ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 B
1. A healthcare professional is caring for a client with impaired mobility. Which of the following support devices should the healthcare professional plan to use to prevent the client from developing plantar flexion contractures?
- A. Sheepskin heel pad
- B. Footboard
- C. Trochanter roll
- D. Abduction pillow
Correct answer: B
Rationale: A footboard is the correct choice to prevent plantar flexion contractures by maintaining proper alignment of the feet. Plantar flexion contractures involve the foot pointing downward, and a footboard helps keep the foot in a neutral position. Choice A, the sheepskin heel pad, is used for pressure ulcer prevention and comfort but does not specifically address plantar flexion contractures. Choice C, the trochanter roll, is used for hip positioning, not foot alignment. Choice D, the abduction pillow, is used to maintain proper positioning of the legs but does not directly address plantar flexion contractures.
2. A nurse is providing teaching to a client who has a new prescription for an albuterol inhaler. Which of the following instructions should the nurse include?
- A. Take one puff every 5 minutes until symptoms improve.
- B. Hold your breath for 10 seconds after inhaling the medication.
- C. Shake the inhaler for 2 seconds before use.
- D. Exhale forcefully after each puff.
Correct answer: B
Rationale: The correct answer is B. Instructing the client to hold their breath for 10 seconds after inhaling the medication allows it to reach deeper into the lungs for maximum effectiveness. Choice A is incorrect because taking one puff every 5 minutes may lead to overuse of the medication. Choice C is incorrect as shaking the inhaler for only 2 seconds may not provide adequate mixing of the medication. Choice D is incorrect because exhaling forcefully after each puff may reduce the amount of medication that reaches the lungs.
3. According to Jean Piaget, what is the balance between internal structures and information that children encounter in their everyday worlds?
- A. imitation
- B. adaptation
- C. cognition
- D. equilibrium
Correct answer: D
Rationale: According to Jean Piaget, equilibrium is the balance between what children already know (internal structures) and the new information they encounter. Imitation (choice A) is not directly related to this concept. Adaptation (choice B) involves adjusting to new information and is part of Piaget's theory, but it does not specifically refer to the balance between internal structures and external information. Cognition (choice C) is a broader term that encompasses mental processes, including thinking, learning, and problem-solving, but it is not specifically about the balance between internal structures and external information as equilibrium is.
4. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What important contraindication should the nurse emphasize during patient education?
- A. Use of nitrates
- B. History of hypertension
- C. History of peptic ulcer disease
- D. Use of antihypertensive medications
Correct answer: A
Rationale: The correct answer is A: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients using nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices B, C, and D are incorrect because they are not direct contraindications for sildenafil use. While a history of hypertension or peptic ulcer disease may require caution, they are not absolute contraindications like the concomitant use of nitrates.
5. Maria’s statement “Bow down before me! I am the holy mother of Christ! I am the blessed Virgin Mary!†is an example of:
- A. Delusion of grandeur
- B. Visual Hallucination
- C. Religious delusion
- D. Auditory Hallcucination
Correct answer: B
Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.
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