ATI RN
RN ATI Capstone Proctored Comprehensive Assessment A
1. The nurse has received a report from the emergency department that a patient with tuberculosis will be coming to the unit. Which items will the nurse need to care for this patient?
- A. N95 respirator, gown, gloves, eyewear
- B. Communication signs for droplet precautions
- C. Negative-pressure airflow in room
- D. Communication signs for airborne precautions
Correct answer: A
Rationale: The correct answer is A. Caring for a patient with tuberculosis requires the nurse to use an N95 respirator, gown, gloves, and eyewear to protect against airborne transmission of the disease. Choice B and D are incorrect because while communication signs for precautions are important, the essential items needed for caring for a patient with tuberculosis are personal protective equipment to prevent transmission. Choice C is also incorrect as negative-pressure airflow in the room is a facility-related requirement and not an item carried by the nurse.
2. The patient has the nursing diagnosis of Impaired physical mobility related to pain in the left shoulder. Which priority action will the nurse take?
- A. Assist the patient with comfort measures.
- B. Keep the patient as mobile as possible.
- C. Encourage the patient to perform ROM.
- D. Encourage the patient to do self-care.
Correct answer: A
Rationale: The correct answer is A: 'Assist the patient with comfort measures.' When a patient is experiencing impaired physical mobility due to pain, the priority action is to provide comfort measures to help manage the pain. By addressing the pain, the patient may then feel more comfortable moving and engaging in mobility exercises. Option B, 'Keep the patient as mobile as possible,' could exacerbate the pain and should not be the initial action. While encouraging range of motion (ROM) exercises (Option C) and self-care (Option D) are important aspects of care, addressing pain and comfort should take precedence in this scenario.
3. A healthcare provider is providing teaching for a patient with a prescription for oral metronidazole, what is the priority teaching point?
- A. Report headaches
- B. Report a rash
- C. Avoid sunlight
- D. Take with meals
Correct answer: B
Rationale: The correct answer is to 'Report a rash.' Metronidazole can cause severe adverse reactions like Stevens-Johnson syndrome, a life-threatening rash. It is crucial to educate the patient to report any rash immediately to prevent serious complications. Choices A, C, and D are incorrect because while they may be relevant to consider during metronidazole therapy, they are not the priority teaching point. Headaches can occur but are not as serious as a rash; avoiding sunlight is more related to doxycycline, not metronidazole; and taking with meals is a general instruction for some medications but not the priority teaching point for metronidazole.
4. Which intervention will best help a patient with chronic pain maintain mobility?
- A. Provide the patient with opioids to control pain.
- B. Encourage stretching exercises to improve flexibility.
- C. Teach the patient to use assistive devices like a cane.
- D. Recommend complete bed rest until the pain subsides.
Correct answer: B
Rationale: Encouraging stretching exercises is the most appropriate nursing intervention to help a patient with chronic pain maintain mobility. Stretching exercises can improve flexibility, prevent stiffness, and promote better range of motion in patients with chronic pain. Providing opioids (Choice A) may help control pain but does not directly address mobility. Teaching the patient to use assistive devices (Choice C) may be beneficial but does not focus on improving mobility directly. Recommending complete bed rest (Choice D) can lead to deconditioning and further loss of mobility, which is not recommended for chronic pain management.
5. Which of the following is a common manifestation of opioid withdrawal?
- A. Bradycardia and hypotension
- B. Tremors and increased blood pressure
- C. Severe muscle weakness and fatigue
- D. Severe hallucinations and delusions
Correct answer: B
Rationale: The correct answer is B: Tremors and increased blood pressure. During opioid withdrawal, individuals commonly experience symptoms such as tremors, increased blood pressure, and restlessness. Choice A, which suggests bradycardia and hypotension, is incorrect as opioid withdrawal often leads to tachycardia (rapid heart rate) and increased blood pressure. Choice C, severe muscle weakness and fatigue, is not a typical manifestation of opioid withdrawal. Choice D, severe hallucinations and delusions, is more characteristic of conditions like delirium tremens associated with alcohol withdrawal, rather than opioid withdrawal.
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