plays a crucial role in fighting off infections. Therefore, an increase in neutrophil count would indicate a therapeutic effect of filgrastim. The other options, such as erythrocyte count (red blood cells), lymphocyte count, and thrombocyte count (platelets), are not directly affected by filgrastim and would not indicate a therapeutic effect of this medication.
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