ATI RN
RN ATI Capstone Proctored Comprehensive Assessment A
1. The client has a do-not-resuscitate (DNR) order. The family asks the nurse to ignore the DNR if the client codes. What is the nurse's responsibility?
- A. Follow the family's wishes
- B. Explain that the DNR must be honored
- C. Ignore the DNR and proceed with CPR
- D. Perform CPR if the client codes
Correct answer: B
Rationale: The correct answer is B: 'Explain that the DNR must be honored.' The nurse's responsibility is to follow the DNR order, as it is a legal and ethical obligation. Choice A is incorrect because following the family's wishes would go against the established DNR order. Choice C is incorrect as ignoring the DNR order is not appropriate. Choice D is also incorrect as performing CPR would be contrary to the client's expressed wishes in the DNR order.
2. A nurse is caring for a client who is postoperative and has compression stockings. Which action should the nurse take?
- A. Check the stockings for wrinkles
- B. Apply the stockings while the client is sitting in a chair
- C. Measure the size of the client's foot
- D. Remove the stockings once each day
Correct answer: A
Rationale: The correct action for the nurse to take is to check the stockings for wrinkles. This is important to ensure that the stockings are applied correctly without any folds or wrinkles, which can hinder proper circulation and compression. Option B is incorrect because compression stockings should be applied with the client lying down, not sitting in a chair. Option C is unnecessary as the size of the client's foot is unlikely to change postoperatively. Option D is incorrect as compression stockings are usually worn continuously except for specific care needs.
3. A client is preparing for surgery wearing a necklace. What is the appropriate action?
- A. Remove the necklace and place it in a drawer
- B. Tape the necklace to the patient's skin
- C. Ask the patient for permission to lock it in a safe
- D. Ask the family to hold onto the necklace
Correct answer: C
Rationale: The appropriate action when a client is wearing a necklace before surgery is to ask the patient for permission to lock it in a safe. This is in line with hospital policy to secure valuables before entering surgery. Choice A is incorrect because simply placing the necklace in a drawer may not be secure. Choice B is incorrect as taping the necklace to the patient's skin can cause skin irritation and is not a standard practice. Choice D is incorrect because the responsibility for securing valuables typically lies with the healthcare team, not the patient's family.
4. A nurse manager of a rural clinic is orienting a new employee. Which of the following information should the nurse include as a characteristic of rural health?
- A. Lower rates of maternal morbidity
- B. Reduced incidence of death from motor-vehicle crashes
- C. Increased rates of chronic illness
- D. More frequent dental preventative care visits
Correct answer: C
Rationale: The correct answer is C: 'Increased rates of chronic illness.' Rural areas often face challenges such as limited access to healthcare services, healthcare provider shortages, socioeconomic factors, and lifestyle choices that contribute to higher rates of chronic illnesses. Maternal morbidity rates are typically higher in rural areas due to limited access to obstetric care. While rural areas may have fewer motor-vehicle crashes compared to urban areas, the severity of crashes is usually higher due to factors like longer emergency response times. Dental care access can also be limited in rural areas, leading to less frequent preventative care visits.
5. Which action by the nurse represents the ethical principle of beneficence?
- A. Ensuring all clients are treated fairly
- B. Preventing harm by providing accurate information
- C. Allowing the client to refuse treatment
- D. Ensuring the client's family agrees with the treatment
Correct answer: B
Rationale: The correct answer is B. Beneficence is the ethical principle of doing good or acting in the best interest of the client. Preventing harm by providing accurate information and necessary care aligns with the principle of beneficence, as it focuses on promoting the well-being and safety of the client. Choices A, C, and D do not directly reflect the concept of beneficence. Ensuring all clients are treated fairly relates more to justice, allowing the client to refuse treatment pertains to autonomy, and ensuring the client's family agrees with the treatment involves collaboration and communication but not specifically beneficence.
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