ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 A with NGN
1. A healthcare provider prescribes a higher-than-usual dose of medication. What is the nurse's first action?
- A. Administer the medication and monitor closely.
- B. Hold the medication and consult the pharmacist.
- C. Ask another nurse to verify the dose.
- D. Call the provider for clarification.
Correct answer: D
Rationale: The correct answer is to call the provider for clarification. When faced with a higher-than-usual dose of medication, the nurse's first action should be to contact the prescribing healthcare provider to confirm the dosage. Administering the medication without clarifying the dose with the provider can pose serious risks to the patient's safety. Holding the medication and consulting the pharmacist may be appropriate after contacting the provider for clarification. Asking another nurse to verify the dose is not the most appropriate action when dealing with an unusual prescription; direct communication with the provider is essential in such situations.
2. A patient with a left arm fracture reports severe pain unrelieved by medication. What should the nurse assess for?
- A. Check for compartment syndrome
- B. Increase the pain medication
- C. Prepare the patient for surgery immediately
- D. Administer a sedative to calm the patient
Correct answer: A
Rationale: Correct answer: When a patient with a left arm fracture reports severe pain unrelieved by medication, the nurse should assess for compartment syndrome. Compartment syndrome is a condition where increased pressure within a muscle compartment compromises circulation and can lead to tissue damage. It is a surgical emergency that requires immediate intervention. Choice B is incorrect because simply increasing pain medication without identifying the cause of the unrelieved pain may mask symptoms of a serious issue like compartment syndrome. Choice C is incorrect as surgery would only be necessary if compartment syndrome is confirmed. Choice D is incorrect as administering a sedative does not address the underlying issue of unrelieved pain and may delay appropriate treatment.
3. The nurse is evaluating the effectiveness of guided imagery for pain management in a patient with second- and third-degree burns requiring extensive dressing changes. Which finding best indicates the effectiveness of guided imagery?
- A. The patient's need for analgesic medication decreases during the dressing changes.
- B. The patient rates pain during the dressing change as a 6 on a scale of 0 to 10.
- C. The patient asks for pain medication during the dressing changes only once throughout the procedure.
- D. The patient's facial expressions remain stoic during the procedure.
Correct answer: A
Rationale: The correct answer is A. A reduction in the need for analgesic medication indicates that guided imagery is effective in managing the patient's pain. Choices B, C, and D do not directly measure the effectiveness of guided imagery. A patient rating pain as 6 on a scale of 0 to 10, asking for pain medication once, or having stoic facial expressions may not necessarily reflect the impact of guided imagery on pain management.
4. A healthcare provider gives a verbal order for a medication. The nurse is uncomfortable with the order and questions its appropriateness. What should the nurse do?
- A. Refuse to administer the medication and document the refusal.
- B. Clarify the order with the provider before proceeding.
- C. Administer the medication and monitor the patient.
- D. Call a pharmacy consult to discuss the medication.
Correct answer: B
Rationale: The correct action for the nurse to take when uncomfortable with a verbal order for medication is to clarify the order with the provider before proceeding. This ensures patient safety by confirming the appropriateness of the order and prevents any potential harm. Choice A is incorrect because refusing to administer the medication without clarification may delay necessary treatment for the patient. Choice C is incorrect as administering the medication without clarification could pose risks if the order is indeed inappropriate. Choice D is also incorrect as the first step should be direct clarification with the provider before involving others.
5. A nurse is preparing to administer a medication that requires a peak and trough level. What is the nurse's priority action?
- A. Administer the medication before the peak level is obtained.
- B. Withhold the medication until the trough level is obtained.
- C. Administer the medication based on the previous trough level.
- D. Ensure that the medication is administered within 2 hours of the peak level.
Correct answer: B
Rationale: The nurse's priority action should be to withhold the medication until the trough level is obtained. This is crucial to ensure accurate dosing based on the patient's levels. Administering the medication before the peak level is obtained (choice A) can lead to incorrect dosing. Administering the medication based on the previous trough level (choice C) may not reflect the current levels accurately. Ensuring that the medication is administered within 2 hours of the peak level (choice D) is not necessary for obtaining accurate peak and trough levels.
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