ATI RN TEST BANK

RN ATI Capstone Proctored Comprehensive Assessment Form B

How should a healthcare provider manage a patient with deep vein thrombosis (DVT)?

    A. Monitoring for signs of pulmonary embolism

    B. Applying compression stockings

    C. Administering anticoagulants as prescribed

    D. Encouraging leg elevation to reduce swelling

Correct Answer: A
Rationale: Corrected Rationale: Monitoring for signs of pulmonary embolism is crucial in patients with deep vein thrombosis (DVT) as it can be a life-threatening complication. While administering anticoagulants as prescribed is important for preventing clot progression, the immediate concern is detecting potential pulmonary embolism. Applying compression stockings and encouraging leg elevation are beneficial measures for managing DVT symptoms but are not as critical as monitoring for pulmonary embolism.

A health care provider asks the nurse to administer a medication with a dosage significantly higher than usual. What is the nurse's first action?

  • A. Administer the medication as ordered.
  • B. Question the provider and verify the dose.
  • C. Administer half the dosage as a precaution.
  • D. Refuse to administer the medication without clarification.

Correct Answer: B
Rationale: When a health care provider orders a medication with a dosage significantly higher than usual, the nurse's initial action should be to question the provider and verify the dose. This is crucial to ensure patient safety and prevent medication errors. Administering the medication as ordered (Choice A) without clarification could potentially harm the patient if there was an error in the prescription. Administering half the dosage as a precaution (Choice C) is not a safe practice as it deviates from the prescribed order. Refusing to administer the medication without clarification (Choice D) is important, but the first step should be to seek clarification from the provider to prevent any unnecessary delays in patient care.

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.

A healthcare professional is preparing to insert an indwelling urinary catheter. What is the most important action to prevent infection?

  • A. Use sterile gloves during the procedure.
  • B. Clean the catheter insertion site with alcohol.
  • C. Insert the catheter as quickly as possible.
  • D. Use a smaller catheter size to minimize trauma.

Correct Answer: A
Rationale: Using sterile gloves during catheter insertion is crucial to prevent infection. Sterile gloves help maintain asepsis during the procedure, reducing the risk of introducing microorganisms into the urinary tract. Cleaning the insertion site with alcohol, as mentioned in choice B, is important but not as critical as using sterile gloves. Choice C, inserting the catheter as quickly as possible, is not recommended as it can lead to errors and increase the risk of contamination. Choice D, using a smaller catheter size to minimize trauma, is not directly related to preventing infection but rather focuses on patient comfort and reducing tissue damage.

A nurse is planning a staff education program to review nursing interventions for clients who have kidney failure. Which of the following sources should the nurse identify as the best resource for obtaining evidence-based information?

  • A. The advice of an expert nephrology nurse
  • B. Retrospective chart reviews
  • C. Facility critical pathway
  • D. A recent peer-reviewed nursing research article

Correct Answer: D
Rationale: A peer-reviewed nursing research article is the best resource for obtaining evidence-based information because it provides the most current and reliable data on nursing interventions. Choice A, the advice of an expert nephrology nurse, may be helpful but could be based on individual experience rather than the latest research. Retrospective chart reviews (Choice B) focus on past cases and may not reflect current best practices. Facility critical pathways (Choice C) offer standardized care plans but may not always incorporate the most up-to-date evidence-based practices.

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