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PN Capstone Proctored Post-Assessment
PN ATI Capstone Proctored Post-Assessment
Total Questions : 82
Showing 10 questions Sign up for moreA nurse is collecting data from a client who is recovering from a recent stroke. Which of the following findings should indicate to the nurse the need for a referral to a speech-language pathologist?
Explanation
A. Urinary incontinence
While common post-stroke, this is typically managed by physical therapy or medical providers, not speech pathologists.
B. Fine motor tremors
This is related to motor control and is best addressed by occupational or physical therapy.
C. Coughing while eating
This suggests possible dysphagia, a common post-stroke complication. A speech-language pathologist evaluates swallowing function to prevent aspiration.
D. Facial flushing
Not related to speech or swallowing. May be a nonspecific autonomic or emotional response.
A nurse is assisting with the care of a client.
Explanation
A. Respiratory rate
Increased to 28/min from baseline of 18/min. This may indicate respiratory distress or pulmonary embolism.
B. Pedal pulses
Still 2+, no change noted - not an immediate concern.
C. Breath sounds
Crackles at the bases are new and could suggest fluid overload, atelectasis, or early pneumonia/PE.
D. Oxygen saturation
Dropped to 88% on room air, indicating hypoxia, which requires urgent intervention.
E. Movement of right foot
No change - sensation and movement intact, not an urgent issue.
F. Heart rate
Increased from 88 to 112/min. Can indicate pain, infection, or respiratory compromise.
A nurse is reinforcing teaching about HbA1c with a client who has type 1 diabetes mellitus. Which of the following information should the nurse include?
Explanation
A. An HbA1c value greater than 8% indicates diabetic control of blood sugar.
>8% suggests poor control. Ideal is <7% for most adults.
B. The HbA1c value is altered by eating habits the day before the test.
HbA1c is not affected by recent food intake-it reflects long-term glucose trends.
C. The HbA1c value determines long-term blood glucose control for the past 120 days.
HbA1c reflects average glucose levels over ~3 months and helps assess long-term control.
D. An HbA1c test is performed once per year.
For patients with diabetes, it's typically performed every 3–6 months.
The nurse is assisting in the care of an adolescent athlete in the emergency department.
Explanation
A. Blood pressure
124/72 mm Hg is normal.
B. Heart rate
64/min is normal.
C. Level of consciousness
Disorientation and hallucinations ("looking for the cat") suggest altered mental status, possibly from hypernatremia or hyperosmolality.
D. BUN level
14 mg/dL is within normal range.
E. Sodium level
Sodium of 150 mEq/L is elevated. Hypernatremia can cause neurological changes and must be corrected cautiously.
A nurse is assisting with the care of a client who gave birth.
After review of the medical record of the client, the nurse notes concerning data collection findings.
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
Explanation
Potential Condition:
Uterine atony
Boggy uterus, heavy bleeding, fundus responds to massage but returns to boggy state.
Actions to Take:
Massage fundus.
First-line measure to stimulate contraction and reduce bleeding.
Administer IV oxytocin.
Oxytocin promotes uterine contractions to reduce bleeding.
Parameters to Monitor:
Amount of lochia.
Helps assess ongoing blood loss.
Urine output.
Indicates perfusion status and potential hypovolemia.
A nurse is caring for a client who is experiencing a manic episode. The nurse should identify that which of the following factors can prolong the client's mania?
Explanation
A. Low lighting in the day room
Helps reduce stimulation and promote calmness.
B. Frequent rest periods throughout the day
Important for energy conservation and reducing hyperactivity.
C. Structured activities with the assistive personnel
Helps channel energy in a safe way and maintain boundaries.
D. A roommate who is also experiencing mania
Stimulation from another manic client can worsen or prolong manic behaviors.
A nurse is caring for a client whose calcium level is 7.6 mg/dL. Which of the following foods should the nurse recommend to the client as containing the greatest amount of calcium?
Explanation
A. 1⁄2 cup long grain rice
Low in calcium (~2 mg per ½ cup).
B. 1 medium avocado
Low in calcium (~20 mg per avocado).
C. 2 tbsp peanut butter
Contains some calcium (~17 mg) but much less than dairy.
D. 1 cup frozen yogurt
Frozen yogurt contains significant calcium (~200–300 mg per cup).
A nurse is assisting in the care of a toddler in the outpatient setting.
Complete the following sentence by using the lists of options.
The nurse recognizes that the toddler has likely developed
Explanation
Correct answer: The nurse recognizes that the toddler has likely developed Reye syndrome due to aspirin administration during a viral illness.
Reye syndrome is a rare but serious condition associated with aspirin use in children recovering from viral infections like influenza. It causes liver dysfunction and cerebral edema, manifesting as vomiting, lethargy, and altered mental status.
A nurse is caring for a client who is postoperative following a mastectomy. Which of the following actions should the nurse take to help the client cope with the body image change resulting from the surgery?
Explanation
A. Suggest that the client decide about reconstruction as soon as possible.
Reconstruction is a personal decision. The client should have time to grieve and consider options.
B. Encourage the client to help care for their surgical incision.
Promotes body image acceptance and gives the client a sense of control.
C. Postpone referrals to support services until the client requests them.
Support should be offered proactively, not delayed.
D. Avoid talking to the client about the surgery.
Avoidance can hinder emotional processing and coping.
A nurse is assisting with the plan of care for a client who is at 35 weeks of gestation. Which of the following laboratory tests should the nurse collect?
Explanation
A. Hepatitis B screening
Typically performed in early pregnancy, not at 35 weeks.
B. Group B streptococcus B-hemolytic
Group B strep screening is done between 35–37 weeks to assess risk for neonatal infection.
C. 3-hr oral glucose tolerance
Done at 24–28 weeks to diagnose gestational diabetes.
D. Rubella titer
Checked early in pregnancy to determine immunity, not in late pregnancy.
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