ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 B with NGN
1. A nurse is receiving change-of-shift report on a group of clients. Which of the following clients should the nurse assess first?
- A. A client who has urolithiasis and reports severe ankle pain extending toward the abdomen
- B. A client who has acute cholecystitis and reports abdominal pain radiating to the right shoulder
- C. A client who has had a total knee arthroplasty, is 1 day postoperative, and reports a pain level of 8 on a 0 to 10 pain scale
- D. A client who has a fractured femur and reports sudden sharp chest pain
Correct answer: D
Rationale: The correct answer is D because a client with a fractured femur and sudden chest pain may be experiencing a pulmonary embolism, which requires immediate assessment. Choice A is incorrect because although severe pain is present, it is more indicative of musculoskeletal issues related to urolithiasis rather than a life-threatening condition. Choice B, related to acute cholecystitis, is less urgent than choice D as the pain radiating to the right shoulder is a common symptom but does not indicate an immediate life-threatening situation. Choice C, regarding a client post-total knee arthroplasty with a pain level of 8, is important but not as urgent as a potential pulmonary embolism in choice D.
2. A client with chronic kidney disease is being taught by a nurse about managing protein intake. Which of the following instructions should the nurse include?
- A. You should increase your intake of high-protein foods.
- B. You should limit your intake of high-protein foods.
- C. You should avoid all protein sources to prevent further kidney damage.
- D. You should increase your intake of animal protein.
Correct answer: B
Rationale: The correct answer is B: 'You should limit your intake of high-protein foods.' Clients with chronic kidney disease should restrict their intake of high-protein foods to lessen the workload on the kidneys and prevent further kidney damage. Option A is incorrect as increasing intake of high-protein foods can exacerbate the condition. Option C is incorrect as avoiding all protein sources is not advisable, as some proteins are essential for overall health. Option D is incorrect as increasing the intake of animal protein can put more strain on the kidneys due to the metabolites produced during protein breakdown.
3. The nurse is administering an ACE inhibitor to a client. What is the most common side effect?
- A. Cough
- B. Dizziness
- C. Hypotension
- D. Hyperkalemia
Correct answer: A
Rationale: The correct answer is A: Cough. Cough is a well-known side effect of ACE inhibitors due to an increase in bradykinin levels. This irritating cough can be bothersome to clients and should be monitored. Choice B, Dizziness, is not the most common side effect of ACE inhibitors. While ACE inhibitors can cause hypotension (Choice C), cough is more prevalent. Hyperkalemia (Choice D) is a possible side effect of ACE inhibitors but is less common compared to cough.
4. During a skin inspection at the outpatient clinic, the nurse notices patches of thick, red skin with silvery scales on the client’s elbows and knees. What skin abnormality does the nurse suspect?
- A. Scabies
- B. Rosacea
- C. Psoriasis
- D. Statis dermatitis
Correct answer: Psoriasis
Rationale:
5. A patient with COPD is admitted with shortness of breath and a productive cough. Which of the following interventions should the nurse implement first?
- A. Administer oxygen at 4 L/min via nasal cannula
- B. Encourage the patient to cough and deep breathe
- C. Place the patient in a high-Fowler’s position
- D. Administer a bronchodilator as prescribed
Correct answer: C
Rationale: Placing the patient in a high-Fowler’s position should be implemented first. This intervention helps improve lung expansion, making it easier for the patient to breathe. Elevating the head of the bed reduces the work of breathing and can alleviate symptoms of respiratory distress. Administering oxygen, encouraging coughing and deep breathing, and administering a bronchodilator are important interventions in the care of a patient with COPD, but positioning the patient for optimal lung expansion takes precedence in this scenario.
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