a nurse manager of a rural clinic is orienting a new employee which of the following information should the nurse include as a characteristic of rural
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Nursing Elites

ATI RN

RN ATI Capstone Proctored Comprehensive Assessment 2019 B

1. A nurse manager of a rural clinic is orienting a new employee. Which of the following information should the nurse include as a characteristic of rural health?

Correct answer: C

Rationale: The correct answer is C: 'Increased rates of chronic illness.' Rural areas often face challenges such as limited access to healthcare services, healthcare provider shortages, socioeconomic factors, and lifestyle choices that contribute to higher rates of chronic illnesses. Maternal morbidity rates are typically higher in rural areas due to limited access to obstetric care. While rural areas may have fewer motor-vehicle crashes compared to urban areas, the severity of crashes is usually higher due to factors like longer emergency response times. Dental care access can also be limited in rural areas, leading to less frequent preventative care visits.

2. A nurse is providing discharge teaching to a client following a myocardial infarction (MI). Which of the following activities should the client avoid?

Correct answer: B

Rationale: The correct answer is B: Driving a car. Driving a car can be physically and emotionally taxing, increasing the risk of complications soon after a myocardial infarction. It requires quick reflexes and decision-making abilities, which may be impaired during the recovery period. Swimming in a pool, light housework, and walking on flat ground are generally safe and beneficial activities for clients following a myocardial infarction as they promote circulation, muscle strength, and overall well-being.

3. A nursing instructor is observing a nursing student practicing standard precautions. Which observation by the instructor indicates a need for further teaching?

Correct answer: C

Rationale: The correct answer is C. The nursing student washing her hands before glove removal after emptying a Foley bag indicates a need for further teaching. Hands should be washed after glove removal to maintain proper infection control. Choice A is correct as wearing a gown when changing the bed of an incontinent client is a standard precaution. Choice B is correct as washing hands before making contact with the client is a good practice. Choice D is correct as changing gloves between tasks and procedures is a standard precaution to prevent the spread of infection.

4. The patient has been in bed for several days and needs to be ambulated. What action should the nurse take first?

Correct answer: A

Rationale: The correct answer is A: 'Dangle the patient at the bedside.' When a patient has been in bed for an extended period and needs to be ambulated, it is essential to dangle the patient at the bedside first. Dangling involves helping the patient sit on the edge of the bed with their legs over the side before standing up. This action helps prevent orthostatic hypotension, a sudden drop in blood pressure when moving from lying down to standing up, which can lead to dizziness or fainting. Encouraging isometric exercises (choice B) or suggesting a high-calcium diet (choice C) are not the first actions to take before ambulating a patient. Maintaining a narrow base of support (choice D) is related to assisting with ambulation but is not the initial step that should be taken.

5. A client with a new diagnosis of type 1 diabetes mellitus is being taught about self-administration of insulin by a nurse. Which of the following instructions should the nurse include?

Correct answer: A

Rationale: The correct answer is to store the current bottle of insulin at room temperature. Insulin should be stored this way to maintain its potency and effectiveness. Choice B is incorrect because massaging the injection site after removing the needle is not recommended practice and can cause bruising. Choice C is incorrect as pulling back on the plunger after injecting insulin can lead to injecting air bubbles into the tissue. Choice D is incorrect as syringes should not be reused multiple times due to the risk of contamination and inaccurate dosing.

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