ATI RN
RN ATI Capstone Proctored Comprehensive Assessment Form B
1. A nurse is teaching a client who has a new prescription for amoxicillin clavulanate to treat pharyngitis. Which statement indicates understanding?
- A. I will double my dose if I miss one
- B. I should take this medication on an empty stomach between meals
- C. I will take the medication until my sore throat goes away
- D. I will stop taking this medication if I develop itching
Correct answer: C
Rationale: The client should never double the dose if a dose is missed. This can lead to an overdose, which can cause serious adverse effects. Instead, the client should take the next dose as scheduled or consult the provider for guidance.
2. A nurse is assessing a client who is postoperative following a transurethral resection of the prostate (TURP) and notices clots in the client's urinary catheter and decreased urinary output. Which of the following actions should the nurse take?
- A. Administer an antispasmodic
- B. Irrigate the catheter with 0.9% sodium chloride irrigation
- C. Apply gentle manual pressure to the bladder
- D. Clamp the catheter tubing
Correct answer: B
Rationale: In this situation, the nurse should irrigate the catheter with 0.9% sodium chloride irrigation. This action helps clear the clots in the catheter and restore proper urine flow after a TURP. Administering an antispasmodic (Choice A) is not the appropriate action for clots in the catheter and decreased urinary output. Applying gentle manual pressure to the bladder (Choice C) or clamping the catheter tubing (Choice D) could potentially worsen the situation by causing bladder distention or preventing urine drainage.
3. Which nursing action will best help a patient with diabetes manage their condition?
- A. Monitor the patient's blood sugar levels regularly.
- B. Encourage the patient to follow a diabetic meal plan.
- C. Teach the patient how to administer insulin.
- D. Teach the patient about the complications of diabetes.
Correct answer: C
Rationale: The correct answer is C: Teach the patient how to administer insulin. This action is crucial in promoting self-management and control of diabetes. By educating the patient on administering insulin, they can actively participate in their treatment plan. Monitoring blood sugar levels (choice A) is important but doesn't empower the patient to take direct action. Encouraging a diabetic meal plan (choice B) is beneficial but may not directly address the need for insulin administration. Teaching about the complications of diabetes (choice D) is essential but may not be as immediately impactful as teaching insulin administration for day-to-day management.
4. What are the key nursing interventions for a patient experiencing acute respiratory distress syndrome (ARDS)?
- A. Positioning the patient in a prone position
- B. Monitoring vital signs and lung sounds
- C. Preparing for mechanical ventilation
- D. Administering supplemental oxygen
Correct answer: A
Rationale: The correct answer is A: Positioning the patient in a prone position. Prone positioning is a key nursing intervention for patients with acute respiratory distress syndrome (ARDS) as it helps improve oxygenation by allowing better lung ventilation. Choice B, monitoring vital signs and lung sounds, is important but not a key intervention specific to ARDS. Choice C, preparing for mechanical ventilation, may be necessary in severe cases of ARDS but is not a primary nursing intervention. Choice D, administering supplemental oxygen, is a common supportive measure but is not specific to ARDS interventions.
5. The healthcare provider is assessing how a patient's pain is affecting mobility. Which assessment question is most appropriate?
- A. What activities, if any, has your pain prevented you from doing?
- B. When does your pain medication typically take effect on your pain?
- C. Would you please rate your pain on a scale from 0 to 10 for me?
- D. Have you considered working with a physical therapist?
Correct answer: A
Rationale: The most appropriate assessment question in this scenario is asking the patient, 'What activities, if any, has your pain prevented you from doing?' This question helps the healthcare provider understand how pain is impacting the patient's daily activities and mobility, providing valuable insight into the limitations caused by the pain. Choice B focuses on pain medication effectiveness, which is not directly related to mobility assessment. Choice C aims at pain intensity assessment but does not directly address mobility issues. Choice D suggests a solution rather than gathering information about the current impact of pain on mobility.
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