ATI RN
ATI Capstone Comprehensive Assessment B
1. What is the most appropriate action for a healthcare provider to take when a patient refuses a prescribed medication?
- A. Document the refusal and notify the healthcare provider.
- B. Administer the medication at a later time.
- C. Explain the importance of the medication and its effects.
- D. Respect the patient's right to refuse the medication.
Correct answer: D
Rationale: The correct answer is to respect the patient's right to refuse the medication. It is crucial to uphold the patient's autonomy and decision-making capacity when it comes to their treatment. Administering the medication later without the patient's consent (Choice B) disregards their autonomy and can lead to ethical issues. Documenting the refusal and notifying the healthcare provider (Choice A) is important for legal and continuity of care purposes but should come after respecting the patient's decision. While explaining the importance of the medication (Choice C) is valuable for promoting understanding and compliance, the immediate concern should be respecting the patient's refusal.
2. A client with left hemiparesis is learning how to use a cane. Which of the following instructions should the nurse include?
- A. Place the cane approximately 61 cm (24 in) in front of their feet before advancing
- B. Advance the stronger leg and the cane together to support the weaker leg
- C. Remove the rubber tip when using the cane
- D. Hold the cane on the right side to provide support for the weaker leg
Correct answer: D
Rationale: The correct way to use a cane for a client with left hemiparesis is to hold the cane on the right side to provide support for the weaker left leg. This allows for better stability and weight distribution. Placing the cane approximately 61 cm (24 in) in front of their feet before advancing (Choice A) is not necessary and may lead to improper gait. Advancing the stronger leg and the cane together (Choice B) is incorrect as it does not provide support for the weaker leg. Removing the rubber tip when using the cane (Choice C) is also incorrect as the rubber tip helps provide traction and stability.
3. A client is preparing for surgery wearing a necklace. What is the appropriate action?
- A. Remove the necklace and place it in a drawer
- B. Tape the necklace to the patient's skin
- C. Ask the patient for permission to lock it in a safe
- D. Ask the family to hold onto the necklace
Correct answer: C
Rationale: The appropriate action when a client is wearing a necklace before surgery is to ask the patient for permission to lock it in a safe. This is in line with hospital policy to secure valuables before entering surgery. Choice A is incorrect because simply placing the necklace in a drawer may not be secure. Choice B is incorrect as taping the necklace to the patient's skin can cause skin irritation and is not a standard practice. Choice D is incorrect because the responsibility for securing valuables typically lies with the healthcare team, not the patient's family.
4. A healthcare provider notices a discrepancy in the narcotics log. What is the appropriate response?
- A. Correct the narcotics log and move on.
- B. Report the discrepancy to the supervisor.
- C. Confront the provider responsible for the discrepancy.
- D. Dispose of the medication and ignore the discrepancy.
Correct answer: B
Rationale: When a healthcare provider notices a discrepancy in the narcotics log, the appropriate response is to report the issue to the supervisor. Reporting discrepancies is crucial to maintain accountability and prevent potential misuse. Choice A is incorrect because simply correcting the log without addressing the underlying issue does not ensure accountability. Choice C is inappropriate as confronting the provider directly may not be the best approach and could lead to a confrontational situation. Choice D is highly inappropriate as ignoring the discrepancy and disposing of medication without proper documentation can lead to serious consequences.
5. A patient has just undergone a tracheostomy. What is the nurse's priority intervention?
- A. Suction the tracheostomy to maintain a patent airway.
- B. Administer pain medication as prescribed.
- C. Change the tracheostomy dressing every 4 hours.
- D. Monitor the patient's oxygen saturation closely.
Correct answer: A
Rationale: The correct answer is to suction the tracheostomy to maintain a patent airway. After a tracheostomy, the priority intervention is to ensure a clear airway to prevent respiratory distress. Administering pain medication, changing the tracheostomy dressing, and monitoring oxygen saturation are important but are secondary to maintaining a patent airway in a patient who has just undergone a tracheostomy.
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