ATI RN
RN ATI Capstone Proctored Comprehensive Assessment Form B
1. When teaching a patient with a new prescription for brimonidine to treat open-angle glaucoma, what indicates an understanding of the instructions?
- A. I can expect my vision to improve quickly
- B. I should use it only when my eyes are irritated
- C. I can expect to feel some irritation when I put these drops in my eyes
- D. I will need regular eye exams
Correct answer: C
Rationale: The correct answer is C. When using brimonidine to treat open-angle glaucoma, patients may experience temporary irritation in the eyes. Choice A is incorrect because vision improvement from brimonidine is not immediate. Choice B is incorrect as brimonidine should be used as prescribed, not just when eyes are irritated. Choice D is important but does not directly indicate an understanding of the medication's use.
2. Which of the following clients requiring crutches should a nurse teach about how to use a three-point gait?
- A. A client who has a right femur fracture with no weight-bearing on the affected leg
- B. A client who has bilateral leg braces due to paralysis of the lower extremities
- C. A client who has bilateral knee replacements with partial weight-bearing on both legs
- D. A client who is able to bear full weight on both lower extremities
Correct answer: A
Rationale: A three-point gait is recommended for clients who are non-weight bearing on one leg. In this case, a client with a right femur fracture requiring no weight-bearing on the affected leg would benefit from learning how to use a three-point gait. Choices B, C, and D are incorrect because they involve clients who have varying degrees of weight-bearing ability on both legs, which would not require the use of a three-point gait.
3. A nurse is monitoring an older adult female client who had a myocardial infarction (MI) for the development of an acute kidney injury (AKI). Which of the following findings should the nurse identify as indicating an increased risk of AKI?
- A. Magnesium 2.0 mEq/L
- B. Blood urea nitrogen (BUN) 20 mg/dL
- C. Serum Osmolality 290 mOsm/kg H2O
- D. Serum creatinine 1.8 mg/dL
Correct answer: D
Rationale: An elevated serum creatinine level (1.8 mg/dL) is a significant indicator of potential kidney impairment. In acute kidney injury (AKI), serum creatinine levels rise due to decreased kidney function, reflecting the kidneys' inability to effectively filter waste from the blood. Magnesium level, BUN, and serum osmolality are not direct indicators of kidney function or risk of AKI. Magnesium levels are more related to electrolyte balance, BUN can be affected by factors other than kidney function, and serum osmolality reflects the concentration of solutes in the blood, not specifically kidney function.
4. What is the primary focus of secondary prevention in community mental health care?
- A. Teaching stress-reduction techniques
- B. Early detection of mental illness
- C. Leading support groups for clients with substance use disorder
- D. Rehabilitation and prevention of further issues
Correct answer: B
Rationale: The correct answer is B: Early detection of mental illness. Secondary prevention in community mental health care focuses on identifying mental health issues at an early stage to provide timely interventions. Choice A, teaching stress-reduction techniques, is more aligned with primary prevention aimed at preventing the onset of mental health problems. Choice C, leading support groups for clients with substance use disorder, pertains more to providing specific interventions for individuals with substance use issues rather than the general focus of secondary prevention. Choice D, rehabilitation and prevention of further issues, is more related to tertiary prevention, which involves addressing existing mental health conditions and preventing complications or recurrence.
5. A nurse is teaching an older adult client who has left-sided weakness about cane use. Which of the following instructions should the nurse include?
- A. Hold the cane with your left hand
- B. Move the cane forward 18 inches with each step
- C. When walking, move your left foot forward first
- D. Keep your elbow straight when you hold the cane
Correct answer: C
Rationale: The correct instruction for a client with left-sided weakness using a cane is to move the left foot forward first. This technique helps improve stability and safety by ensuring weight-bearing on the stronger side while providing support with the cane. Choice A is incorrect because the cane should be held on the stronger side, which is the right side in this case. Choice B is incorrect as the recommended distance to move the cane forward with each step is about 6 inches, not 18 inches. Choice D is incorrect as it is essential to maintain a slight bend in the elbow while using the cane to absorb shock and provide flexibility.
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