ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 A with NGN
1. A nurse manager notices a discrepancy in a nurse's narcotics record. What is the appropriate action?
- A. Ask the nurse for clarification about the record.
- B. Report the discrepancy to the pharmacy.
- C. Report the issue to the nurse manager immediately.
- D. Ignore the discrepancy as a clerical error.
Correct answer: B
Rationale: The appropriate action when a nurse manager notices a discrepancy in a nurse's narcotics record is to report the discrepancy to the pharmacy. Reporting such discrepancies is crucial to ensure accountability and patient safety. Choice A is incorrect because the nurse manager should not confront the nurse directly without proper investigation. Choice C is incorrect because reporting to the nurse manager may not address the issue effectively. Choice D is incorrect because ignoring the discrepancy can compromise patient safety and violates protocols.
2. A client is being educated about the use of Fluticasone to treat Perennial Rhinitis. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should use the spray every 4 hours while I am awake.
- B. It can take as long as 3 weeks before the medication takes maximum effect.
- C. This medication can also be used to treat motion sickness.
- D. I can use this medication when my nasal passages are blocked.
Correct answer: B
Rationale: The correct answer is B because Fluticasone may show some benefits within a few hours, but its full therapeutic effect may take up to 3 weeks to be achieved in treating Perennial Rhinitis. Option A is incorrect as the frequency of Fluticasone use is usually once daily. Option C is incorrect as Fluticasone is not used for motion sickness. Option D is incorrect as Fluticasone is a preventive medication and not used for immediate relief when nasal passages are blocked.
3. A client with deep vein thrombosis has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?
- A. Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level.
- B. I will call the provider to get a prescription for discontinuing the IV heparin today.
- C. Both heparin and warfarin work together to dissolve the clots.
- D. The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay.
Correct answer: A
Rationale: The correct answer is A because warfarin takes several days to reach a therapeutic level and exert its full anticoagulant effect. During this time, the IV heparin is continued to prevent clotting until the warfarin is effective. Both medications are used together temporarily for this reason. Discontinuing heparin prematurely can increase the risk of clot formation. Therefore, the nurse should explain to the client that the IV heparin will be continued until the warfarin reaches a therapeutic level.
4. Which of the following is one of the positive benefits of conflict within an organization?
- A. Conflict leads to compromise on values and beliefs.
- B. Conflict leads to intergroup competition.
- C. Conflict helps people recognize differences and motivates people towards improved performance.
- D. Conflict always leads to a win-win resolution.
Correct answer: C
Rationale: The correct answer is C. Conflict within an organization can help people recognize legitimate differences and motivate them towards improved performance. This recognition of differences can lead to constructive discussions and solutions. Choice A is incorrect because conflict does not necessarily always lead to compromising values and beliefs. Choice B is incorrect as conflict should not be about fostering intergroup competition but rather about addressing and resolving issues. Choice D is incorrect as conflicts do not always result in a win-win resolution; sometimes, compromises or trade-offs are necessary for resolution.
5. A nurse assesses a client who has a mediastinal chest tube. Which symptoms require the nurse's immediate intervention? (Select ONE that does not apply)
- A. Production of pink sputum
- B. Tracheal deviation
- C. Pain at insertion site
- D. Sudden onset of shortness of breath
Correct answer: A
Rationale: In a client with a mediastinal chest tube, the presence of pink sputum does not necessarily require immediate intervention. However, tracheal deviation could indicate a tension pneumothorax, sudden shortness of breath could signal tube issues or pneumothorax, and drainage exceeding 70 mL/hr might suggest hemorrhage. Disconnection at the Y site could lead to air entering the tubing, necessitating prompt attention.
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