ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 A with NGN
1. Which intervention will best help a patient with chronic pain maintain mobility?
- A. Provide the patient with opioids to control pain.
- B. Encourage stretching exercises to improve flexibility.
- C. Teach the patient to use assistive devices like a cane.
- D. Recommend complete bed rest until the pain subsides.
Correct answer: B
Rationale: Encouraging stretching exercises is the most appropriate nursing intervention to help a patient with chronic pain maintain mobility. Stretching exercises can improve flexibility, prevent stiffness, and promote better range of motion in patients with chronic pain. Providing opioids (Choice A) may help control pain but does not directly address mobility. Teaching the patient to use assistive devices (Choice C) may be beneficial but does not focus on improving mobility directly. Recommending complete bed rest (Choice D) can lead to deconditioning and further loss of mobility, which is not recommended for chronic pain management.
2. A patient reports feeling dizzy when standing up. What is the most appropriate nursing intervention?
- A. Encourage the patient to take deep breaths.
- B. Assist the patient to sit down slowly.
- C. Instruct the patient to use a walker for support.
- D. Teach the patient how to change positions safely.
Correct answer: B
Rationale: The correct answer is to assist the patient to sit down slowly. This intervention is appropriate for a patient experiencing dizziness when standing up, as it helps prevent falls due to orthostatic hypotension. Encouraging deep breaths (Choice A) may not address the underlying cause of dizziness, which is related to postural changes. Instructing the patient to use a walker for support (Choice C) or teaching the patient how to change positions safely (Choice D) are not the most immediate and direct interventions to address the immediate risk of falling when feeling dizzy upon standing.
3. What are the instructions for a behind-the-ear hearing aid?
- A. Remove before sleeping
- B. Remove before shower
- C. Keep on during all activities
- D. Replace every week
Correct answer: B
Rationale: The correct answer is to remove a behind-the-ear hearing aid before showering to prevent water damage. Choice A is incorrect because it is safe to wear the hearing aid while sleeping as it does not pose a risk of damage. Choice C is incorrect because it is advisable to remove the hearing aid during certain activities to prevent damage or loss. Choice D is incorrect as hearing aids do not need to be replaced weekly unless there is an issue with the device.
4. A nurse is assigned to care for four clients. Which client should the nurse assess first?
- A. A client with chest pain and shortness of breath
- B. A client with a fever of 100°F
- C. A client scheduled for surgery
- D. A client with stable vital signs
Correct answer: A
Rationale: The correct answer is A. Chest pain and shortness of breath are symptoms that could indicate a life-threatening condition such as a heart attack or pulmonary embolism. Therefore, this client should be assessed first to ensure prompt intervention and treatment. Choice B, a client with a fever of 100°F, may indicate an infection but is not immediately life-threatening compared to the symptoms of chest pain and shortness of breath. Choice C, a client scheduled for surgery, is not an immediate priority unless there are specific preoperative assessments or interventions required. Choice D, a client with stable vital signs, does not indicate an urgent need for assessment compared to the client with chest pain and shortness of breath.
5. A nurse in an emergency department is preparing a change-of-shift report for an adult client who is transferring to a medical-surgical unit using the SBAR communication tool. Which of the following information should the nurse include in the report?
- A. The client has a do-not-resuscitate order.
- B. The client has a continuous IV of lactated Ringer's.
- C. The client was straight catheterized for 350 mL 2 hours ago.
- D. The client has Medicare insurance.
Correct answer: A
Rationale: In an SBAR report, key information such as the client's do-not-resuscitate (DNR) status should be included as it directly impacts the client's care and treatment plan. Choices B and C are important details but may not be as critical for immediate care planning during the shift change. Choice D, the client having Medicare insurance, is important for billing purposes but does not directly impact the client's immediate care needs.
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