ATI RN
RN ATI Capstone Proctored Comprehensive Assessment A
1. A healthcare provider orders a medication dose three times higher than usual. What is the nurse's first step?
- A. Administer the medication but monitor the patient closely.
- B. Verify the dosage with the prescribing provider.
- C. Administer a lower dose to minimize the risk.
- D. Hold the medication and wait for further clarification.
Correct answer: B
Rationale: The correct answer is B: Verify the dosage with the prescribing provider. When faced with an unusual medication dose, the nurse's initial action should be to confirm the order with the healthcare provider who prescribed it. This step is crucial to prevent medication errors and ensure patient safety. Choices A, C, and D are incorrect because administering the medication without clarification, administering a lower dose without approval, or holding the medication without consulting the provider can all pose risks to the patient's well-being.
2. A nursing instructor is observing a nursing student practicing standard precautions. Which observation by the instructor indicates a need for further teaching?
- A. The nursing student wears a gown to change the bed of an incontinent client.
- B. The nursing student washes hands before making contact with the client.
- C. The nursing student washes her hands before glove removal after emptying a Foley bag.
- D. The nursing student changes gloves between tasks and procedures.
Correct answer: C
Rationale: The correct answer is C. The nursing student washing her hands before glove removal after emptying a Foley bag indicates a need for further teaching. Hands should be washed after glove removal to maintain proper infection control. Choice A is correct as wearing a gown when changing the bed of an incontinent client is a standard precaution. Choice B is correct as washing hands before making contact with the client is a good practice. Choice D is correct as changing gloves between tasks and procedures is a standard precaution to prevent the spread of infection.
3. A community health nurse is reviewing primary prevention strategies for West Nile virus with a group of clients in a rural health clinic. Which of the following instructions should the nurse include?
- A. Avoid exposure to deer ticks.
- B. Eliminate areas of standing water.
- C. Use a respiratory mask when cleaning bird coops.
- D. Plan outdoor activities after dusk.
Correct answer: B
Rationale: The correct answer is B: 'Eliminate areas of standing water.' This is an essential primary prevention strategy for West Nile virus as it helps prevent the breeding of mosquitoes that spread the virus. Choices A, C, and D are incorrect. Avoiding exposure to deer ticks is more relevant for Lyme disease, using a respiratory mask when cleaning bird coops is not a primary prevention strategy for West Nile virus, and planning outdoor activities after dusk does not directly address the prevention of West Nile virus transmission.
4. A nurse is caring for a female client who has osteoporosis and a new prescription for raloxifene. What should the nurse assess prior to initiating therapy?
- A. Pregnancy status
- B. Bone density
- C. Calcium levels
- D. Blood pressure
Correct answer: A
Rationale: The correct answer is A: Pregnancy status. Raloxifene is a pregnancy category X drug, which means it can cause serious birth defects. Therefore, it is crucial for the nurse to assess the client's pregnancy status before initiating therapy. Choice B, bone density, while important in osteoporosis management, is not a specific concern related to initiating raloxifene therapy. Choice C, calcium levels, and choice D, blood pressure, are not directly related to the initiation of raloxifene therapy in a female client with osteoporosis.
5. A client with severe dyspnea is scheduled for multiple diagnostic tests. Which test should the nurse prioritize?
- A. Administer an echocardiogram first.
- B. Prioritize a chest x-ray for the client.
- C. Prepare the client for a CT scan.
- D. Order an MRI first.
Correct answer: B
Rationale: The correct answer is B: Prioritize a chest x-ray for the client. When a client presents with severe dyspnea, a chest x-ray should be prioritized as it helps in assessing the lungs and heart, which are crucial in cases of respiratory distress. Echocardiograms are more focused on assessing heart function and may not provide immediate information needed in cases of dyspnea. CT scans and MRIs are more detailed imaging studies that are not typically the first-line diagnostic tests for severe dyspnea.
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