ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 A with NGN
1. A patient with a urinary catheter reports discomfort. What is the nurse's priority action?
- A. Ensure the catheter tubing is not kinked.
- B. Irrigate the catheter to relieve the discomfort.
- C. Change the catheter to a smaller size.
- D. Remove the catheter and replace it with a new one.
Correct answer: A
Rationale: The correct answer is to ensure the catheter tubing is not kinked. This is the priority action because a kinked tubing can obstruct urine flow, leading to discomfort and potential complications. It is essential to troubleshoot the current catheter first before considering other interventions. Irrigating the catheter (Choice B) may not address the underlying issue of kinking. Changing the catheter to a smaller size (Choice C) or removing and replacing it with a new one (Choice D) should only be considered if ensuring the tubing is unkinked does not resolve the discomfort.
2. Which major theory of human development emphasizes plasticity at all ages?
- A. psychoanalytic perspective
- B. ethology
- C. evolutionary developmental psychology
- D. lifespan perspective
Correct answer: D
Rationale: The correct answer is D, the lifespan perspective. This perspective underscores the idea that individuals have the capacity for growth and change at any age, highlighting plasticity throughout the lifespan. It acknowledges the continuous development and adaptability of individuals to various experiences and factors. Choice A, the psychoanalytic perspective, focuses more on unconscious processes and early childhood experiences. Choice B, ethology, emphasizes the study of animal behavior in natural environments. Choice C, evolutionary developmental psychology, examines how evolutionary principles influence human development but does not specifically focus on plasticity at all ages.
3. A client with viral hepatitis has no appetite, and food makes the client nauseated. Which of the following interventions would be most appropriate?
- A. Explain that high-fat diets usually are tolerated better.
- B. Encourage intake of foods high in protein.
- C. Explain that the majority of calories need to be consumed in the evening hours.
- D. Monitor for fluid and electrolyte imbalance.
Correct answer: D
Rationale: If nausea occurs and persists, the client will need to be assessed for fluid and electrolyte imbalance. Explaining to the client that the majority of calories should be eaten in the morning hours is important because nausea occurs most often in the afternoon and evening. Clients should select a diet high in calories because energy is required for healing. Protein increases the workload on the liver. Changes in bilirubin interfere with fat absorption, so low-fat diets are tolerated better.
4. Ongoing fluid losses can overwhelm the child’s ability to compensate, resulting in shock. What early clinical sign precedes shock?
- A. Tachycardia
- B. Slow respirations
- C. Warm, flushed skin
- D. Decreased blood pressure
Correct answer: A
Rationale: Tachycardia is an early sign of shock as the body tries to maintain cardiac output in the face of declining circulatory volume. Blood pressure often remains normal until late in the progression, at which point decompensated shock is occurring.
5. George has a T tube in place after gallbladder surgery. Before discharge, what information or instructions should be given regarding the T tube drainage?
- A. If there is any drainage, notify the surgeon immediately.
- B. The drainage will decrease daily until the bile duct heals.
- C. First, the drainage is dark green; then it becomes dark yellow.
- D. If the drainage stops, milk the tube toward the puncture wound.
Correct answer: B
Rationale: Before discharge, inform the patient that the drainage will decrease daily until the bile duct heals.
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