ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 A with NGN
1. A patient has a DNR (do-not-resuscitate) order but their family insists on resuscitation if necessary. What should the nurse do?
- A. Follow the family's wishes to resuscitate.
- B. Explain that the nurse must follow the DNR order.
- C. Ask the provider for clarification on the DNR.
- D. Call the ethics committee to discuss the situation.
Correct answer: B
Rationale: The correct answer is B. The nurse must follow the legal DNR order, even if the family insists on resuscitation. Respecting the patient's wishes is crucial in providing ethical care. Choice A is incorrect because the nurse should prioritize the patient's documented wishes over the family's requests. Choice C may cause unnecessary delays in care as the DNR order is a legal document. Choice D is not the initial action to take in this situation; the nurse should first address the conflict between the family's wishes and the patient's DNR order.
2. When administering Phenytoin, what should you monitor?
- A. Behavior
- B. Therapeutic blood levels
- C. For signs of Stevens-Johnson syndrome
- D. All of the above
Correct answer: D
Rationale: When administering Phenytoin, monitoring the patient's behavior is important to assess for any changes that may indicate adverse effects. Monitoring therapeutic blood levels helps ensure the medication is within the effective range and not causing toxicity. Additionally, being vigilant for signs of Stevens-Johnson syndrome, a severe skin reaction associated with Phenytoin use, is crucial for early detection and intervention. Therefore, monitoring behavior, therapeutic blood levels, and for signs of Stevens-Johnson syndrome are all essential when administering Phenytoin.
3. During a health education program, a facilitator continues to ask questions and encourages attendees to contribute examples from their own lives relevant to the discussion. Which best describes the rationale for the facilitator’s action?
- A. To avoid having to prepare more material related to the topic
- B. To let the participants feel appreciated and knowledgeable
- C. To allow the participants to learn by doing through active participation
- D. To apply Freire’s principles of learning
Correct answer: C
Rationale: The facilitator's action of encouraging active participation, where attendees contribute examples from their own lives, is aimed at facilitating learning through doing. This approach engages participants directly in the learning process, enhancing understanding and retention by connecting theoretical concepts to real-life experiences. Active participation promotes a deeper understanding of the material and increases the likelihood of behavior and attitude change.
4. A healthcare professional is assessing a client who has a fracture of the femur. Vital signs are obtained on admission and again in 2 hours. Which of the following changes in assessment should indicate to the healthcare professional that the client could be developing a serious complication?
- A. Increased respiratory rate from 18 to 44/min
- B. Increased oral temperature from 36.6° C (97.8° F) to 37° C (98.6° F)
- C. Increased blood pressure from 112/68 to 120/72 mm Hg
- D. Increased heart rate from 68 to 72/min
Correct answer: Increased respiratory rate from 18 to 44/min
Rationale: An increased respiratory rate from 18 to 44/min is a significant change that should alert the healthcare professional to a potential serious complication. Such a drastic increase in respiratory rate may indicate respiratory distress or hypoxia, which are critical conditions requiring immediate attention. The other options show minor changes in vital signs that are within normal limits and are less likely to indicate a serious complication.
5. The genetic influences that determine behavior may never be fully understood due to ________
- A. the ease of researching to differentiate between the effects of the environment and the effects of genes.
- B. the likelihood that most behaviors are determined by the interaction of many genes and the environment.
- C. the tendency to rely on twin studies in genetic research.
- D. our significant understanding of how genes impact brain chemistry.
Correct answer: B
Rationale: The correct answer is B because most behaviors are influenced by a complex interaction of many genes and the environment. Choice A is incorrect because it states that it is easy to differentiate between the effects of the environment and genes, which is not the case. Choice C is incorrect because although twin studies are commonly used in genetic research, this alone does not hinder the full understanding of genetic influences on behavior. Choice D is incorrect because even though we have some understanding of how genes impact brain chemistry, this does not mean that we fully understand the genetic influences on behavior.
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