ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 A with NGN
1. A patient is admitted and is placed on fall precautions. The nurse teaches the patient and family about fall precautions. Which action will the nurse take in accordance with hospital policy?
- A. Encourage visitors during visiting hours.
- B. Keep the patient on fall precautions until discharge.
- C. Check on the patient every shift.
- D. Raise all four side rails.
Correct answer: B
Rationale: The correct answer is B because patients on fall precautions need continuous monitoring until discharge to prevent falls. While encouraging visitors during visiting hours (Choice A) is important for the patient's well-being, it is not related to fall precautions. Checking on the patient every shift (Choice C) is an essential nursing intervention, but keeping the patient on fall precautions is more specific to preventing falls. Raising all four side rails (Choice D) is not recommended as it can restrict the patient's mobility and is considered a restraint practice.
2. Which of the following is a genetic disorder that causes thick, sticky mucus to build up in the lungs and digestive system, leading to severe respiratory and digestive problems?
- A. Cystic fibrosis
- B. Pulmonary fibrosis
- C. Pulmonary edema
- D. Bronchiectasis
Correct answer: A
Rationale: The correct answer is A, cystic fibrosis. Cystic fibrosis is a genetic disorder characterized by the buildup of thick, sticky mucus in the lungs and digestive system, resulting in severe respiratory and digestive issues. Choice B, pulmonary fibrosis, involves scarring and thickening of lung tissue, not excessive mucus production. Choice C, pulmonary edema, refers to fluid accumulation in the lungs, not mucus buildup. Choice D, bronchiectasis, is a condition where the airways in the lungs are damaged and widened, leading to chronic cough and sputum production, but it does not specifically involve the thick, sticky mucus characteristic of cystic fibrosis.
3. The chief mechanism for maintaining fluid balance is to:
- A. adjust fluid intake so it equals fluid output.
- B. adjust fluid intake so it is slightly above fluid output.
- C. adjust fluid output so it equals fluid input.
- D. adjust fluid intake so it is slightly below fluid output.
Correct answer: C
Rationale: The correct answer is C: 'adjust fluid output so it equals fluid input.' Maintaining fluid balance involves ensuring that the amount of fluid lost through processes like urination, sweating, and respiration equals the amount of fluid taken in. This ensures that the body stays properly hydrated. Choices A, B, and D are incorrect because they do not focus on the balance between fluid input and output, which is crucial for maintaining proper fluid balance. By adjusting fluid output to equal fluid input, the body can regulate hydration levels effectively, preventing dehydration or overhydration.
4. A client is prescribed spironolactone. Which of the following findings would indicate an adverse effect of this medication?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hyponatremia
- D. Hypernatremia
Correct answer: A
Rationale: Hyperkalemia is the correct answer as it is an adverse effect associated with spironolactone, a potassium-sparing diuretic. Spironolactone works by blocking the aldosterone receptor in the distal convoluted tubule, leading to decreased potassium excretion and potential hyperkalemia. Hypokalemia (choice B) and hyponatremia (choice C) are not typically associated with spironolactone use. Hypernatremia (choice D) is also an unlikely finding with spironolactone.
5. The nurse is teaching the client diagnosed with colon cancer who is scheduled for a colostomy the next day. Which behavior indicates the best method of applying adult teaching principles?
- A. The nurse repeats the information as indicated by the client’s questions
- B. The nurse teaches all the information needed by the client in one session
- C. The nurse uses a video to explain medical terms to the client
- D. The nurse waits until the client asks questions about the surgery
Correct answer: A
Rationale: Choice A is the correct answer because repeating information and addressing the client’s questions as they arise is an effective method for reinforcing learning in adults. This approach allows for immediate clarification and reinforcement of important points. Choice B is incorrect because teaching all the information in one session may be overwhelming for the client and hinder retention. Choice C is incorrect as using a video with medical terms may not necessarily address the client's specific questions or concerns. Choice D is also incorrect because waiting for the client to ask questions may lead to missed opportunities for providing crucial information and addressing uncertainties.
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