ATI RN
RN ATI Capstone Proctored Comprehensive Assessment A
1. What is the priority intervention for a patient experiencing chest pain?
- A. Administer nitroglycerin as prescribed.
- B. Encourage the patient to take deep breaths.
- C. Monitor the patient's blood pressure closely.
- D. Encourage the patient to rest in a comfortable position.
Correct answer: A
Rationale: The correct answer is to administer nitroglycerin as prescribed. Nitroglycerin helps relieve chest pain by dilating blood vessels and improving blood flow, addressing the immediate concern of chest pain. Encouraging deep breaths may not be appropriate for chest pain, monitoring blood pressure, although important, is not the priority when the patient is experiencing chest pain, and while resting in a comfortable position is beneficial, administering nitroglycerin is the priority intervention to address the chest pain.
2. A nurse is reviewing the medical record of a client who has osteomyelitis and a prescription for gentamicin IV every 8 hours. Which of the following serum laboratory results should the nurse report to the provider before administering the gentamicin?
- A. Hematocrit 45%
- B. Sodium 140 mEq/L
- C. Creatinine 2.4 mg/dL
- D. Potassium 4.0 mEq/L
Correct answer: C
Rationale: An elevated creatinine level indicates potential kidney dysfunction, which is crucial when administering gentamicin as it can be nephrotoxic. Reporting a high creatinine level to the provider is essential to prevent further kidney damage. Choice A (Hematocrit 45%) is within the normal range and not directly related to gentamicin administration. Choice B (Sodium 140 mEq/L) and Choice D (Potassium 4.0 mEq/L) are also within normal limits and do not directly impact the administration of gentamicin.
3. A school nurse is developing a teaching plan about testicular cancer for a group of clients. Which of the following information should the nurse include in the teaching?
- A. Perform a testicular self-examination weekly.
- B. Do not palpate the epididymis when performing a testicular self-examination.
- C. Expect testicles to be uniform in consistency when performing a testicular self-examination.
- D. Perform a testicular self-examination after a cool shower.
Correct answer: C
Rationale: The correct answer is C because testicles should be uniform in consistency when performing a self-exam, and any lumps or abnormalities should be reported. Choice A is incorrect as testicular self-examinations should be performed monthly, not weekly. Choice B is incorrect because the epididymis should be included in the examination. Choice D is incorrect because a warm shower helps relax the scrotum, making the exam easier to perform.
4. A nurse manager is preparing to complete staff performance appraisals. Which of the following principles should the nurse manager consider when completing the appraisals?
- A. Performance appraisals should be written in measurable terms
- B. Appraisal objectives should be applicable to staff at every level
- C. Performance appraisals should be based on the nurse manager's preferences
- D. Completed appraisals should be approved by a provider
Correct answer: A
Rationale: Corrected Rationale: Performance appraisals should indeed be written in measurable terms to ensure objective evaluations based on specific outcomes achieved. This allows for a clear assessment of staff performance. Choice B is incorrect because appraisal objectives should be tailored to each staff member's role and responsibilities, not necessarily applicable at every level. Choice C is incorrect as performance appraisals should be objective and based on predefined criteria, not solely on the nurse manager's preferences. Choice D is incorrect as completed appraisals usually require approval from higher-level management or HR, not necessarily a provider.
5. What is the most appropriate method for preventing catheter-associated urinary tract infections (CAUTIs)?
- A. Insert a urinary catheter using clean gloves.
- B. Limit the duration of catheter use.
- C. Use a smaller size catheter to prevent trauma.
- D. Change the catheter tubing every 24 hours.
Correct answer: B
Rationale: The correct answer is B: Limit the duration of catheter use. Limiting the duration of catheterization is a crucial method for preventing catheter-associated urinary tract infections (CAUTIs). Prolonged catheter use increases the risk of introducing pathogens into the urinary tract, leading to infections. Using clean gloves for insertion (choice A) is important for preventing contamination but does not address the main cause of CAUTIs. Using a smaller size catheter (choice C) may help reduce trauma but does not directly prevent infections. Changing the catheter tubing every 24 hours (choice D) is not necessary unless clinically indicated, and it is not the most effective method for preventing CAUTIs.
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