ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 A with NGN
1. A client with a do-not-resuscitate (DNR) order has requested resuscitation during a family visit. How should the nurse respond?
- A. Follow the client's wishes and start resuscitation.
- B. Explain that the DNR must be honored.
- C. Ignore the client's request.
- D. Consult with the family regarding the decision.
Correct answer: B
Rationale: The correct answer is B. Nurses have a legal and ethical obligation to honor a client's do-not-resuscitate (DNR) order, regardless of any request for resuscitation during a family visit. It is crucial for the nurse to explain to the client that the DNR order must be respected. Choice A is incorrect because starting resuscitation against the client's documented wishes goes against the principle of autonomy. Choice C is inappropriate as it disregards the client's autonomy and legal directives. Choice D is not the best option as the nurse should prioritize honoring the client's decision as per the DNR order.
2. A healthcare provider is planning care for a client who has fluid overload. Which of the following actions should the provider plan to take first?
- A. Assess for edema
- B. Evaluate electrolytes
- C. Restrict fluid intake
- D. Administer diuretics
Correct answer: B
Rationale: Evaluating electrolytes is crucial when addressing fluid overload as it helps determine the severity of the imbalance and guides treatment. Assessing for edema (Choice A) is important but not the priority over evaluating electrolytes. Restricting fluid intake (Choice C) and administering diuretics (Choice D) are interventions that may be necessary but should be based on the electrolyte evaluation to ensure safe and effective care.
3. The nurse is caring for a patient who is at risk for infection. Which action by the nurse indicates correct understanding about standard precautions?
- A. Teaches the patient about good nutrition.
- B. Disposes of an uncapped needle in the designated container.
- C. Wears eyewear when emptying the urinary drainage bag.
- D. Dons gloves when wearing artificial nails.
Correct answer: C
Rationale: The correct understanding of standard precautions includes wearing appropriate personal protective equipment to prevent exposure to body fluids. Wearing eyewear when emptying the urinary drainage bag is crucial as it protects the nurse's eyes from potential splashes of body fluids. Teaching the patient about good nutrition (Choice A) is important for overall health but is not directly related to standard precautions. Disposing of an uncapped needle correctly (Choice B) is part of safe needle handling but does not specifically relate to standard precautions. Donning gloves when wearing artificial nails (Choice D) is not a correct understanding of standard precautions, as artificial nails can harbor microorganisms and increase the risk of infection transmission.
4. A healthcare provider prescribes a higher-than-usual dose of medication. What is the nurse's first action?
- A. Administer the medication and monitor closely.
- B. Hold the medication and consult the pharmacist.
- C. Ask another nurse to verify the dose.
- D. Call the provider for clarification.
Correct answer: D
Rationale: The correct answer is to call the provider for clarification. When faced with a higher-than-usual dose of medication, the nurse's first action should be to contact the prescribing healthcare provider to confirm the dosage. Administering the medication without clarifying the dose with the provider can pose serious risks to the patient's safety. Holding the medication and consulting the pharmacist may be appropriate after contacting the provider for clarification. Asking another nurse to verify the dose is not the most appropriate action when dealing with an unusual prescription; direct communication with the provider is essential in such situations.
5. During an initial visit, a home health nurse is assessing a client who has cultural beliefs different from their own. Which of the following questions should the nurse ask to determine the client's beliefs about environmental control?
- A. Do you spend more time thinking about the past, present, or future?
- B. Who makes most of the decisions in your family group?
- C. What do you think you can do to affect your health status?
- D. Can you list any diseases that your parents or siblings have had?
Correct answer: C
Rationale: The correct question to ask in this scenario is: 'What do you think you can do to affect your health status?' This question directly addresses the client's beliefs about their ability to control their health and reflects their beliefs about environmental control. Choices A, B, and D do not directly relate to assessing the client's beliefs about environmental control. Choice A focuses on time orientation, choice B pertains to family decision-making dynamics, and choice D is related to family medical history, which are not directly relevant to understanding the client's beliefs about environmental control.
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