ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 A with NGN
1. A nurse is preparing to administer medications to a client via a nasogastric (NG) tube. What should the nurse do first?
- A. Crush all medications and administer them all at once.
- B. Flush the NG tube before and after each medication.
- C. Administer only liquid forms of medications.
- D. Skip flushing the tube entirely.
Correct answer: B
Rationale: The correct answer is B: 'Flush the NG tube before and after each medication.' Flushing the NG tube is essential to ensure that the medication passes through smoothly without any obstruction. It helps prevent clogging of the tube and ensures that the full dose of the medication reaches the patient. Options A, C, and D are incorrect because crushing all medications at once, administering only liquid forms of medications, and skipping tube flushing entirely can lead to complications such as tube blockages, incomplete medication administration, and potential harm to the client.
2. When providing discharge instructions for a patient with diabetes, what is the most important information to include?
- A. Encourage the patient to maintain a high-carbohydrate diet.
- B. Teach the patient how to monitor their blood sugar levels.
- C. Recommend the patient engage in regular exercise.
- D. Provide the patient with a list of restricted foods.
Correct answer: B
Rationale: The most critical information to include when providing discharge instructions for a patient with diabetes is teaching them how to monitor their blood sugar levels. This empowers the patient to actively manage their condition, make informed decisions about their diet and medication, and prevent complications. Encouraging a high-carbohydrate diet (Choice A) can be detrimental for diabetic patients as it may lead to unstable blood sugar levels. While regular exercise (Choice C) is important in diabetes management, monitoring blood sugar levels takes precedence. Providing a list of restricted foods (Choice D) is relevant but not as crucial as teaching the patient how to monitor their blood sugar levels.
3. A client is prescribed Clopidogrel. Which of the following laboratory values should the nurse monitor to assess for potential adverse effects?
- A. White blood cell count
- B. Platelet count
- C. Hemoglobin
- D. Blood glucose
Correct answer: B
Rationale: Clopidogrel is an antiplatelet medication that works by inhibiting platelet aggregation. Therefore, the nurse should monitor the client's platelet count to assess for potential bleeding complications. Changes in platelet count can indicate the effectiveness of Clopidogrel therapy and help prevent adverse effects related to clotting or bleeding. Monitoring white blood cell count, hemoglobin, or blood glucose levels is not directly related to the action or side effects of Clopidogrel.
4. A nurse is providing dietary teaching to a client who has cholecystitis. Which of the following foods should the nurse instruct the client to avoid?
- A. Bananas.
- B. Oatmeal.
- C. Brown rice.
- D. Whole milk.
Correct answer: D
Rationale: The correct answer is D: Whole milk. Clients with cholecystitis should avoid high-fat foods, and whole milk contains high levels of fat. Bananas, oatmeal, and brown rice are generally considered safe for clients with cholecystitis as they are low in fat and easily digestible. Bananas are a good source of potassium, oatmeal is high in fiber, and brown rice provides complex carbohydrates. Therefore, the nurse should advise the client to avoid whole milk but can recommend the other choices as part of a balanced diet for cholecystitis.
5. A healthcare provider at an urgent care clinic is assessing an adolescent client who has an upper respiratory tract infection. Which of the following findings should the provider recognize as a manifestation of pertussis?
- A. Inflamed throat with exudate
- B. Purulent eye drainage
- C. Dry, hacking cough
- D. Koplik spots on buccal mucosa
Correct answer: C
Rationale: The correct answer is C: 'Dry, hacking cough.' A dry, hacking cough is a classic manifestation of pertussis. Pertussis typically presents with symptoms of an upper respiratory tract infection, starting with a persistent, severe, and uncontrollable cough that can worsen at night. This cough is often followed by a high-pitched 'whoop' sound as the patient tries to catch their breath, hence the term 'whooping cough.' In contrast, options A, B, and D are not typically associated with pertussis. Inflamed throat with exudate may suggest a bacterial throat infection like streptococcal pharyngitis, purulent eye drainage is more indicative of a bacterial conjunctivitis, and Koplik spots on the buccal mucosa are specific to measles. Therefore, recognizing the dry, hacking cough as a manifestation of pertussis is crucial for early identification and appropriate management of the disease.
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