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 newly licensed nurse is giving a change-of-shift report using I-SBAR to an oncoming nurse. Which of the following statements by the newly licensed nurse should be included in the 'Background' portion of the report?
- A. The client has a new prescription for incentive spirometry
- B. The client's partner plans to return later today
- C. The client has no living family members
- D. I initiated a consultation with a nutritionist
Correct answer: C
Rationale: In the 'Background' portion of the report, the nurse should include relevant historical information about the client, such as the fact that the client has no living family members. This information helps provide a more comprehensive understanding of the client's situation. Choices A, B, and D are not typically included in the 'Background' section as they do not pertain to the client's history or background.
3. When educating a patient with hypertension about lifestyle changes, what is the most crucial advice to provide?
- A. Advise the patient to reduce salt intake.
- B. Instruct the patient to limit alcohol consumption.
- C. Recommend the patient to exercise for 30 minutes every day.
- D. Instruct the patient to avoid high-cholesterol foods.
Correct answer: A
Rationale: The most critical lifestyle change for a patient with hypertension is to reduce salt intake. Excessive salt consumption can lead to increased blood pressure levels. While limiting alcohol consumption (Choice B) and regular exercise (Choice C) are also beneficial for managing hypertension, reducing salt intake has a more direct impact on blood pressure control. Avoiding high-cholesterol foods (Choice D) is important for heart health but may not have as significant an impact on blood pressure as reducing salt intake.
4. A client with chronic obstructive pulmonary disease (COPD) is being assessed by a nurse. Which finding indicates the condition is worsening?
- A. Increased shortness of breath
- B. Decreased wheezing
- C. Productive cough with green sputum
- D. Slight increase in fatigue
Correct answer: A
Rationale: The correct answer is A: Increased shortness of breath. In COPD, worsening symptoms often include increased shortness of breath due to impaired lung function. This indicates a decline in respiratory status and the need for prompt intervention. Choice B, decreased wheezing, is not indicative of worsening COPD as it could suggest better airflow. Choice C, productive cough with green sputum, may indicate an infection but not necessarily worsening COPD. Choice D, a slight increase in fatigue, is non-specific and may not directly correlate with the worsening of COPD.
5. A client is being prepared for discharge after a stroke. Which of the following interventions should be included in the discharge plan to prevent complications?
- A. Recommend physical therapy to improve mobility
- B. Teach the client how to use an incentive spirometer
- C. Encourage the client to ambulate daily
- D. Provide education on proper medication management
Correct answer: D
Rationale: The correct answer is to provide education on proper medication management. Proper medication management is crucial in reducing the risk of stroke recurrence and ensuring the client adheres to the treatment plan. While physical therapy, incentive spirometer use, and daily ambulation are important aspects of stroke rehabilitation, they are not directly related to preventing complications during the discharge phase.
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