ATI RN
ATI Capstone Fundamentals Assessment Proctored
1. A nurse is sitting with the partner of a client who recently died. Which action should the nurse take to facilitate mourning?
- A. Avoid discussing the deceased
- B. Encourage the partner to ask for help when needed
- C. Suggest bereavement counseling
- D. Offer to contact family members
Correct answer: B
Rationale: Encouraging the partner to ask for help when needed is the most appropriate action in this scenario as it promotes healthy coping mechanisms and support during the mourning process. This approach empowers the individual to seek assistance when required, fostering a sense of control and acknowledging the partner's autonomy in dealing with their grief. Avoiding discussing the deceased (Choice A) may hinder the grieving process by suppressing emotions and preventing the partner from expressing their feelings. While suggesting bereavement counseling (Choice C) is important, the immediate support and encouragement to seek help when needed are crucial. Offering to contact family members (Choice D) may not be the most effective step at this stage, as the focus should be on empowering the partner to cope and seek help on their terms.
2. A nurse is caring for a client who has an indwelling urinary catheter. What finding indicates a catheter occlusion?
- A. Bladder distention
- B. Bladder spasms
- C. Hematuria
- D. Increased urine output
Correct answer: A
Rationale: Bladder distention is the correct finding that indicates a catheter occlusion. When the catheter is occluded, urine cannot drain properly, leading to the build-up of urine in the bladder, causing distention. Bladder spasms (Choice B) are not typically associated with catheter occlusion but may indicate irritation or infection. Hematuria (Choice C) refers to blood in the urine and is not specific to catheter occlusion. Increased urine output (Choice D) is not indicative of catheter occlusion but may suggest other conditions like diabetes insipidus.
3. A nurse is preparing to transfer a client from a bed to a chair. The client can bear partial weight and has upper body strength. What device should the nurse use?
- A. Mechanical lift
- B. Gait belt
- C. Slide board
- D. Stand-assist lift
Correct answer: D
Rationale: A stand-assist lift is the correct choice in this scenario. This device is suitable for clients who can bear partial weight and have upper body strength, as it allows them to actively participate in the transfer process. A mechanical lift is typically used for clients who are non-weight bearing or have limited mobility. A gait belt is used for providing support and stability during walking or transferring short distances. A slide board is used for transferring clients who are unable to bear weight and need assistance moving from one surface to another.
4. A client with chronic obstructive pulmonary disease (COPD) is being taught breathing exercises by a nurse. What instruction should the nurse include to improve oxygenation?
- A. Use pursed-lip breathing during activities
- B. Use deep breathing exercises after meals
- C. Perform diaphragmatic breathing during exercise
- D. Breathe in short, shallow breaths
Correct answer: A
Rationale: The correct instruction the nurse should include to improve oxygenation for a client with COPD is to 'Use pursed-lip breathing during activities.' Pursed-lip breathing helps improve oxygenation by slowing down the respiratory rate, reducing the work of breathing, and keeping the airways open. This technique also helps prevent the collapse of small airways during exhalation, allowing for more complete emptying of the lungs. Choices B, C, and D are incorrect because deep breathing exercises after meals, diaphragmatic breathing during exercise, and breathing in short, shallow breaths do not specifically target the improvement of oxygenation in individuals with COPD.
5. A nurse is providing discharge instructions to a client with chronic obstructive pulmonary disease (COPD). What instruction should the nurse include to help improve oxygenation?
- A. Avoid physical activity
- B. Use pursed-lip breathing during activities
- C. Limit sun exposure
- D. Perform weight-bearing exercises
Correct answer: B
Rationale: The correct answer is B: 'Use pursed-lip breathing during activities.' Pursed-lip breathing improves oxygenation by keeping airways open longer, facilitating better exhalation of carbon dioxide. Choice A is incorrect because avoiding physical activity can lead to deconditioning and worsen oxygenation. Choice C is irrelevant to improving oxygenation in COPD. Choice D is not directly related to improving oxygenation in COPD; weight-bearing exercises are important for bone health but not for oxygenation.
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