ATI RN
RN ATI Capstone Proctored Comprehensive Assessment Form A
1. What are the nursing considerations when caring for a patient with chronic obstructive pulmonary disease (COPD)?
- A. Encouraging pursed-lip breathing to improve ventilation
- B. Administering bronchodilators and corticosteroids
- C. Monitoring oxygen saturation and ABGs
- D. Teaching the patient how to use an inhaler
Correct answer: A
Rationale: The correct answer is A. Pursed-lip breathing is a nursing consideration for patients with COPD as it helps improve oxygenation and reduces air trapping. While administering bronchodilators and corticosteroids (choice B) is part of the treatment plan, it is typically done by healthcare providers. Monitoring oxygen saturation and arterial blood gases (ABGs) (choice C) is important but not a direct nursing consideration. Teaching the patient how to use an inhaler (choice D) is relevant but not specific to COPD care.
2. Which nursing action is essential when administering a blood transfusion?
- A. Ensure the blood is administered within 4 hours.
- B. Check the patient's vital signs every 30 minutes during the transfusion.
- C. Administer the transfusion at a slow rate for the first 15 minutes.
- D. Document the transfusion in the patient's medical record immediately after administration.
Correct answer: C
Rationale: The correct answer is to administer the transfusion at a slow rate for the first 15 minutes. This practice is crucial as it helps in detecting any adverse reactions early on. Checking the patient's vital signs every 30 minutes (choice B) is important but not as essential as ensuring a slow rate at the beginning. Administering blood within 4 hours (choice A) is a standard practice but not directly related to the initial administration. Documenting the transfusion immediately (choice D) is necessary but does not directly impact the safety of the initial administration.
3. An occupational health nurse in a factory is planning interventions to reduce environmental stressors for employees. Which of the following interventions should the nurse use to affect physical agents in the environment?
- A. Teach workers to choose personal strategies to cope with work stress
- B. Limit the amount of time workers spend in temperatures over 43.3°C (110°F)
- C. Provide ear plugs for use at workstations throughout the factory
- D. Obtain dosimeters for employees to wear when using new machinery that emits radiation
Correct answer: B
Rationale: Limiting exposure to extreme temperatures is important to protect workers from heat-related illnesses.
4. A client is vomiting, and a nurse is providing care. Which of the following actions should the nurse take first?
- A. Administer an antiemetic to the client
- B. Notify housekeeping
- C. Prevent the client from aspirating
- D. Provide the client with an emesis basin
Correct answer: C
Rationale: Preventing aspiration is the priority when caring for a client who is vomiting to reduce the risk of pneumonia or other respiratory complications. Aspiration can occur when vomitus enters the airway, leading to respiratory distress. Ensuring the airway is protected during vomiting episodes is essential. Administering an antiemetic (Choice A) can be considered after addressing the immediate risk of aspiration. Notifying housekeeping (Choice B) and providing an emesis basin (Choice D) are important but are secondary to preventing aspiration, which is crucial for the client's safety and well-being.
5. A healthcare professional is preparing to insert an indwelling urinary catheter. What is the most important action to prevent infection?
- A. Use sterile gloves during the procedure.
- B. Clean the catheter insertion site with alcohol.
- C. Insert the catheter as quickly as possible.
- D. Use a smaller catheter size to minimize trauma.
Correct answer: A
Rationale: Using sterile gloves during catheter insertion is crucial to prevent infection. Sterile gloves help maintain asepsis during the procedure, reducing the risk of introducing microorganisms into the urinary tract. Cleaning the insertion site with alcohol, as mentioned in choice B, is important but not as critical as using sterile gloves. Choice C, inserting the catheter as quickly as possible, is not recommended as it can lead to errors and increase the risk of contamination. Choice D, using a smaller catheter size to minimize trauma, is not directly related to preventing infection but rather focuses on patient comfort and reducing tissue damage.
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