ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 B with NGN
1. A nurse is assessing a client who is postoperative. Which of the following findings should the nurse prioritize?
- A. Elevated temperature
- B. Low blood pressure
- C. Decreased urine output
- D. Increased heart rate
Correct answer: C
Rationale: In a postoperative client, decreased urine output is a crucial finding as it can indicate impaired kidney function or inadequate fluid balance. Prioritizing assessment and intervention for decreased urine output is essential to prevent complications like acute kidney injury. Elevated temperature, low blood pressure, and increased heart rate are also important, but they may not be as urgent or directly related to kidney function in a postoperative client.
2. What is a major goal for home care nurses?
- A. Restoring maximum health function.
- B. Promoting the health of populations.
- C. Minimizing the progress of disease.
- D. Maintaining the health of populations.
Correct answer: A
Rationale: A major goal for home care nurses is restoring maximum health function. This involves helping patients achieve their highest level of health and independence, focusing on individualized care plans tailored to each patient's needs. Choice B, promoting the health of populations, is more aligned with public health nursing rather than home care nursing. Choice C, minimizing the progress of disease, is important but not as comprehensive as restoring maximum health function. Choice D, maintaining the health of populations, is more about preventive care at a population level rather than the individualized care provided by home care nurses.
3. How should a healthcare provider handle a patient with non-compliance to hypertension medication?
- A. Provide education about medication
- B. Refer the patient to a specialist
- C. Explore alternative treatments
- D. Reassess the patient in 6 months
Correct answer: A
Rationale: Providing education about the importance of medication adherence is crucial in managing hypertension. By educating the patient about the significance of taking their medication as prescribed, the healthcare provider can help improve compliance and control the patient's blood pressure. Referring the patient to a specialist (Choice B) may be necessary in some cases but addressing non-compliance should start with education. Exploring alternative treatments (Choice C) could be considered if the current medication is not suitable, but initial steps should focus on improving adherence. Reassessing the patient in 6 months (Choice D) may be too delayed if non-compliance is an issue that needs immediate attention.
4. A toddler’s mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurse’s response should be based on which premise?
- A. An emergency laparotomy is very likely.
- B. The location needs to be confirmed by radiographic examination.
- C. Surgery will be necessary if the battery has not passed in the stool in 48 hours.
- D. Careful observation is essential because an ingested battery cannot be accurately detected.
Correct answer: B
Rationale: Radiographic examination is essential to confirm the location of the battery, as it can cause significant damage, particularly if lodged in the esophagus. Immediate surgery may be required depending on its location and the potential for causing harm.
5. A patient taking oral contraceptives reports breakthrough bleeding. What should the nurse assess in this patient?
- A. Adherence to the medication schedule
- B. The possibility of pregnancy
- C. The need for an increased dosage
- D. The effectiveness of the current oral contraceptive
Correct answer: A
Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, the nurse should assess the patient's adherence to the medication schedule. Breakthrough bleeding can be a sign of missed doses or inconsistent timing, which can decrease the effectiveness of oral contraceptives. Assessing the patient's adherence helps in ensuring proper use of the medication. Choices B, C, and D are incorrect because breakthrough bleeding is more likely related to adherence issues rather than pregnancy, the need for increased dosage, or the effectiveness of the current oral contraceptive.
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