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PN ATI Capstone Proctored Comprehensive Assessment Form A
1. A patient is receiving discharge teaching for esophageal cancer and starting radiation therapy. What instruction should the healthcare provider include?
- A. Remove dye markings after each radiation treatment
- B. Apply a warm compress to the irradiated site
- C. Wear clothing over the area of radiation treatment
- D. Use a washcloth to bathe the treatment area
Correct answer: C
Rationale: The correct instruction for a patient starting radiation therapy for esophageal cancer is to wear clothing over the area of radiation treatment. This helps to prevent irritation and protect the skin. Removing dye markings after each treatment (choice A) is unnecessary and not typically part of the patient's self-care. Applying a warm compress (choice B) can exacerbate skin irritation caused by radiation. Using a washcloth to bathe the treatment area (choice D) can potentially irritate the skin further, making it important to avoid.
2. A client with a new ileostomy is receiving discharge instructions from a nurse. Which statement indicates the client understands the teaching?
- A. I will make sure my medications are enteric-coated.
- B. My stoma will drain liquid continuously.
- C. I will change my pouch system every two weeks.
- D. My stoma size will stay the same after it heals.
Correct answer: B
Rationale: The correct answer is B. Ileostomy stomas typically drain liquid continuously, unlike colostomies. This continuous drainage is a key characteristic that clients should understand postoperatively. Choice A is incorrect because ensuring medications are enteric-coated is not directly related to understanding ileostomy care. Choice C is incorrect as changing the pouch system every two weeks is not a general rule and may vary depending on the individual's needs. Choice D is incorrect because the stoma size can change during the healing process and clients should be informed about this possibility.
3. A nurse is preparing to teach a client with chronic renal failure. Which dietary instruction is most appropriate?
- A. Increase calcium intake
- B. Increase potassium intake
- C. Increase protein intake
- D. Restrict protein intake
Correct answer: D
Rationale: The correct answer is to restrict protein intake for a client with chronic renal failure. In renal failure, the kidneys are unable to effectively filter waste products. Excessive protein intake can lead to the accumulation of waste products, increasing the workload on the kidneys. Therefore, restricting protein intake is essential to prevent further kidney damage. Choices A, B, and C are incorrect. Increasing calcium intake is not specifically indicated for chronic renal failure. Increasing potassium intake can be dangerous in renal failure as impaired kidneys may not be able to excrete excess potassium. Increasing protein intake is contraindicated in chronic renal failure as it can worsen kidney function and increase the accumulation of waste products.
4. A nurse is caring for a client with a chest tube following a thoracotomy. Which of the following findings requires intervention by the nurse?
- A. Tidaling with spontaneous respirations
- B. Drainage collection chamber is 1/3 full
- C. 1 cm of water present in the water seal chamber
- D. Suction chamber pressure of -20 cm H2O
Correct answer: C
Rationale: 1 cm of water in the water seal chamber is insufficient to ensure proper functioning of the chest tube. The water seal chamber typically requires a water level of 2 cm. Tidaling with spontaneous respirations (choice A) is an expected finding indicating proper functioning. Having the drainage collection chamber 1/3 full (choice B) is within the normal range. A suction chamber pressure of -20 cm H2O (choice D) is an appropriate level for chest tube drainage.
5. A healthcare provider is reviewing a client’s care plan. Which of the following goals is most appropriate?
- A. Client will inject insulin twice daily
- B. Client will keep appointments with the healthcare provider for 6 months
- C. Client's A1c will be 5% within one year
- D. Client's blood glucose will stay between 60-120 mg/dL
Correct answer: C
Rationale: The correct answer is C. A1c is a key indicator of long-term diabetes management, reflecting average blood sugar levels over the past 2-3 months. Achieving a target A1c of 5% indicates good control of blood sugar levels and reduces the risk of diabetes-related complications. Choices A, B, and D are not as appropriate as they focus on short-term tasks or individual blood glucose readings, rather than long-term management and outcomes.
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