ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 A with NGN
1. A client reports pain and swelling at the IV site. What should the nurse do first?
- A. Flush the IV line and continue the infusion.
- B. Stop the infusion and notify the healthcare provider.
- C. Increase the IV infusion rate to reduce discomfort.
- D. Apply a warm compress to the IV site and continue monitoring.
Correct answer: B
Rationale: The correct answer is B: Stop the infusion and notify the healthcare provider. Pain and swelling at an IV site can indicate infiltration or infection, which are serious complications. Stopping the infusion helps prevent further harm to the client, and notifying the healthcare provider promptly allows for appropriate assessment and intervention. Choice A is incorrect because flushing the IV line and continuing the infusion could exacerbate the issue. Choice C is incorrect as increasing the IV infusion rate is not the appropriate action for pain and swelling at the site. Choice D is incorrect because applying a warm compress may not address the underlying issue of infiltration or infection; it's crucial to stop the infusion and seek further guidance.
2. You are taking part in a survey that asks about your attitudes toward physical punishment of children. Even though you believe that spanking is sometimes necessary, you answer that you are opposed to any sort of physical punishment. Which of the following terms best describes why you answered the way you did?
- A. Random responding
- B. Faking bad
- C. Placebo effect
- D. Social desirability
Correct answer: D
Rationale: The correct answer is D, social desirability. Social desirability bias occurs when respondents answer questions in a way they think will be viewed favorably by others, rather than according to their true beliefs. In this scenario, the respondent may feel pressured to provide an answer that aligns with societal norms or expectations, even if it contradicts their personal beliefs. Choices A, B, and C are incorrect. Random responding refers to answering survey questions haphazardly, without consideration. Faking bad is intentionally providing extreme or negative responses. The placebo effect is a phenomenon where a person's belief in a treatment's effectiveness produces a positive outcome, unrelated to the treatment's actual effects.
3. Which factor is most likely to cause a "brittle" diabetic state in a child with type 1 diabetes?
- A. Noncompliance with diet
- B. Insulin resistance
- C. Frequent infections
- D. Hypothyroidism
Correct answer: C
Rationale: Frequent infections can destabilize blood sugar levels, leading to a "brittle" diabetic state in children with type 1 diabetes. Infections increase metabolic demands and can result in significant blood glucose fluctuations, requiring careful monitoring and adjustment of insulin therapy. Noncompliance with diet may affect blood sugar control but is not the primary cause of a "brittle" state. Insulin resistance is more common in type 2 diabetes rather than type 1. Hypothyroidism can impact metabolism but is not directly linked to the development of a "brittle" diabetic state in type 1 diabetes.
4. A nasogastric tube for suction is ordered for a neonate diagnosed with a diaphragmatic hernia. Which complication related to gastric drainage is the priority when planning care for this neonate?
- A. Weight loss
- B. Metabolic alkalosis
- C. Dehydration
- D. Hyperbilirubinemia
Correct answer: B
Rationale: Metabolic alkalosis is the priority complication to consider when a neonate with a diaphragmatic hernia is placed on gastric suction. Prolonged gastric drainage can lead to the loss of stomach acids, resulting in metabolic alkalosis, which can have serious consequences for the neonate's health.
5. Which of the following diuretics inhibits sodium reabsorption in the kidneys while sparing K+ and hydrogen ions?
- A. Spironolactone
- B. Furosemide
- C. Hydrochlorothiazide
- D. Bumetanide
Correct answer: A
Rationale: Spironolactone is the correct answer as it is classified as a potassium-sparing diuretic. It works by inhibiting sodium reabsorption in the kidneys while promoting the retention of potassium and hydrogen ions. This mechanism of action helps in reducing fluid retention without causing excessive loss of potassium, which is a common side effect of other diuretics. Furosemide (choice B), Hydrochlorothiazide (choice C), and Bumetanide (choice D) are not correct as they are not potassium-sparing diuretics. Furosemide and Bumetanide are loop diuretics that inhibit sodium, potassium, and chloride reabsorption in the loop of Henle. Hydrochlorothiazide is a thiazide diuretic that inhibits sodium and chloride reabsorption in the distal convoluted tubule, leading to potassium loss.
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