ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment A
1. A nurse working at the clinic is teaching a group of clients who are pregnant on the use of nonpharmacological pain management. Which of the following is an appropriate description of the use of hypnosis during labor?
- A. Hypnosis focuses on biofeedback as a relaxation technique
- B. Hypnosis promotes increased control of pain perception during contractions
- C. Hypnosis uses therapeutic touch to reduce anxiety during labor
- D. Hypnosis provides instruction to minimize pain
Correct answer: B
Rationale: The correct answer is B. Hypnosis during labor helps the client gain increased control over her perception of pain, allowing for better pain management during contractions. Choice A is incorrect because hypnosis and biofeedback are distinct techniques. Choice C is incorrect as therapeutic touch and hypnosis are different modalities. Choice D is incorrect as hypnosis does not simply provide instruction to minimize pain, but rather helps the individual control their perception of pain.
2. A nurse is caring for a client with encephalopathy secondary to liver failure. The client has been prescribed a high-calorie, low-protein diet. Which of the following meal selections is appropriate for this client?
- A. Scrambled eggs, bacon, and pancakes
- B. Grilled cheese sandwich, potato chips, chocolate pudding
- C. Steak, French fries, corn
- D. Chicken breast, mashed potatoes, spinach
Correct answer: D
Rationale: The correct answer is D: Chicken breast provides a low-fat protein source, and mashed potatoes and spinach provide high-calorie nutrients suitable for managing liver failure. Option A (Scrambled eggs, bacon, and pancakes) is high in protein, which is not suitable for a low-protein diet. Option B (Grilled cheese sandwich, potato chips, chocolate pudding) contains high protein and may not be appropriate for the client. Option C (Steak, French fries, corn) is high in protein and fat, which are not recommended for this client's dietary requirements.
3. A client is being taught how to use a diaphragm for contraception. Which of the following client statements indicate an understanding of the teaching?
- A. I will leave the diaphragm in place for at least 6 hours after intercourse.
- B. I will remove the diaphragm by catching the rim below the dome with my finger.
- C. I will not apply mineral oil on the diaphragm.
- D. I will place 2 teaspoons of spermicide on the inside of the diaphragm before inserting it.
Correct answer: D
Rationale: The correct answer is D. The client should place spermicide inside the diaphragm before insertion to enhance contraceptive effectiveness. It is recommended to leave the diaphragm in place for at least 6 hours after intercourse, but not more than 24 hours. Choice A is incorrect because the diaphragm should be left in place for at least 6 hours, not 4 hours. Choice B is incorrect as the diaphragm should be removed by hooking the rim below the dome, not above. Choice C is incorrect because mineral oil should not be used with the diaphragm as it can weaken the latex.
4. A nurse is caring for a client who is in labor and receiving electronic fetal monitoring. The nurse is reviewing the monitor tracing and notes early decelerations. What should the nurse expect?
- A. Fetal hypoxia
- B. Abruptio placentae
- C. Post-maturity
- D. Head compression
Correct answer: D
Rationale: When early decelerations are noted on the fetal monitor tracing, it indicates fetal head compression, which is typically a benign finding associated with the progress of labor. Early decelerations mirror the uterine contractions and are often not a cause for concern as they are a normal response to fetal head compression during contractions. Choices A, B, and C are incorrect as they do not align with the expected outcome of early decelerations. Fetal hypoxia, abruptio placentae, and post-maturity would present with different patterns on the fetal monitor tracing and would require different interventions.
5. A client is prescribed omeprazole. Which of the following should the nurse monitor?
- A. Liver function
- B. Magnesium levels
- C. Blood glucose
- D. Hemoglobin levels
Correct answer: B
Rationale: Corrected Rationale: Omeprazole can cause hypomagnesemia, a condition characterized by low magnesium levels in the blood. Monitoring magnesium levels is crucial to detect and address this potential adverse effect. Liver function (Choice A) is not typically affected by omeprazole. Blood glucose (Choice C) and hemoglobin levels (Choice D) are not directly impacted by omeprazole administration. Therefore, magnesium levels (Choice B) are the most appropriate parameter to monitor in a client prescribed omeprazole.
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