ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment 2020 B
1. A healthcare provider is reviewing the medical records of a group of older adults (OA). The provider should identify that which of the following is a risk factor that places OA at an increased risk for developing infections?
- A. Improved circulation
- B. Increased immune function
- C. Lowered immune system function
- D. Dehydration
Correct answer: C
Rationale: The correct answer is C: 'Lowered immune system function.' As individuals age, their immune system tends to weaken, making them more susceptible to infections. Choices A, B, and D are incorrect because improved circulation and increased immune function would typically reduce the risk of infections, while dehydration can impact overall health but is not directly related to immune system function in the context of infection risk.
2. A nurse is caring for a client with diabetes who is experiencing hypoglycemia. Which of the following interventions should the nurse perform first?
- A. Administer insulin
- B. Give the client a carbohydrate snack
- C. Call for assistance
- D. Monitor blood glucose
Correct answer: B
Rationale: The correct answer is to give the client a carbohydrate snack. When a client is experiencing hypoglycemia, the priority intervention is to raise their blood glucose levels quickly. Administering insulin (Choice A) would further lower the blood glucose levels and is contra-indicated in this situation. Calling for assistance (Choice C) may be necessary but is not the priority over addressing the low blood sugar. Monitoring blood glucose (Choice D) is important but not the initial action needed to raise blood glucose levels rapidly.
3. A nurse is teaching a client about the use of sildenafil. Which of the following should be included?
- A. It should not be taken with nitrates
- B. Monitor for headaches
- C. It is a prescription medication
- D. It may have side effects
Correct answer: B
Rationale: The correct answer is to monitor for headaches when taking sildenafil. This medication can cause headaches and other side effects, so it is crucial to inform clients about these potential adverse reactions. Choice A is incorrect because sildenafil should not be taken with nitrates due to the risk of severe hypotension. Choice C is incorrect as sildenafil is a prescription medication, not an over-the-counter one. Choice D is incorrect because sildenafil, like any medication, can have side effects that should be discussed with the client.
4. A nurse enters a client's room and sees smoke coming from the trash can. Which of the following actions should the nurse take first?
- A. Close the window
- B. Evacuate the room
- C. Call the fire department
- D. Attempt to extinguish the fire
Correct answer: B
Rationale: The correct answer is to evacuate the room first. In a fire situation, the priority is safety, following the RACE protocol: Rescue, Alarm, Contain, Extinguish. Evacuating the room ensures the safety of both the client and the nurse. Closing the window (Choice A) can wait until after evacuation when there is no immediate danger. Calling the fire department (Choice C) is important but comes after ensuring personal safety and evacuating. Attempting to extinguish the fire (Choice D) is not recommended as it can put the nurse and the client at risk; firefighting should be left to professionals.
5. A nurse is caring for a client who has been prescribed methadone. Which of the following client statements indicates a need for further teaching?
- A. I understand methadone slows my breathing.
- B. I understand methadone may cause me to have trouble sleeping.
- C. I will avoid alcohol while I’m taking this medication.
- D. I’ll change positions slowly, especially when standing.
Correct answer: B
Rationale: The correct answer is B because methadone typically causes sedation and respiratory depression, not trouble sleeping. The statement about trouble sleeping indicates a need for further teaching. Choices A, C, and D are incorrect because understanding that methadone slows breathing, avoiding alcohol while taking the medication, and changing positions slowly to prevent dizziness are all appropriate client statements when prescribed methadone.
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