ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 B with NGN
1. How is the effectiveness of a diuretic in a patient with heart failure evaluated?
- A. Checking daily weights and lung sounds for improvement
- B. Assessing the patient's blood pressure and urine output
- C. Monitoring for weight loss and reduction in edema
- D. Measuring the patient's heart rate and lung sounds
Correct answer: A
Rationale: The correct way to evaluate the effectiveness of a diuretic in a patient with heart failure is by checking daily weights and lung sounds for improvement. Daily weights help to assess fluid retention changes, while improvement in lung sounds indicates reduced pulmonary congestion. Assessing blood pressure and urine output (Choice B) is important but does not directly evaluate the effectiveness of the diuretic. Monitoring for weight loss and reduction in edema (Choice C) are valid indicators of diuretic effectiveness, but direct observation of daily weights and lung sounds is more specific. Measuring heart rate and lung sounds (Choice D) is relevant but does not directly assess the impact of the diuretic on fluid balance and pulmonary status.
2. A client at 14 weeks gestation reports feelings of ambivalence about being pregnant. Which of the following responses should the nurse make?
- A. Describe your feelings to me about being pregnant.
- B. You should discuss your feelings with your provider.
- C. Have you discussed these feelings with your partner?
- D. When did you start having these feelings?
Correct answer: A
Rationale: The correct response is to use open-ended questions that allow the client to explore and express their feelings. Choice A encourages the client to describe their feelings, fostering open communication and providing an opportunity for the client to express themselves freely. Choices B and C do not directly address the client's feelings and may not promote open communication. Choice D focuses on the timing of the feelings rather than exploring the feelings themselves, making it a less therapeutic response.
3. A client signed an informed consent form for surgery but has expressed doubts about the need for surgery. What should the nurse say?
- A. Reassure the client of the surgeon's skill
- B. The surgeon will answer your questions before surgery
- C. Tell the client surgery is necessary
- D. Encourage the client to seek a second opinion
Correct answer: B
Rationale: The correct answer is B because the surgeon should address the client's doubts before surgery. Informed consent requires that the client fully understands the procedure. Choice A is incorrect because reassuring the client of the surgeon's skill does not address the client's doubts about the need for surgery. Choice C is incorrect because telling the client surgery is necessary may not address their concerns and could violate the principle of autonomy. Choice D is incorrect as the immediate concern is addressing the client's doubts before surgery, not necessarily seeking a second opinion.
4. A patient who is recovering from surgery should increase their intake of which nutrient to promote healing?
- A. Fats
- B. Carbohydrates
- C. Protein
- D. Fiber
Correct answer: C
Rationale: Protein is crucial for tissue repair and recovery after surgery. Proteins provide the building blocks necessary for tissue healing and regeneration. Fats are important for various bodily functions but are not as directly involved in tissue repair as proteins. Carbohydrates provide energy but do not play a primary role in tissue healing. Fiber is essential for digestive health but is not a nutrient that directly promotes tissue repair.
5. In conducting a cleansing enema, how does the nurse position the client?
- A. Right lateral position
- B. Left lateral position
- C. Right Sim's position
- D. Left Sim's position
Correct answer: B
Rationale: In preparing a patient for a cleansing enema, the nurse typically positions the patient in the left lateral position. This position allows for the best flow of the solution due to the anatomical configuration of the colon. The right lateral position, right Sim's position, and left Sim's position are not typically used for this procedure. The rationale provided initially is incorrect as it pertains to lung expansion and postural drainage, which are not relevant to a cleansing enema procedure.
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