ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 B with NGN
1. When administering a subcutaneous injection of insulin to a client, what angle should the nurse use for the injection?
- A. 45-degree angle
- B. 60-degree angle
- C. 90-degree angle
- D. 30-degree angle
Correct answer: C
Rationale: The correct angle for administering a subcutaneous injection, such as insulin, is 90 degrees. This angle allows for the medication to be delivered into the subcutaneous layer of tissue beneath the skin. A 45-degree angle is typically used for administering subcutaneous injections in infants or those with reduced adipose tissue, while a 60-degree angle is commonly used for intramuscular injections. A 30-degree angle is not a standard angle for subcutaneous injections.
2. An occupational health nurse in a factory is planning interventions to reduce environmental stressors for employees. Which of the following interventions should the nurse use to affect physical agents in the environment?
- A. Teach workers to choose personal strategies to cope with work stress
- B. Limit the amount of time workers spend in temperatures over 43.3°C (110°F)
- C. Provide ear plugs for use at workstations throughout the factory
- D. Obtain dosimeters for employees to wear when using new machinery that emits radiation
Correct answer: B
Rationale: Limiting exposure to extreme temperatures is important to protect workers from heat-related illnesses.
3. 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.
4. A patient is receiving a blood transfusion and develops chills, a headache, and low back pain. What is the nurse’s priority action?
- A. Administer acetaminophen
- B. Stop the transfusion
- C. Slow the transfusion rate
- D. Administer antihistamines
Correct answer: B
Rationale: The correct answer is to stop the transfusion (Choice B). The symptoms described - chills, headache, and low back pain - are indicative of a transfusion reaction. The priority action is to immediately stop the transfusion to prevent further complications such as more severe reactions like hemolytic reactions or anaphylaxis. Administering acetaminophen (Choice A) may help with symptoms but does not address the underlying cause. Slowing the transfusion rate (Choice C) may not be sufficient if a serious transfusion reaction is occurring. Administering antihistamines (Choice D) is not the priority in this situation; stopping the transfusion takes precedence to ensure patient safety.
5. When preparing to give a report during a shift change, what information is most critical to communicate?
- A. Include a full family medical history.
- B. Focus on changes in the patient's condition.
- C. Summarize the patient's treatment plan.
- D. Provide updates on the patient's lab results.
Correct answer: B
Rationale: During a shift change report, the most critical information to communicate is focusing on changes in the patient's condition. This helps ensure that all healthcare providers are aware of any significant developments or deterioration in the patient's health status, allowing for timely and appropriate interventions. Choices A, C, and D are not as crucial during a shift report. While a full family medical history and treatment plan are important aspects of patient care, they are not the primary focus during a shift change report. Providing updates on lab results may be important but may not be as time-sensitive or immediately impactful as changes in the patient's condition.
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