ATI RN
ATI Capstone Fundamentals Assessment Proctored
1. A nurse is discussing immunity with a client who has received an immunization. The nurse should identify that an immunization functions as part of which type of immunity?
- A. Natural immunity
- B. Acquired immunity
- C. Passive immunity
- D. Cell-mediated immunity
Correct answer: B
Rationale: An immunization functions as part of acquired immunity. Acquired immunity involves the production of antibodies after immunization, which helps protect against future infections. Natural immunity is not induced by immunization but is present from birth. Passive immunity is temporary and acquired through the transfer of pre-formed antibodies. Cell-mediated immunity is a type of immune response that involves the activation of phagocytes, antigen-specific cytotoxic T-lymphocytes, and the release of various cytokines in response to an antigen.
2. You are the surgical nurse caring for a 65-year-old female patient who is postoperative day 1 following a thyroidectomy. During your shift assessment, the patient complains of tingling in her lips and fingers. She tells you that she has an intermittent spasm in her wrist and hand, and she exhibits increased muscle tone. What electrolyte imbalance should you first suspect?
- A. Hypophosphatemia
- B. Hypocalcemia
- C. Hypermagnesemia
- D. Hyperkalemia
Correct answer: B
Rationale: The symptoms described, including tingling in the lips and fingers, intermittent spasms, and increased muscle tone, are indicative of tetany, which is a common manifestation of hypocalcemia. Hypocalcemia can lead to neuromuscular irritability, causing symptoms such as paresthesias and muscle spasms. Hypophosphatemia primarily affects the central nervous system, resulting in seizures and coma. Hypermagnesemia typically presents with hypoactive reflexes and somnolence. Hyperkalemia can cause paresthesias and anxiety, but in this case, the patient's symptoms are more suggestive of hypocalcemia.
3. A patient has questioned the nurses administration of IV normal saline, asking whether sterile water would be a more appropriate choice than saltwater. Under what circumstances would the nurse administer electrolyte-free water intravenously?
- A. Never, because it rapidly enters red blood cells, causing them to rupture.
- B. When the patient is severely dehydrated resulting in neurologic signs and symptoms
- C. When the patient is in excess of calcium and/or magnesium ions
- D. When a patients fluid volume deficit is due to acute or chronic renal failure
Correct answer: Never, because it rapidly enters red blood cells, causing them to rupture.
Rationale:
4. A client has a new prescription for Brimonidine ophthalmic drops and wears soft contact lenses. Which of the following instructions should the nurse include in the teaching?
- A. This medication can stain your contacts.
- B. This medication can cause your pupils to constrict.
- C. This medication can absorb into your contacts.
- D. This medication can slow your heart rate.
Correct answer: C
Rationale: The correct instruction the nurse should include is that Brimonidine can absorb into soft contact lenses. To prevent this, the client should remove the contacts, instill the medication, and wait at least 15 minutes before putting the contacts back in to avoid any potential absorption of the medication into the lenses. Choices A, B, and D are incorrect because Brimonidine is not known to stain contacts, cause pupil constriction, or slow heart rate.
5. Causes of acute renal failure include:
- A. chronic renal failure
- B. uncontrolled diabetes mellitus
- C. recurrent urinary tract infections
- D. severe injury such as extensive burns
Correct answer: D
Rationale: The correct answer is D. Severe injuries, like extensive burns, can cause acute renal failure due to shock, reduced blood flow to the kidneys, and tissue damage. Choices A, B, and C are incorrect because chronic renal failure, uncontrolled diabetes mellitus, and recurrent urinary tract infections are more likely to contribute to chronic kidney disease rather than acute renal failure.
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