ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 A with NGN
1. How should a healthcare professional position a patient to reduce the risk of pressure ulcers?
- A. Position the patient in the supine position for long periods.
- B. Use pillows to support bony prominences.
- C. Turn the patient every 4 hours.
- D. Place the patient on an alternating pressure mattress.
Correct answer: B
Rationale: Correctly positioning a patient to reduce the risk of pressure ulcers involves using pillows to support bony prominences. This helps to relieve pressure from vulnerable areas and prevent the development of pressure ulcers. Choice A is incorrect because keeping a patient in the supine position for extended periods can increase the risk of pressure ulcers. Choice C is incorrect as turning the patient every 2 hours, rather than every 4 hours, is recommended to prevent pressure ulcers. Choice D is not the best option mentioned for positioning a patient to reduce pressure ulcer risk; although alternating pressure mattresses can be beneficial, using pillows for support is a more direct and commonly used method.
2. How should a healthcare provider respond when a patient expresses concerns about the side effects of a prescribed medication?
- A. Reassure the patient that side effects are rare.
- B. Discuss the benefits and risks of the medication with the patient.
- C. Encourage the patient to speak to the pharmacist.
- D. Refer the patient to another healthcare provider for information.
Correct answer: B
Rationale: When a patient expresses concerns about medication side effects, it is crucial for the healthcare provider to discuss the benefits and risks of the medication with the patient. This approach helps the patient make an informed decision about their treatment. Choice A is incorrect because dismissing the patient's concerns by reassuring them that side effects are rare may not address the patient's specific worries. Choice C, while pharmacists can provide valuable information, the primary responsibility lies with the healthcare provider. Choice D is incorrect as referring the patient to another healthcare provider may disrupt continuity of care and not address the patient's concerns effectively.
3. Which action by the nurse will help prevent ventilator-associated pneumonia (VAP) in a patient on mechanical ventilation?
- A. Provide oral care every 4 hours.
- B. Reposition the patient every 2 hours.
- C. Suction the patient as needed.
- D. Administer antibiotics as prescribed.
Correct answer: A
Rationale: The correct answer is A. Providing oral care every 4 hours helps prevent ventilator-associated pneumonia by reducing the buildup of bacteria in the mouth that can be aspirated into the lungs. Repositioning the patient every 2 hours is important for preventing pressure ulcers but is not directly related to preventing VAP. Suctioning the patient as needed is essential for maintaining airway patency but does not specifically prevent VAP. Administering antibiotics as prescribed is a treatment for infections but does not prevent VAP.
4. A client with asthma is taking fluticasone. The nurse should monitor the client for which of the following adverse effects?
- A. Polyuria
- B. Oral candidiasis
- C. Hypertension
- D. Hypoglycemia
Correct answer: B
Rationale: Correct. Fluticasone, a corticosteroid medication commonly used to manage asthma, can lead to oral candidiasis due to its immunosuppressive effects. This fungal infection can manifest as white patches in the mouth and throat. Monitoring for signs of oral candidiasis is essential to initiate appropriate treatment. Polyuria (excessive urination) is not a common adverse effect of fluticasone. Hypertension and hypoglycemia are also not typically associated with this medication, making them incorrect choices.
5. A nurse is caring for a client who is requesting to leave the facility against medical advice (AMA). The client states, 'I am ready to go immediately.' Which of the following actions should the nurse take first?
- A. Teach the client about the potential health risks of leaving early
- B. Ask the client to sign a document stating they are leaving AMA
- C. Document the client's statement in direct quotes in the medical record
- D. Complete an incident report detailing the client scenario
Correct answer: A
Rationale: The correct action for the nurse to take first is to educate the client about the potential health risks of leaving against medical advice (AMA). By providing this information, the nurse can help the client make an informed decision regarding their healthcare. Choice B, asking the client to sign a document, can be done after the client has been informed about the risks. Choice C, documenting the client's statement, is important but should not take precedence over educating the client. Choice D, completing an incident report, is not the priority when a client is requesting to leave AMA.
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