ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 B
1. 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.
2. A nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of the following statements indicates an understanding of the teaching?
- A. I should avoid taking acetaminophen while taking this medication
- B. I will take this medication at the same time each day
- C. I will need to get my blood tested regularly while taking this medication
- D. I should increase my intake of leafy green vegetables
Correct answer: C
Rationale: The correct answer is C. Warfarin therapy requires regular blood testing to monitor INR levels and ensure therapeutic dosing. Option A is incorrect because acetaminophen can be taken with warfarin. Option B is not specific to warfarin administration. Option D is incorrect as it does not address the key monitoring requirement of blood testing while on warfarin.
3. A client with hypertension is receiving teaching from a healthcare provider. Which statement demonstrates comprehension of the instruction?
- A. I will limit my daily salt intake to 3g
- B. I will discontinue my medication when I start feeling better
- C. I will adhere to a consistent daily medication schedule
- D. I will engage in 60 minutes of exercise every day
Correct answer: C
Rationale: Choice C is the correct answer because taking hypertension medication at the same time each day ensures its effectiveness in managing blood pressure. Consistency in medication intake is crucial to control hypertension. Option A focuses on dietary management, which is essential but not directly related to medication adherence. Option B is incorrect as stopping hypertension medication abruptly can lead to complications. Option D addresses the importance of exercise, which is beneficial for hypertension but not directly related to medication adherence.
4. Which of the following best describes a somatic symptom disorder?
- A. Client experiences sudden onset of symptoms due to stress
- B. Physical manifestations occur due to underlying medical conditions
- C. Client has excessive preoccupation with physical symptoms without a medical cause
- D. Client avoids medical care due to fear of receiving a diagnosis
Correct answer: C
Rationale: The correct answer is C. Somatic symptom disorder is characterized by individuals having excessive preoccupation with physical symptoms that may or may not have an identifiable medical cause. Choice A is incorrect because the sudden onset of symptoms due to stress is more indicative of acute stress reaction. Choice B is incorrect as it describes physical manifestations related to known medical conditions, not somatic symptom disorder. Choice D is incorrect as it relates to health anxiety or illness anxiety disorder, where individuals avoid seeking medical care due to fear of receiving a diagnosis.
5. How should a healthcare professional respond to a patient experiencing hypoglycemia?
- A. Rechecking the blood glucose level in 15 minutes
- B. Encouraging the patient to eat a high-protein snack
- C. Administering 15g of fast-acting carbohydrates
- D. Administering glucagon if the patient is unconscious
Correct answer: C
Rationale: The correct response to a patient experiencing hypoglycemia is to administer 15g of fast-acting carbohydrates. This helps quickly increase the blood glucose levels in the patient, addressing the low blood sugar. Rechecking the blood glucose level in 15 minutes (Choice A) may delay necessary intervention, encouraging a high-protein snack (Choice B) is not recommended as it does not rapidly increase blood sugar levels, and administering glucagon if the patient is unconscious (Choice D) is typically done in severe cases of hypoglycemia when the patient is unable to eat or drink.
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