ATI RN
ATI Capstone Comprehensive Assessment B
1. A nurse is preparing to administer a blood transfusion. What is the most important action to ensure patient safety?
- A. Check the patient's vital signs every 15 minutes during the transfusion.
- B. Verify the patient's identity with two identifiers before starting the transfusion.
- C. Ensure the blood product is administered within 4 hours of removal from the blood bank.
- D. Ensure the patient has signed the informed consent form.
Correct answer: B
Rationale: The most important action to ensure patient safety when administering a blood transfusion is to verify the patient's identity with two identifiers before starting the transfusion. This step is crucial to prevent transfusion errors, such as giving the blood to the wrong patient. Checking vital signs, ensuring timely administration, and confirming informed consent are also important aspects of blood transfusion safety but verifying the patient's identity is the highest priority to prevent errors.
2. What is the definition of malpractice in the context of professional negligence?
- A. Failure to follow personal standards of care
- B. Failure to act in a reasonable and prudent manner by a professional
- C. Harm caused by a healthcare team due to miscommunication
- D. Failure to document patient care properly
Correct answer: B
Rationale: The correct definition of malpractice in the context of professional negligence is the failure to act in a reasonable and prudent manner by a professional. This choice is correct because malpractice occurs when a professional does not meet the standard of care expected in their field, leading to harm or injury to the client. Choices A, C, and D are incorrect because malpractice is specifically about the failure to meet professional standards of care, rather than personal standards, miscommunication within a healthcare team, or inadequate documentation of patient care.
3. A client has a new prescription for beclomethasone inhaler to use with an albuterol inhaler for asthma maintenance. What should the nurse instruct the client?
- A. Skip doses if breathing improves
- B. Use the albuterol inhaler first
- C. Gargle with water after each use
- D. Store inhaler in the refrigerator
Correct answer: C
Rationale: The correct answer is to instruct the client to gargle with water after each use of the beclomethasone inhaler. Beclomethasone can cause oral thrush, and gargling with water helps prevent this complication. Choice A is incorrect because the client should not skip doses even if breathing improves, as the medications are prescribed for maintenance. Choice B is incorrect as there is no specific instruction to use the albuterol inhaler first in this scenario. Choice D is incorrect because inhalers should not be stored in the refrigerator unless specified by the manufacturer.
4. A school nurse is developing a teaching plan about testicular cancer for a group of clients. Which of the following information should the nurse include in the teaching?
- A. Perform a testicular self-examination weekly.
- B. Do not palpate the epididymis when performing a testicular self-examination.
- C. Expect testicles to be uniform in consistency when performing a testicular self-examination.
- D. Perform a testicular self-examination after a cool shower.
Correct answer: C
Rationale: The correct answer is C because testicles should be uniform in consistency when performing a self-exam, and any lumps or abnormalities should be reported. Choice A is incorrect as testicular self-examinations should be performed monthly, not weekly. Choice B is incorrect because the epididymis should be included in the examination. Choice D is incorrect because a warm shower helps relax the scrotum, making the exam easier to perform.
5. A nursing instructor is observing a nursing student practicing standard precautions. Which observation by the instructor indicates a need for further teaching?
- A. The nursing student wears a gown to change the bed of an incontinent client.
- B. The nursing student washes hands before making contact with the client.
- C. The nursing student washes her hands before glove removal after emptying a Foley bag.
- D. The nursing student changes gloves between tasks and procedures.
Correct answer: C
Rationale: The correct answer is C. The nursing student washing her hands before glove removal after emptying a Foley bag indicates a need for further teaching. Hands should be washed after glove removal to maintain proper infection control. Choice A is correct as wearing a gown when changing the bed of an incontinent client is a standard precaution. Choice B is correct as washing hands before making contact with the client is a good practice. Choice D is correct as changing gloves between tasks and procedures is a standard precaution to prevent the spread of infection.
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