ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 B
1. A client is being taught about which foods to include in a low fiber diet. Which statement indicates understanding?
- A. Choosing a fresh pear would be a good snack option
- B. I should make refried beans for supper
- C. Selecting white rice as a side dish is a good choice
- D. Opting for bran cereal would be a good breakfast choice
Correct answer: C
Rationale: The correct answer is C because white rice is a low-fiber food suitable for a low-fiber diet, making it an appropriate choice. Choices A, B, and D are incorrect because fresh pear, refried beans, and bran cereal are high-fiber foods and not suitable for a low-fiber diet.
2. A patient with severe pain and leg swelling is admitted. What should the nurse assess for?
- A. Check for signs of deep vein thrombosis.
- B. Assess for compartment syndrome.
- C. Increase the patient's fluid intake.
- D. Prepare the patient for surgery to relieve pain.
Correct answer: B
Rationale: When a patient presents with severe pain and leg swelling, the nurse should assess for compartment syndrome. Compartment syndrome is a serious condition that can develop due to increased pressure within a muscle compartment, leading to compromised circulation and potential tissue damage. It is crucial to identify compartment syndrome promptly as it may require immediate intervention to prevent further complications. Checking for signs of deep vein thrombosis (Choice A) is also important in a patient with leg swelling, but in this scenario, the focus should be on assessing for compartment syndrome due to the severity of the symptoms. Increasing fluid intake (Choice C) may not address the underlying cause of the patient's symptoms. Preparing the patient for surgery (Choice D) without a comprehensive assessment and diagnosis is premature and may not be the appropriate initial intervention.
3. A nurse is reviewing the medical record of a client who has osteomyelitis and a prescription for gentamicin IV every 8 hours. Which of the following serum laboratory results should the nurse report to the provider before administering the gentamicin?
- A. Hematocrit 45%
- B. Sodium 140 mEq/L
- C. Creatinine 2.4 mg/dL
- D. Potassium 4.0 mEq/L
Correct answer: C
Rationale: An elevated creatinine level indicates potential kidney dysfunction, which is crucial when administering gentamicin as it can be nephrotoxic. Reporting a high creatinine level to the provider is essential to prevent further kidney damage. Choice A (Hematocrit 45%) is within the normal range and not directly related to gentamicin administration. Choice B (Sodium 140 mEq/L) and Choice D (Potassium 4.0 mEq/L) are also within normal limits and do not directly impact the administration of gentamicin.
4. A healthcare professional is caring for a client with impaired mobility. Which of the following support devices should the healthcare professional plan to use to prevent the client from developing plantar flexion contractures?
- A. Sheepskin heel pad
- B. Footboard
- C. Trochanter roll
- D. Abduction pillow
Correct answer: B
Rationale: A footboard is the correct choice to prevent plantar flexion contractures by maintaining proper alignment of the feet. Plantar flexion contractures involve the foot pointing downward, and a footboard helps keep the foot in a neutral position. Choice A, the sheepskin heel pad, is used for pressure ulcer prevention and comfort but does not specifically address plantar flexion contractures. Choice C, the trochanter roll, is used for hip positioning, not foot alignment. Choice D, the abduction pillow, is used to maintain proper positioning of the legs but does not directly address plantar flexion contractures.
5. A healthcare provider is assessing a client who has carpal tunnel syndrome. The provider should expect which of the following findings?
- A. Positive Chvostek's sign
- B. Cool extremities
- C. Positive Phalen's sign
- D. Decreased radial pulse
Correct answer: C
Rationale: Phalen's sign is often positive in clients with carpal tunnel syndrome due to nerve compression. Chvostek's sign (Choice A) is related to hypocalcemia, cool extremities (Choice B) are not typically associated with carpal tunnel syndrome, and decreased radial pulse (Choice D) is not a common finding in carpal tunnel syndrome.
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