ATI RN
RN ATI Capstone Proctored Comprehensive Assessment Form A
1. A school nurse is providing care for students in an elementary education facility. Which of the following interventions by the nurse addresses the primary level of prevention?
- A. Design interventions for a student's individual education plan (IEP).
- B. Teach students about healthy food choices.
- C. Perform first aid for minor injuries.
- D. Perform scoliosis screenings for students.
Correct answer: B
Rationale: The correct answer is B because teaching students about healthy food choices is a primary prevention strategy that aims to prevent future health issues by promoting healthy behaviors. Choice A, designing interventions for an individual education plan (IEP), is more related to addressing specific educational needs rather than preventing health issues. Choice C, performing first aid for minor injuries, is a form of secondary prevention aimed at reducing the impact of existing health problems. Choice D, performing scoliosis screenings for students, falls under secondary prevention by detecting health issues early rather than preventing them.
2. A nurse is teaching a client about how to use her new hearing aids. Which of the following statements should the nurse identify as an indication that the client needs further instruction?
- A. I will not use hairspray if I am wearing the hearing aids
- B. I will clean the hearing aids with alcohol wipes
- C. I will change the batteries once a week
- D. I will expect the hearing aids to whistle when I cup my hand over them
Correct answer: B
Rationale: The correct answer is B because cleaning the hearing aids with alcohol wipes can damage them. It is important to use specialized cleaning tools or follow specific cleaning instructions provided by the manufacturer to prevent harm to the hearing aids. Choices A, C, and D demonstrate good understanding and appropriate care for hearing aids, indicating that the client does not need further instruction in those areas.
3. What are the clinical manifestations of hypovolemic shock, and how should a nurse respond?
- A. Hypertension, bradycardia, and oliguria
- B. Bradycardia, hypertension, and peripheral edema
- C. Tachypnea, cool skin, and confusion
- D. Tachycardia, hypotension, and decreased urine output
Correct answer: D
Rationale: The correct answer is D: Tachycardia, hypotension, and decreased urine output are classic clinical manifestations of hypovolemic shock. In hypovolemic shock, the body tries to compensate for low blood volume by increasing the heart rate (tachycardia) to maintain cardiac output, leading to hypotension and decreased urine output. Prompt fluid replacement is necessary to restore intravascular volume. Choices A, B, and C are incorrect because they do not represent the typical manifestations of hypovolemic shock.
4. A client has a new prescription for clopidogrel. Which of the following instructions should the nurse include?
- A. Take this medication with food
- B. Take this medication three times daily
- C. You might have to stop taking this medication 5 days before any planned surgeries
- D. Expect to have black-colored stools while taking this medication
Correct answer: C
Rationale: The correct answer is C. When instructing a client who is prescribed clopidogrel, the nurse should include information about stopping the medication 5 days before any planned surgeries to reduce the risk of bleeding. This is crucial to prevent excessive bleeding during surgical procedures. Choices A, B, and D are incorrect because taking the medication with food, the frequency of administration, and the possibility of black-colored stools are not specific instructions related to clopidogrel use.
5. A nurse is preparing a client for surgery. The client refuses to remove a religious medal. What is the nurse's best response?
- A. Ask the family to remove the medal
- B. Place the medal in a safe place for the client
- C. Allow the client to keep the medal during surgery
- D. Inform the client that the medal must be removed
Correct answer: C
Rationale: The correct answer is to allow the client to keep the medal during surgery. Clients may retain religious medals or jewelry during surgery if it does not interfere with the procedure. Asking the family to remove the medal (Choice A) may not be respecting the client's wishes. Placing the medal in a safe place for the client (Choice B) may cause distress to the client who wants to keep it. Informing the client that the medal must be removed (Choice D) disregards the client's beliefs and preferences.
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