ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 A with NGN
1. What is the most important nursing intervention when caring for a patient with a wound?
- A. Apply an occlusive dressing over the wound.
- B. Clean the wound with normal saline.
- C. Administer antibiotics as prescribed.
- D. Reassess the wound every 4 hours for changes.
Correct answer: B
Rationale: The most important nursing intervention when caring for a patient with a wound is to clean the wound with normal saline. This is crucial for preventing infection and promoting healing. Applying an occlusive dressing (Choice A) can be important but should come after cleaning the wound. Administering antibiotics (Choice C) is not the first-line intervention for all wounds and should be based on the healthcare provider's prescription. Reassessing the wound (Choice D) is essential but not the most important initial intervention.
2. A nurse manager is discussing electronic medical records with a newly licensed nurse. Which of the following actions should the nurse take to maintain client confidentiality?
- A. Log out of the computer terminal before leaving.
- B. Share passwords for computer access with colleagues.
- C. Change computer access passwords on a regular basis.
- D. Avoid accessing information about clients admitted to other units.
Correct answer: A
Rationale: The correct answer is A: Log out of the computer terminal before leaving. Logging out before leaving the computer terminal is crucial to ensuring patient data remains confidential and to prevent unauthorized access. Choice B is incorrect because sharing passwords compromises confidentiality. Choice C is incorrect as changing passwords regularly, although a good practice for security, is not directly related to maintaining client confidentiality. Choice D is incorrect as it does not address the immediate concern of maintaining client confidentiality through proper access to electronic medical records.
3. In the context of personality disorders, what is a common characteristic of a client with Borderline Personality Disorder?
- A. A need for admiration and a grandiose view of self-importance
- B. Unlawful actions and lack of empathy
- C. Fear of abandonment and impulsiveness
- D. A disregard for others with manipulative behaviors
Correct answer: C
Rationale: The correct answer is C: Fear of abandonment and impulsiveness. Individuals with Borderline Personality Disorder often exhibit intense fears of abandonment, engage in impulsive behaviors such as self-harm or substance abuse, and struggle with unstable relationships. Choices A, B, and D do not align with the characteristic features commonly associated with Borderline Personality Disorder. A need for admiration and grandiosity (Choice A) is more characteristic of Narcissistic Personality Disorder. Unlawful actions and lack of empathy (Choice B) are more typical of Antisocial Personality Disorder. A disregard for others with manipulative behaviors (Choice D) is often seen in individuals with traits of Histrionic or Antisocial Personality Disorders.
4. A healthcare provider writes a prescription for a medication dose three times the normal range. What should the nurse do?
- A. Administer the medication as prescribed
- B. Question the prescription with the provider
- C. Consult with the pharmacist about the dosage
- D. Delay the medication until verification can be made
Correct answer: B
Rationale: The correct action for the nurse in this situation is to question the prescription with the provider. Administering a medication dose three times the normal range without clarification could pose serious risks to the client. Consulting with the pharmacist about the dosage or delaying the medication until verification can be made are not the initial steps to take; the nurse should first clarify the prescription with the healthcare provider to ensure patient safety.
5. What are the common side effects of opioid analgesics, and how should they be managed?
- A. Drowsiness and dizziness, ensuring safety precautions
- B. Respiratory depression, ensuring adequate ventilation
- C. Constipation and nausea, managed with stool softeners
- D. Nausea and vomiting, managing with antiemetics
Correct answer: A
Rationale: The correct answer is A. Common side effects of opioid analgesics include drowsiness and dizziness. These side effects can impair a person's ability to operate machinery or drive safely. To manage these side effects, it is essential to advise patients to avoid activities that require alertness until they know how the medication affects them. Choices B, C, and D are incorrect because respiratory depression, constipation, and nausea are also common side effects of opioids, but they are not the primary side effects being asked for in this question.
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