ATI RN
RN ATI Capstone Proctored Comprehensive Assessment Form A
1. A county public health nurse is developing a list of interventions to address the three core functions of public health. Which of the following interventions should the nurse include as part of the assurance function?
- A. Use surveillance to investigate outbreaks of foodborne illness
- B. Monitor the incidence rates of varicella every 2 months
- C. Organize an immunization clinic for at-risk members of the community
- D. Educate the community about the health risks of alcohol use
Correct answer: C
Rationale: The correct answer is C: 'Organize an immunization clinic for at-risk members of the community.' This intervention is part of the assurance function in public health, as it ensures that the community has access to preventive health services. Choice A is related to the assessment function as it involves surveillance to investigate outbreaks. Choice B is also related to the assessment function since it involves monitoring incidence rates. Choice D is associated with the policy development function as it involves educating the community about health risks.
2. How can a healthcare provider prevent pressure ulcers in an immobile patient?
- A. Turn the patient every 4 hours.
- B. Provide the patient with a special mattress.
- C. Elevate the patient's legs to reduce pressure.
- D. Limit the patient's movement to reduce friction.
Correct answer: B
Rationale: Providing the immobile patient with a special mattress is an effective way to prevent pressure ulcers. Special mattresses help distribute pressure evenly and reduce the risk of developing pressure ulcers by relieving pressure on sensitive areas. Turning the patient every 4 hours (Choice A) is a standard practice to prevent pressure ulcers but may not be as effective as using a special mattress. Elevating the patient's legs (Choice C) can help with circulation but may not directly prevent pressure ulcers. Limiting the patient's movement (Choice D) can lead to other complications and is not a recommended method for preventing pressure ulcers.
3. A nurse is assessing the skin of an immobilized patient. What will the nurse do?
- A. Use a standardized tool such as the Braden Scale.
- B. Limit the amount of fluid intake.
- C. Have special times for inspection so as not to interrupt routine care.
- D. Assess the skin every 4 hours.
Correct answer: A
Rationale: The correct answer is A. When assessing the skin of an immobilized patient, it is essential to use a standardized tool such as the Braden Scale to identify patients at high risk for impaired skin integrity. This tool helps in early identification and appropriate intervention. Choice B, limiting fluid intake, is not directly related to skin assessment. Choice C, having special times for inspection, may not ensure timely identification of skin issues. Choice D, assessing the skin every 4 hours, lacks specificity regarding the use of a validated tool for risk assessment.
4. A client reports difficulty sleeping while in the hospital. Which of the following actions taken by the assistive personnel (AP) while the client is sleeping should prompt the nurse to intervene?
- A. Closes the door to the client's room
- B. Flushes the client's toilet after emptying the urinary catheter's drainage bag
- C. Measures the client's vital signs routinely
- D. Asks a group of personnel in the hall to speak quietly
Correct answer: B
Rationale: The correct answer is B because flushing the client's toilet after emptying the urinary catheter's drainage bag could disturb the client's rest. The nurse should intervene to ensure a restful environment for the client. Choices A, C, and D are not actions that would be disruptive to the client's sleep. Closing the door to the client's room, measuring vital signs routinely, and asking personnel in the hall to speak quietly are appropriate actions that do not directly disturb the client's rest.
5. What are the nursing interventions for a patient with pneumonia?
- A. Providing fluids and rest
- B. Monitoring lung sounds and respiratory rate
- C. Encouraging coughing and deep breathing exercises
- D. Administering antibiotics and providing oxygen therapy
Correct answer: B
Rationale: The correct nursing interventions for a patient with pneumonia include monitoring lung sounds and respiratory rate to assess the effectiveness of treatment and the patient's respiratory status. Providing fluids and rest (Choice A) can be supportive measures but are not specific nursing interventions for pneumonia. Encouraging coughing and deep breathing exercises (Choice C) can be helpful for airway clearance but may not be appropriate for all patients with pneumonia. Administering antibiotics and providing oxygen therapy (Choice D) are medical interventions rather than nursing interventions.
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