ATI RN
RN ATI Capstone Proctored Comprehensive Assessment Form B
1. An occupational health nurse is preparing to teach a health promotion class for workers at a warehouse. Which of the following statements should the nurse include?
- A. Rub your hands together for at least 10 seconds when washing them.
- B. Keep your abdominal muscles tightened when lifting objects.
- C. Ensure that 20% or less of calories come from saturated fats.
- D. Engage in aerobic exercise 2 to 4 days per week for 20 minutes.
Correct answer: B
Rationale: The correct statement to include is to 'Keep your abdominal muscles tightened when lifting objects.' This practice helps protect the back from injury by providing core stability. Rubbing hands together for 10 seconds when washing them (Choice A) is a good hygiene practice, but not directly related to warehouse work safety. Ensuring 20% or less of calories come from saturated fats (Choice C) is important for overall health but not specific to workplace safety. Engaging in aerobic exercise 2 to 4 days per week for 20 minutes (Choice D) is beneficial for health but not as directly relevant to preventing injuries while working in a warehouse.
2. A client complains of pain in their leg, and the nurse notes swelling and pallor. What is the priority nursing action?
- A. Administer pain medication.
- B. Elevate the limb and monitor closely.
- C. Encourage movement to reduce swelling.
- D. Notify the provider immediately about the symptoms.
Correct answer: D
Rationale: The correct answer is D: Notify the provider immediately about the symptoms. Swelling and pallor in a limb can be indicative of serious circulatory issues or compartment syndrome. It is crucial to inform the healthcare provider promptly to assess and address the situation. Administering pain medication (choice A) may temporarily alleviate the symptoms but does not address the underlying cause. Elevating the limb and monitoring closely (choice B) can be beneficial but does not replace the need for immediate professional evaluation. Encouraging movement to reduce swelling (choice C) is contraindicated in this scenario as it may worsen the condition if a circulatory issue or compartment syndrome is present.
3. A nurse is preparing to administer a blood transfusion. What is the most important action to ensure patient safety?
- A. Check the patient's vital signs every 15 minutes during the transfusion.
- B. Verify the patient's identity with two identifiers before starting the transfusion.
- C. Ensure the blood product is administered within 4 hours of removal from the blood bank.
- D. Ensure the patient has signed the informed consent form.
Correct answer: B
Rationale: The most important action to ensure patient safety when administering a blood transfusion is to verify the patient's identity with two identifiers before starting the transfusion. This step is crucial to prevent transfusion errors, such as giving the blood to the wrong patient. Checking vital signs, ensuring timely administration, and confirming informed consent are also important aspects of blood transfusion safety but verifying the patient's identity is the highest priority to prevent errors.
4. A nurse is caring for a patient who has just returned from surgery. What is the nurse's priority action?
- A. Monitor the patient's pain level.
- B. Assess the patient's vital signs.
- C. Assess the surgical incision site.
- D. Position the patient in a high Fowler's position.
Correct answer: B
Rationale: The correct answer is B: Assess the patient's vital signs. Assessing vital signs is crucial as it helps to detect any early signs of complications such as bleeding, shock, or changes in oxygenation. Monitoring the patient's pain level (Choice A) is important but assessing vital signs takes precedence. While assessing the surgical incision site (Choice C) is essential, ensuring the patient's physiological stability through vital sign assessment is the priority. Positioning the patient in a high Fowler's position (Choice D) may be necessary for comfort but does not address the immediate need to assess the patient's condition post-surgery.
5. A nurse is developing a plan of care for an older adult who is at risk for falls. Which of the following actions should the nurse include?
- A. Lock beds and wheelchairs when not in use
- B. Administer a sedative at bedtime
- C. Provide information about home safety checks
- D. Teach balance and strengthening exercises
Correct answer: A
Rationale: The correct action for the nurse to include in the plan of care for an older adult at risk for falls is to lock beds and wheelchairs when not in use. This measure is crucial for preventing falls and ensuring patient safety in healthcare settings. Administering sedatives at bedtime (Choice B) is not recommended as it does not address the underlying risk factors for falls and may increase the risk of injury. Providing information about home safety checks (Choice C) is important for fall prevention in the home environment but is not directly related to healthcare settings. Teaching balance and strengthening exercises (Choice D) is beneficial for fall prevention but may not be suitable for all older adults at risk for falls, especially in acute care settings.
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