ATI RN
RN ATI Capstone Proctored Comprehensive Assessment A
1. What is the most appropriate action for a healthcare professional to take when a medication error occurs?
- A. Document the error in the patient's medical record.
- B. Report the error to the healthcare provider immediately.
- C. Apologize to the patient and explain what happened.
- D. Continue administering the medication and monitor the patient closely.
Correct answer: B
Rationale: When a medication error occurs, the most appropriate action for a healthcare professional is to report the error to the healthcare provider immediately. This is crucial for ensuring prompt corrective action to mitigate any potential harm to the patient. Documenting the error is important but should come after reporting it to the relevant authorities. Apologizing to the patient is important for maintaining trust and communication but should not take precedence over reporting and addressing the error. Continuing to administer the medication without addressing the error is unsafe and goes against patient safety protocols.
2. A patient requires assistance to stand from a sitting position. Which action by the nurse ensures patient safety?
- A. Allow the patient to pull up on the nurse's arm.
- B. Place a gait belt around the patient for support.
- C. Have the patient push off the chair with their hands.
- D. Ask the patient to lift themselves up without support.
Correct answer: B
Rationale: The correct answer is B. Placing a gait belt around the patient for support is the safest option when assisting a patient to stand from a sitting position. This belt provides stability and support, reducing the risk of falls or injuries during the transfer. Choices A, C, and D are incorrect. Allowing the patient to pull up on the nurse's arm (Choice A) may lead to instability and compromise safety. Having the patient push off the chair with their hands (Choice C) might not provide sufficient support, especially for patients who require assistance. Asking the patient to lift themselves up without support (Choice D) can be dangerous and increase the risk of falls.
3. A nurse is teaching a female client who is experiencing alcohol withdrawal about chlordiazepoxide. Which of the following information should the nurse include in the teaching?
- A. This medication may increase your blood pressure
- B. Breast tenderness may occur with this medication
- C. You can double the dose of medication if you feel anxious
- D. Notify the provider if pregnancy is desired or suspected
Correct answer: D
Rationale: Pregnancy can complicate alcohol withdrawal treatment, and the provider should be notified.
4. A healthcare provider is reviewing the laboratory report of a client who is receiving heparin therapy for a deep vein thrombosis. Which of the following lab values indicates a therapeutic response to the therapy?
- A. PT of 12 seconds
- B. aPTT of 70 seconds
- C. Platelets of 150,000/mm3
- D. INR of 1.5
Correct answer: B
Rationale: An aPTT of 70 seconds is within the therapeutic range for a client receiving heparin therapy. The activated partial thromboplastin time (aPTT) is the most sensitive test to monitor heparin therapy. A therapeutic aPTT range for a client receiving heparin is usually 1.5 to 2.5 times the control value. Choices A, C, and D are not indicators of a therapeutic response to heparin therapy. PT measures the extrinsic pathway of coagulation and is not specific to monitoring heparin therapy. Platelet count is important to monitor for heparin-induced thrombocytopenia, but it does not indicate the therapeutic response to heparin therapy. INR is used to monitor warfarin therapy, not heparin therapy.
5. A nurse is caring for a client who has diarrhea due to shigella. Which of the following precautions should the nurse take?
- A. Wear gloves only
- B. Wear a mask
- C. Wash hands before and after client care
- D. Use an N95 respirator
Correct answer: C
Rationale: The correct precaution for a nurse caring for a client with shigella-induced diarrhea is to wash hands before and after client care. Shigella is a highly contagious bacterium that spreads through contaminated food, water, or contact with infected individuals. While wearing gloves is important when directly handling bodily fluids, hand hygiene is crucial in preventing the transmission of the infection. Wearing a mask or using an N95 respirator is not necessary for preventing the spread of shigella, as it primarily spreads through the fecal-oral route rather than through respiratory droplets.
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