ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 A with NGN
1. A nurse is preparing to administer a medication that requires a peak and trough level. What is the nurse's priority action?
- A. Administer the medication before the peak level is obtained.
- B. Withhold the medication until the trough level is obtained.
- C. Administer the medication based on the previous trough level.
- D. Ensure that the medication is administered within 2 hours of the peak level.
Correct answer: B
Rationale: The nurse's priority action should be to withhold the medication until the trough level is obtained. This is crucial to ensure accurate dosing based on the patient's levels. Administering the medication before the peak level is obtained (choice A) can lead to incorrect dosing. Administering the medication based on the previous trough level (choice C) may not reflect the current levels accurately. Ensuring that the medication is administered within 2 hours of the peak level (choice D) is not necessary for obtaining accurate peak and trough levels.
2. A nurse is assessing a client who is postoperative following abdominal surgery and has an indwelling urinary catheter that is draining dark yellow urine at 25 ml/hr. What intervention should the nurse anticipate?
- A. Clamp the catheter.
- B. Administer a fluid bolus.
- C. Obtain a urine specimen for culture and sensitivity.
- D. Initiate continuous bladder irrigation.
Correct answer: D
Rationale: In this scenario, the nurse should anticipate initiating continuous bladder irrigation. Dark yellow urine output at a rate of 25 ml/hr following abdominal surgery may indicate urinary stasis or obstruction, which could lead to complications like urinary retention. Continuous bladder irrigation helps prevent catheter obstruction and manage urinary retention by ensuring patency and promoting urine flow. Clamping the catheter (Choice A) could lead to urinary stasis and should be avoided. Administering a fluid bolus (Choice B) is not indicated solely based on the urine color and output described. Obtaining a urine specimen for culture and sensitivity (Choice C) may be necessary for assessing infection but does not directly address the issue of urinary stasis or obstruction.
3. After working at your job for 10 months and feeling unable to tolerate the tension and stress between staff nurses and the laissez-faire nurse manager who is not a leader, what is the best course of action?
- A. Submit a resignation and leave within 30 days.
- B. Complain to staff about the nurse manager.
- C. Seek another position within the healthcare organization and apply for a transfer.
- D. Inform the chief nursing officer that you are leaving and explain your dissatisfaction with the lack of leadership.
Correct answer: C
Rationale: In this situation, it is best to seek another position within the healthcare organization and apply for a transfer. Making professional decisions should involve careful evaluation and consideration. It is important to align personal values with the organizational culture. By seeking advice from a mentor or counselor, you can gain valuable insights and consider different perspectives. Resigning abruptly, complaining to staff, or informing the chief nursing officer without exploring other options may not be the most effective or professional approach in this scenario.
4. What do positive feedback mechanisms do?
- A. Cause long-term changes.
- B. Move conditions away from the normal state.
- C. Bring conditions back to the normal state.
- D. Usually produce stable conditions.
Correct answer: Move conditions away from the normal state.
Rationale: Positive feedback mechanisms amplify or increase changes in a system, moving conditions away from the normal state. This makes choice B the correct answer. Choice A is incorrect as positive feedback does not cause long-term changes but rather accelerates deviations from the norm. Choice C is incorrect because positive feedback does not bring conditions back to normal; instead, it amplifies deviations. Choice D is incorrect as positive feedback does not usually lead to stable conditions but rather to further deviations from the normal state.
5. When planning care for a client on mechanical ventilation, which mode of ventilation that increases the effort of the client's respiratory muscles should NOT be included in the plan of care?
- A. Assist-control
- B. Synchronized intermittent mandatory ventilation
- C. Continuous positive airway pressure
- D. Pressure support ventilation
Correct answer: Assist-control
Rationale: Assist-control ventilation mode delivers a preset tidal volume at a set rate; however, it may not be suitable for clients who need to maintain some level of respiratory muscle activity. This mode provides full support for each breath, potentially leading to decreased respiratory muscle strength over time. Therefore, it is important to avoid using assist-control mode for clients who require increased effort of respiratory muscles to prevent muscle atrophy and promote optimal respiratory function.
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