ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 A with NGN
1. A nurse provides instructions to a client about preventing injury while using crutches. What should the nurse tell the client to avoid?
- A. An abnormal stance
- B. Injury to the nerves
- C. A fall and further injury
- D. Skin breakdown
Correct answer: B
Rationale: The correct answer is B: Injury to the nerves. Resting the underside of the arm on the crutch pad can injure the nerves. Choice A, an abnormal stance, is not directly related to nerve injury while using crutches. Choice C, a fall and further injury, is a general risk associated with improper crutch use but does not specifically address nerve injury. Choice D, skin breakdown, is a concern related to pressure ulcers but not the primary focus when discussing injury prevention related to crutch use.
2. A charge nurse on a medical-surgical unit is preparing to delegate tasks to a licensed practical nurse (LPN). Which of the following tasks should the charge nurse delegate to the LPN?
- A. Administering an oral antibiotic to a client
- B. Performing an admission assessment of a client
- C. Creating new teaching for a guardian of a toddler
- D. Administering IV conscious sedation to a client
Correct answer: A
Rationale: Administering oral antibiotics is within the scope of practice for an LPN and can be safely delegated. LPNs are trained to administer medications, including oral ones. Performing an admission assessment (Choice B) involves critical thinking and comprehensive evaluation, typically done by registered nurses. Creating new teaching material (Choice C) requires specialized knowledge and is usually the responsibility of a nurse with additional training in education. Administering IV conscious sedation (Choice D) is a high-risk task that requires advanced skills and should be performed by a registered nurse or higher-level provider.
3. A nurse manager is teaching a group of employees about standards for Quality and Safety Education for Nurses (QSEN). Which of the following statements by an employee should the nurse manager identify as an example of the QSEN concept of quality improvement?
- A. We should start tracking how soon clients are discharged after laparoscopic versus open surgery.
- B. We should involve our clients' partners in care planning as much as possible.
- C. We should be sure to log out of the computers immediately following documentation.
- D. We should provide change-of-shift report as a team, including the assistive personnel who assisted with care.
Correct answer: B
Rationale: Involving partners in care planning is a quality improvement strategy that aligns with QSEN principles. This choice reflects patient-centered care and collaboration, which are essential elements of quality improvement. Choices A, C, and D do not directly relate to quality improvement concepts. Tracking discharge times, logging out of computers, and providing change-of-shift reports are important practices but not specifically focused on quality improvement.
4. The nurse is assessing the patient for respiratory complications of immobility. What action should the nurse take?
- A. Auscultate the entire lung region to assess lung sounds.
- B. Assess the patient at least every 4 hours.
- C. Focus auscultation on the upper lung fields.
- D. Inspect chest wall movements primarily during the expiratory cycle.
Correct answer: A
Rationale: Auscultating the entire lung region is the most appropriate action when assessing a patient for respiratory complications related to immobility. This approach helps the nurse identify any abnormalities in lung sounds, such as diminished breath sounds or the presence of secretions. Assessing the patient at regular intervals (choice B) is important but does not specifically address the respiratory assessment needed in this situation. Focusing auscultation on the upper lung fields (choice C) may miss potential issues in other areas. Inspecting chest wall movements primarily during the expiratory cycle (choice D) is not the most effective way to assess lung sounds and identify respiratory complications.
5. How should a healthcare provider manage a patient with deep vein thrombosis (DVT)?
- A. Monitoring for signs of pulmonary embolism
- B. Applying compression stockings
- C. Administering anticoagulants as prescribed
- D. Encouraging leg elevation to reduce swelling
Correct answer: A
Rationale: Corrected Rationale: Monitoring for signs of pulmonary embolism is crucial in patients with deep vein thrombosis (DVT) as it can be a life-threatening complication. While administering anticoagulants as prescribed is important for preventing clot progression, the immediate concern is detecting potential pulmonary embolism. Applying compression stockings and encouraging leg elevation are beneficial measures for managing DVT symptoms but are not as critical as monitoring for pulmonary embolism.
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