ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 B with NGN
1. When administering a subcutaneous injection of insulin to a client, what angle should the nurse use for the injection?
- A. 45-degree angle
- B. 60-degree angle
- C. 90-degree angle
- D. 30-degree angle
Correct answer: C
Rationale: The correct angle for administering a subcutaneous injection, such as insulin, is 90 degrees. This angle allows for the medication to be delivered into the subcutaneous layer of tissue beneath the skin. A 45-degree angle is typically used for administering subcutaneous injections in infants or those with reduced adipose tissue, while a 60-degree angle is commonly used for intramuscular injections. A 30-degree angle is not a standard angle for subcutaneous injections.
2. When administering an IM injection into a client's deltoid muscle, which of the following actions should the nurse take?
- A. Use a 21-gauge needle for the injection
- B. Inject the medication at a 90-degree angle
- C. Inject the medication 12.7 cm (5 in) below the acromion process
- D. Inject the medication 2.54 cm (1 in) below the acromion process
Correct answer: B
Rationale: The correct answer is to inject the medication at a 90-degree angle when administering an IM injection into the deltoid muscle. This angle ensures proper delivery of the medication into the muscle tissue. Choice A is incorrect because the gauge of the needle for a deltoid IM injection is usually smaller, around 23-25 gauge. Choices C and D are incorrect as the injection site for the deltoid muscle is approximately 2.54 cm (1 in) below the acromion process, not 12.7 cm (5 in).
3. A healthcare professional is reviewing the medical record of a client who received their medications 1 hour ago. The client reports chest pain. This can be an adverse effect of what medication?
- A. Digoxin
- B. Albuterol
- C. Lisinopril
- D. Metoprolol
Correct answer: B
Rationale: The correct answer is B, Albuterol. Albuterol can cause chest pain as a side effect due to its beta-agonist effects, which can lead to chest discomfort. Digoxin (choice A) is not typically associated with causing chest pain. Lisinopril (choice C) and Metoprolol (choice D) are not known to commonly cause chest pain as a side effect.
4. What is the priority action when a patient is experiencing an allergic reaction to a medication?
- A. Monitor the patient's blood pressure every 15 minutes.
- B. Discontinue the medication and notify the healthcare provider.
- C. Administer an antihistamine to reduce symptoms.
- D. Monitor the patient's urine output closely.
Correct answer: B
Rationale: The correct answer is to discontinue the medication and notify the healthcare provider when a patient is experiencing an allergic reaction to a medication. This action is crucial to prevent further harm to the patient. Monitoring blood pressure (choice A) or urine output (choice D) may be important but is not the priority when managing an allergic reaction. Administering an antihistamine (choice C) should only be done after discontinuing the medication and consulting with the healthcare provider.
5. A nurse is preparing to perform a 12-lead electrocardiogram (ECG). Which of the following instructions should the nurse provide to the client?
- A. Remain still once the gel pads are attached
- B. I will be placing electrodes on your chest
- C. I will lower the head of your bed so you can sit up
- D. Breathe normally throughout the procedure
Correct answer: A
Rationale: The correct answer is A. Instructing the client to remain still once the gel pads are attached is crucial to obtaining accurate ECG readings. Choice B is incorrect as electrodes are typically placed on the chest, not the breast. Choice C is incorrect because the client should lie flat during an ECG, not sit up. Choice D is incorrect because the client should breathe normally, rather than holding their breath, throughout the procedure.
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