ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 B with NGN
1. A nurse manager is implementing a quality improvement project to reduce the number of methicillin-resistant Staphylococcus aureus (MRSA) infections at the facility. Which of the following actions should the nurse manager take first?
- A. Develop an MRSA protocol for implementation.
- B. Provide educational in-services for staff.
- C. Evaluate outcomes resulting from interventions.
- D. Conduct a chart review to evaluate precipitating factors of clients who develop MRSA.
Correct answer: D
Rationale: Conducting a chart review to evaluate the precipitating factors of clients who develop MRSA is the initial step in reducing these infections. By identifying factors contributing to MRSA infections, the nurse manager can develop targeted interventions. Developing an MRSA protocol (choice A) and providing educational in-services (choice B) would be premature without understanding the specific factors at play. Evaluating outcomes (choice C) should come after implementing interventions based on the findings from the chart review.
2. The surgical mask the perioperative nurse is wearing becomes moist. Which action will the perioperative nurse take next?
- A. Do not change the mask if the nurse is comfortable.
- B. Change the mask when relieved by the next shift.
- C. Apply a new mask.
- D. Reapply the mask after it air-dries.
Correct answer: C
Rationale: When a surgical mask becomes moist, it loses its effectiveness as a barrier against microorganisms. Therefore, the perioperative nurse should apply a new mask. Choice A is incorrect because a moist mask should not be continued to be worn even if the nurse is comfortable. Choice B is not the best course of action as the mask should be changed immediately when it becomes moist. Choice D is also incorrect as waiting for the mask to air-dry is not recommended due to the loss of barrier effectiveness.
3. A family was referred to crisis intervention services after a natural disaster. One family member refuses to attend, stating, 'No way, I'm not crazy.' What is the nurse's best response?
- A. Don't worry now. The psychiatrists are well trained to help.
- B. Many times, disasters can create mental health problems, so you really should participate with your family.
- C. This will help your family communicate better.
- D. Seeking this kind of help does not mean that you have a mental illness; it is a short-term problem-solving technique.
Correct answer: D
Rationale: The nurse should reassure the family member that seeking help does not imply mental illness, but is part of coping with the disaster.
4. The healthcare provider is assessing an immobile patient for deep vein thrombosis (DVT). What should the healthcare provider do?
- A. Lightly rub the lower leg to check for redness and tenderness.
- B. Apply elastic stockings every 4 hours.
- C. Measure the calf circumference of both legs.
- D. Flex the foot while assessing for patient discomfort.
Correct answer: C
Rationale: Measuring the calf circumference of both legs is crucial when assessing for DVT in an immobile patient. A significant increase in the circumference of one calf compared to the other suggests the presence of a deep vein thrombosis. Option A is incorrect because rubbing the lower leg may dislodge a clot if present. Option B is incorrect as elastic stockings should not be removed frequently as this can increase the risk of clot formation. Option D is incorrect as dorsiflexing the foot can lead to pain and should not be done to assess for DVT.
5. A nurse suspects a colleague of diverting narcotics. What is the nurse's first course of action?
- A. Confront the colleague directly about the suspicion.
- B. Report the suspicion to the nurse manager.
- C. Ignore the situation unless there is clear evidence.
- D. Keep a record of the colleague's actions for future reference.
Correct answer: B
Rationale: The correct first course of action for a nurse suspecting a colleague of diverting narcotics is to report the suspicion to the nurse manager. Confronting the colleague directly may not be safe and could compromise the investigation. Ignoring the situation is not appropriate as it can pose risks to patient safety. Keeping a record of the colleague's actions is not the primary action to take when drug diversion is suspected; reporting to the nurse manager is crucial for proper investigation and ensuring patient safety.
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