ATI RN
RN ATI Capstone Proctored Comprehensive Assessment A
1. A client with severe dyspnea is scheduled for multiple diagnostic tests. Which test should the nurse prioritize?
- A. Administer an echocardiogram first.
- B. Prioritize a chest x-ray for the client.
- C. Prepare the client for a CT scan.
- D. Order an MRI first.
Correct answer: B
Rationale: The correct answer is B: Prioritize a chest x-ray for the client. When a client presents with severe dyspnea, a chest x-ray should be prioritized as it helps in assessing the lungs and heart, which are crucial in cases of respiratory distress. Echocardiograms are more focused on assessing heart function and may not provide immediate information needed in cases of dyspnea. CT scans and MRIs are more detailed imaging studies that are not typically the first-line diagnostic tests for severe dyspnea.
2. What are the signs of infection that should be monitored in a postoperative patient?
- A. Fever and chills
- B. All of the above
- C. Increased pain or tenderness
- D. Redness, swelling, and warmth at the surgical site
Correct answer: D
Rationale: The correct answer is D: 'Redness, swelling, and warmth at the surgical site.' These are specific signs of infection at the surgical site that a nurse should monitor for in a postoperative patient. While fever, chills, and increased pain can also indicate infection, the most direct signs are redness, swelling, and warmth at the surgical site. Therefore, 'D' is the best choice as it directly relates to the site of the surgery and is crucial to monitor for potential postoperative infections.
3. A health care provider asks the nurse to administer a medication with a dosage significantly higher than usual. What is the nurse's first action?
- A. Administer the medication as ordered.
- B. Question the provider and verify the dose.
- C. Administer half the dosage as a precaution.
- D. Refuse to administer the medication without clarification.
Correct answer: B
Rationale: When a health care provider orders a medication with a dosage significantly higher than usual, the nurse's initial action should be to question the provider and verify the dose. This is crucial to ensure patient safety and prevent medication errors. Administering the medication as ordered (Choice A) without clarification could potentially harm the patient if there was an error in the prescription. Administering half the dosage as a precaution (Choice C) is not a safe practice as it deviates from the prescribed order. Refusing to administer the medication without clarification (Choice D) is important, but the first step should be to seek clarification from the provider to prevent any unnecessary delays in patient care.
4. A nurse is preparing to measure a client's level of oxygen saturation and observes edema of both hands and thickened toenails. The nurse should apply the pulse oximeter probe to which of the following locations?
- A. Finger
- B. Earlobe
- C. Toe
- D. Skin fold
Correct answer: B
Rationale: When a client has edema of both hands and thickened toenails, these conditions can impede accurate readings from the finger and toe locations. The earlobe is the best alternative site for the pulse oximeter probe in this scenario. Placing the probe on the earlobe will help ensure a more accurate measurement of oxygen saturation despite the issues with the hands and toenails. Therefore, the correct answer is to apply the pulse oximeter probe to the earlobe. Choices A, C, and D are incorrect because of the potential limitations presented by the edema and thickened toenails.
5. A client with a new diagnosis of type 1 diabetes mellitus is being taught about self-administration of insulin by a nurse. Which of the following instructions should the nurse include?
- A. Store the current bottle of insulin at room temperature
- B. Massage the injection site after removing the needle
- C. Pull back on the plunger after injecting the insulin
- D. Use each syringe up to six times
Correct answer: A
Rationale: The correct answer is to store the current bottle of insulin at room temperature. Insulin should be stored this way to maintain its potency and effectiveness. Choice B is incorrect because massaging the injection site after removing the needle is not recommended practice and can cause bruising. Choice C is incorrect as pulling back on the plunger after injecting insulin can lead to injecting air bubbles into the tissue. Choice D is incorrect as syringes should not be reused multiple times due to the risk of contamination and inaccurate dosing.
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