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. A healthcare provider is assessing a patient with chronic pain. Which finding is most concerning?
- A. The patient reports a pain level of 6 on a scale of 0 to 10.
- B. The patient is lying still and refuses to move.
- C. The patient's pain persists despite medication.
- D. The patient reports feeling anxious and restless.
Correct answer: C
Rationale: In the context of chronic pain management, the most concerning finding is when the patient's pain persists despite medication. This suggests inadequate pain control or the need for a re-evaluation of the treatment plan. Choices A, B, and D are not as concerning in this scenario. A pain level of 6 on a scale of 0 to 10 is moderate and may be manageable with appropriate interventions. Patients with chronic pain can sometimes lie still due to pain or other reasons, and anxiety and restlessness are common in individuals with pain conditions but may not necessarily indicate a critical issue like uncontrolled pain.
3. A patient with severe pain and leg swelling is admitted. What should the nurse assess for?
- A. Check for signs of deep vein thrombosis.
- B. Assess for compartment syndrome.
- C. Increase the patient's fluid intake.
- D. Prepare the patient for surgery to relieve pain.
Correct answer: B
Rationale: When a patient presents with severe pain and leg swelling, the nurse should assess for compartment syndrome. Compartment syndrome is a serious condition that can develop due to increased pressure within a muscle compartment, leading to compromised circulation and potential tissue damage. It is crucial to identify compartment syndrome promptly as it may require immediate intervention to prevent further complications. Checking for signs of deep vein thrombosis (Choice A) is also important in a patient with leg swelling, but in this scenario, the focus should be on assessing for compartment syndrome due to the severity of the symptoms. Increasing fluid intake (Choice C) may not address the underlying cause of the patient's symptoms. Preparing the patient for surgery (Choice D) without a comprehensive assessment and diagnosis is premature and may not be the appropriate initial intervention.
4. A patient with a urinary catheter reports discomfort. What is the nurse's priority action?
- A. Ensure the catheter tubing is not kinked.
- B. Irrigate the catheter to relieve the discomfort.
- C. Change the catheter to a smaller size.
- D. Remove the catheter and replace it with a new one.
Correct answer: A
Rationale: The correct answer is to ensure the catheter tubing is not kinked. This is the priority action because a kinked tubing can obstruct urine flow, leading to discomfort and potential complications. It is essential to troubleshoot the current catheter first before considering other interventions. Irrigating the catheter (Choice B) may not address the underlying issue of kinking. Changing the catheter to a smaller size (Choice C) or removing and replacing it with a new one (Choice D) should only be considered if ensuring the tubing is unkinked does not resolve the discomfort.
5. Which action by the nurse demonstrates effective infection control measures?
- A. Perform hand hygiene before and after patient contact.
- B. Wear gloves when administering medications.
- C. Dispose of used equipment in designated containers.
- D. Wear a mask when interacting with the patient.
Correct answer: A
Rationale: The correct answer is A: Perform hand hygiene before and after patient contact. Effective hand hygiene is a fundamental infection control measure that helps prevent the spread of pathogens. Wearing gloves when administering medications (choice B) is important for protecting both the patient and the nurse but is not a direct demonstration of infection control. Disposing of used equipment in designated containers (choice C) is more related to proper waste management than infection control. Wearing a mask when interacting with the patient (choice D) is essential in certain situations, but hand hygiene is a more universal and critical practice for infection control.
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