ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 A with NGN
1. How can a healthcare provider prevent pressure ulcers in an immobile patient?
- A. Turn the patient every 4 hours.
- B. Provide the patient with a special mattress.
- C. Elevate the patient's legs to reduce pressure.
- D. Limit the patient's movement to reduce friction.
Correct answer: B
Rationale: Providing the immobile patient with a special mattress is an effective way to prevent pressure ulcers. Special mattresses help distribute pressure evenly and reduce the risk of developing pressure ulcers by relieving pressure on sensitive areas. Turning the patient every 4 hours (Choice A) is a standard practice to prevent pressure ulcers but may not be as effective as using a special mattress. Elevating the patient's legs (Choice C) can help with circulation but may not directly prevent pressure ulcers. Limiting the patient's movement (Choice D) can lead to other complications and is not a recommended method for preventing pressure ulcers.
2. A nurse is caring for a client who has not voided for 8 hours following the removal of an indwelling urinary catheter. Which of the following actions should the nurse take first?
- A. Provide assistance to the bathroom
- B. Insert a straight catheter
- C. Increase fluids
- D. Perform a bladder scan
Correct answer: D
Rationale: Performing a bladder scan is the first step to assess bladder retention before any further interventions.
3. A client has a new prescription for clopidogrel. Which of the following instructions should the nurse include?
- A. Take this medication with food
- B. Take this medication three times daily
- C. You might have to stop taking this medication 5 days before any planned surgeries
- D. Expect to have black-colored stools while taking this medication
Correct answer: C
Rationale: The correct answer is C. When instructing a client who is prescribed clopidogrel, the nurse should include information about stopping the medication 5 days before any planned surgeries to reduce the risk of bleeding. This is crucial to prevent excessive bleeding during surgical procedures. Choices A, B, and D are incorrect because taking the medication with food, the frequency of administration, and the possibility of black-colored stools are not specific instructions related to clopidogrel use.
4. A patient is admitted with signs of stroke. Which of the following diagnostic tests should the nurse anticipate as the priority?
- A. CT scan
- B. MRI
- C. X-ray
- D. Ultrasound
Correct answer: A
Rationale: A CT scan is the priority diagnostic test to identify and confirm the location and severity of a stroke.
5. A client is being prepared for discharge after a stroke. Which of the following interventions should be included in the discharge plan to prevent complications?
- A. Recommend physical therapy to improve mobility
- B. Teach the client how to use an incentive spirometer
- C. Encourage the client to ambulate daily
- D. Provide education on proper medication management
Correct answer: D
Rationale: The correct answer is to provide education on proper medication management. Proper medication management is crucial in reducing the risk of stroke recurrence and ensuring the client adheres to the treatment plan. While physical therapy, incentive spirometer use, and daily ambulation are important aspects of stroke rehabilitation, they are not directly related to preventing complications during the discharge phase.
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