ATI RN
RN ATI Capstone Proctored Comprehensive Assessment Form B
1. A patient receiving chemotherapy has developed neutropenia. What should be included in the care plan to reduce infection risk?
- A. Monitor temperature daily
- B. Limit visitors
- C. Administer antibiotics prophylactically
- D. Use reverse isolation precautions
Correct answer: D
Rationale: When a patient receiving chemotherapy develops neutropenia, the priority is to reduce the risk of infection. Using reverse isolation precautions is crucial in this situation to protect the patient from exposure to pathogens. Monitoring temperature daily (Choice A) is important but is not as effective as isolating the patient. Limiting visitors (Choice B) can help reduce the risk of exposure, but reverse isolation is a more stringent measure. Administering antibiotics prophylactically (Choice C) is not recommended unless there is a specific indication, as it can contribute to antibiotic resistance.
2. What should be done to ensure safety during the transfer of a patient with limited mobility?
- A. Have the patient use a gait belt for support.
- B. Encourage the patient to hold onto a walker.
- C. Lock the wheels on the bed and wheelchair.
- D. Ask the patient to transfer independently.
Correct answer: C
Rationale: The correct answer is to lock the wheels on the bed and wheelchair. This action helps prevent accidents by stabilizing the equipment during the transfer process. Having the patient use a gait belt for support (choice A) can be helpful but is not directly related to equipment safety. Encouraging the patient to hold onto a walker (choice B) is beneficial for ambulation but does not address the safety of equipment. Asking the patient to transfer independently (choice D) can pose risks, especially for a patient with limited mobility, and may not ensure safety during the transfer.
3. A healthcare provider is assessing a patient with dehydration. Which finding indicates the patient's condition is worsening?
- A. Dry mucous membranes.
- B. Tachycardia and low blood pressure.
- C. Bradycardia and shallow respirations.
- D. Clear lung sounds.
Correct answer: B
Rationale: Tachycardia and low blood pressure are indicative of worsening dehydration in a patient. Tachycardia is the body's compensatory mechanism to maintain cardiac output in response to decreased intravascular volume, while low blood pressure reflects inadequate perfusion due to decreased fluid levels. Bradycardia and shallow respirations are not typical findings in worsening dehydration, and clear lung sounds do not directly correlate with the severity of dehydration.
4. Which of the following is a correct method of safely using a sterile dressing?
- A. Reuse a dressing that appears clean.
- B. Discard a dressing after 24 hours of use.
- C. Change a dressing only if there is visible drainage.
- D. Change a dressing every 4 hours regardless of condition.
Correct answer: B
Rationale: The correct method of safely using a sterile dressing is to discard it after 24 hours of use. This is important to prevent contamination and promote proper wound healing. Choice A is incorrect because reusing a dressing, even if it appears clean, can introduce contaminants. Choice C is incorrect as dressing changes should not be based solely on visible drainage; they should be done within the recommended time frame. Choice D is incorrect because changing a dressing every 4 hours, regardless of its condition, can lead to unnecessary wastage and disturbance to the wound healing process.
5. A nurse is teaching a client about how to use her new hearing aids. Which of the following statements should the nurse identify as an indication that the client needs further instruction?
- A. I will not use hairspray if I am wearing the hearing aids
- B. I will clean the hearing aids with alcohol wipes
- C. I will change the batteries once a week
- D. I will expect the hearing aids to whistle when I cup my hand over them
Correct answer: B
Rationale: The correct answer is B because cleaning the hearing aids with alcohol wipes can damage them. It is important to use specialized cleaning tools or follow specific cleaning instructions provided by the manufacturer to prevent harm to the hearing aids. Choices A, C, and D demonstrate good understanding and appropriate care for hearing aids, indicating that the client does not need further instruction in those areas.
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