ATI RN
ATI Capstone Comprehensive Assessment B
1. What is the recommended procedure for a healthcare professional to follow when applying sterile gloves?
- A. Use non-sterile gloves first, followed by sterile gloves.
- B. Put on sterile gloves, then gown.
- C. Apply gloves after donning a mask.
- D. Apply gloves before touching any sterile equipment.
Correct answer: D
Rationale: The correct procedure for applying sterile gloves is to do so before touching any sterile equipment or surfaces. This helps maintain the sterility of the gloves. Choices A, B, and C are incorrect because they suggest incorrect sequences that may compromise the sterility of the gloves. Using non-sterile gloves first can introduce contamination, putting on gloves before a gown can lead to contamination of the gloves during gowning, and applying gloves after donning a mask can risk contamination of the gloves from the mask.
2. How should a nurse respond to a client with terminal cancer who has requested a change in the level of pain medication?
- A. Increase the dosage without consulting the healthcare provider.
- B. Consult with the healthcare provider to adjust the medication.
- C. Ignore the request as the client is near the end of life.
- D. Increase the medication to reduce pain faster.
Correct answer: B
Rationale: The correct answer is to consult with the healthcare provider to adjust the medication. It is crucial for the healthcare provider to be involved in changing pain medication for a client with terminal cancer to ensure that the new dosage is appropriate and safe. Option A is incorrect because adjusting medication without consulting the healthcare provider can be dangerous and is not within the scope of the nurse's practice. Option C is incorrect because ignoring the client's request goes against the principles of patient-centered care. Option D is incorrect as the primary goal should be to provide effective pain relief with the appropriate dosage, not to increase the medication arbitrarily.
3. What is the most important action for the nurse to take after finding a patient on the floor who reports, 'I fell out of bed'?
- A. Reassess the patient.
- B. Complete an incident report.
- C. Notify the health care provider.
- D. Take no action, as no harm has occurred.
Correct answer: C
Rationale: The most important action for the nurse to take after finding a patient on the floor who reports falling out of bed is to notify the health care provider. This is crucial to ensure that the incident is reported, documented, and that the patient receives necessary follow-up care. Reassessing the patient is important, but notifying the healthcare provider takes precedence to address any potential injuries or issues that may have resulted from the fall. Completing an incident report is necessary, but immediate notification to the healthcare provider is more critical in this situation. Doing nothing is not an appropriate response, as the patient's safety and well-being must be the top priority.
4. A healthcare provider is caring for a client who has an indwelling urinary catheter. Which of the following assessment findings indicates that the catheter requires irrigation?
- A. Bladder scan shows 525 mL
- B. Absent urinary output for 1 hour
- C. Cloudy urine
- D. Bloody urine
Correct answer: A
Rationale: The correct answer is A. A large bladder scan result (525 mL) suggests catheter blockage and may require irrigation to resolve. Choice B (absent urinary output for 1 hour) could indicate a different issue such as urinary retention but does not specifically indicate the need for catheter irrigation. Choices C (cloudy urine) and D (bloody urine) may suggest infection or other urinary issues, but they do not directly indicate the need for catheter irrigation.
5. During an initial visit, a home health nurse is assessing a client who has cultural beliefs different from their own. Which of the following questions should the nurse ask to determine the client's beliefs about environmental control?
- A. Do you spend more time thinking about the past, present, or future?
- B. Who makes most of the decisions in your family group?
- C. What do you think you can do to affect your health status?
- D. Can you list any diseases that your parents or siblings have had?
Correct answer: C
Rationale: The correct question to ask in this scenario is: 'What do you think you can do to affect your health status?' This question directly addresses the client's beliefs about their ability to control their health and reflects their beliefs about environmental control. Choices A, B, and D do not directly relate to assessing the client's beliefs about environmental control. Choice A focuses on time orientation, choice B pertains to family decision-making dynamics, and choice D is related to family medical history, which are not directly relevant to understanding the client's beliefs about environmental control.
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