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. A public health nurse is developing guidelines for the management of a botulism outbreak. Which of the following information should the nurse include?
- A. High-risk individuals should receive immunoglobulin E (IgE)
- B. Implement airborne precautions for clients who have botulism
- C. Administer an aminoglycoside medication
- D. Rinse skin with soap and water following exposure to the botulism toxin
Correct answer: D
Rationale: The correct answer is D. Rinsing the skin with soap and water following exposure to the botulism toxin is crucial as it helps remove the toxin from the skin, preventing further absorption. Choices A, B, and C are incorrect. Immunoglobulin E (IgE) is not used in the management of botulism. Airborne precautions are not necessary for botulism as it is not transmitted through the air. Aminoglycoside medications are not the treatment of choice for botulism.
3. 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.
4. What are the nursing interventions for a patient with acute kidney injury (AKI)?
- A. Preparing the patient for dialysis if necessary
- B. Providing dietary modifications to reduce potassium
- C. Monitoring urine output and electrolytes
- D. Administering fluids and monitoring blood pressure
Correct answer: A
Rationale: The correct nursing intervention for a patient with acute kidney injury (AKI) includes preparing the patient for dialysis if necessary. While choices B, C, and D are also important aspects of managing AKI, the critical intervention in severe cases is to prepare the patient for dialysis to support kidney function. Providing dietary modifications to reduce potassium, monitoring urine output and electrolytes, and administering fluids are essential components of the overall care plan for AKI patients, but in cases where the condition is severe or if conservative management fails, dialysis may be required to support the patient's kidney function and prevent further complications.
5. When caring for a patient with a nasogastric (NG) tube, what is the most appropriate intervention to prevent aspiration?
- A. Flush the NG tube with water before each feeding.
- B. Check the placement of the NG tube before each feeding.
- C. Elevate the head of the bed to 30-45 degrees.
- D. Provide the patient with oral care every 4 hours.
Correct answer: C
Rationale: Elevating the head of the bed to 30-45 degrees is the most appropriate intervention to prevent aspiration in a patient with an NG tube. This position helps reduce the risk of regurgitation and aspiration by promoting the proper flow of contents through the gastrointestinal tract and minimizing the chances of stomach contents entering the airway. Flushing the NG tube with water before each feeding may not directly prevent aspiration. Checking the placement of the NG tube is important but does not specifically address the prevention of aspiration. Providing oral care every 4 hours is essential for maintaining oral hygiene but is not directly related to preventing aspiration in a patient with an NG tube.
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