ATI RN
RN ATI Capstone Proctored Comprehensive Assessment Form A
1. A nurse is evaluating a client receiving hemodialysis. Which of the following lab values requires immediate intervention?
- A. Sodium 135 mEq/L
- B. Potassium 6.5 mEq/L
- C. Calcium 9 mg/dL
- D. Chloride 98 mEq/L
Correct answer: B
Rationale: The correct answer is B. Potassium levels above 5.0 mEq/L can lead to cardiac issues, and a level of 6.5 mEq/L requires immediate intervention. Hyperkalemia can cause life-threatening cardiac arrhythmias. Choices A, C, and D are within normal ranges and do not require immediate intervention in the context of hemodialysis monitoring.
2. A nurse manager on an acute care unit is preparing a staff presentation about promoting cost-effective care. Which of the following strategies should the nurse plan to include in the presentation?
- A. Change IV solution bags every 36 hr.
- B. Avoid the delegation of hygiene care to assistive personnel (AP)
- C. Wear sterile gloves when removing urinary retention catheters.
- D. Educate staff about the correct use of personal protective equipment (PPE) for isolation precautions
Correct answer: D
Rationale: Teaching staff proper use of PPE helps reduce the spread of infections and promotes cost-effective care.
3. A nurse is providing teaching to the parent of a child who is receiving oral nystatin for oral candidiasis. Which of the following statements by the parent indicates an understanding of the teaching?
- A. I will mix the medication with applesauce
- B. I will provide a snack with the medication
- C. I will store the medication in the refrigerator
- D. I will swab the inside of my child's mouth with the medication
Correct answer: D
Rationale: The correct answer is D because swabbing the inside of the child's mouth with the nystatin solution is the correct administration method for treating oral candidiasis. Mixing the medication with applesauce or providing a snack with it is not the recommended method of administration. Storing the medication in the refrigerator is also unnecessary and not part of the proper administration instructions.
4. A nurse enters a client's room to administer a prescribed medication, and the client asks about the medication. What is the most appropriate response by the nurse?
- A. Give detailed information about the medication, including its potential side effects.
- B. Refer the client to the healthcare provider for more information.
- C. Give a brief explanation and administer the medication.
- D. Ask another nurse to explain the medication and proceed.
Correct answer: B
Rationale: The most appropriate response for the nurse when a client asks about a medication is to refer the client to the healthcare provider for more information. This ensures that the client receives accurate and detailed information from the appropriate source. Providing detailed information or a brief explanation as choices A and C suggest may not be within the nurse's scope of practice and could potentially lead to misinformation or confusion. Asking another nurse to explain the medication, as in choice D, may not guarantee accurate information, so it is best to involve the healthcare provider directly.
5. A nurse at a provider's office is providing teaching to a client who is taking chemotherapy and losing weight. Which of the following should the nurse recommend to increase calorie and protein intake? (SATA)
- A. Top fruits with yogurt
- B. Add cream to soups
- C. Increase fluids during meals
- D. Use milk instead of water in recipes
Correct answer: A
Rationale: Topping fruits with yogurt is the correct recommendation to increase calorie and protein intake for a client on chemotherapy who is losing weight. Yogurt is a good source of protein and adding it to fruits can provide additional calories as well. Choice B, adding cream to soups, may increase calorie intake but does not specifically address protein needs. Choice C, increasing fluids during meals, is important for hydration but does not directly address calorie and protein intake. Choice D, using milk instead of water in recipes, may increase calorie content but does not focus on increasing protein intake, which is essential for clients on chemotherapy.
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