ATI RN
RN ATI Capstone Proctored Comprehensive Assessment A
1. The family member is observing a family member changing a dressing for a patient in the home health environment. Which observation indicates the family member has a correct understanding of how to manage contaminated dressings?
- A. The family member saves part of the dressing because it is clean.
- B. The family member places the used dressings in a plastic bag.
- C. The family member removes gloves and gathers items for disposal.
- D. The family member wraps the used dressing in toilet tissue before placing it in the trash.
Correct answer: B
Rationale: The correct way to manage contaminated dressings is to place them in plastic bags for proper disposal. This helps prevent the spread of infection. Choice A is incorrect because saving part of the dressing is not a recommended practice. Choice C is not directly related to managing contaminated dressings. Choice D is incorrect as wrapping the used dressing in toilet tissue is not the appropriate way to dispose of contaminated dressings.
2. When educating the family of a client diagnosed with dissociative identity disorder, which of the following instructions should the nurse include?
- A. Encourage the client to avoid stressful situations.
- B. Encourage the client to participate in daily activities.
- C. Encourage the client to express their feelings.
- D. Encourage the client to develop a daily routine.
Correct answer: D
Rationale: In cases of dissociative identity disorder, it is beneficial for the client to establish a daily routine. This structure can enhance symptom management and provide a sense of stability, which is particularly important for individuals with this condition. Encouraging the client to avoid stressful situations (Choice A) may not always be possible and does not address the need for structure. While encouraging the client to participate in daily activities (Choice B) is important, having a routine is more crucial for managing dissociative identity disorder. Expressing feelings (Choice C) is valuable but establishing a routine takes precedence in this situation.
3. A client with chronic obstructive pulmonary disease (COPD) is being taught by a nurse. What nutrition information should the nurse include in the teaching?
- A. Avoid drinking fluids just before and during meals.
- B. Rest before meals if experiencing dyspnea.
- C. Consume about six small meals a day.
- D. Consume high-fiber foods to promote gastric emptying.
Correct answer: D
Rationale: While some of the other options may be helpful, the most appropriate advice for a client with COPD is to consume high-fiber foods to promote gastric emptying. Avoiding fluids just before and during meals can help prevent bloating, resting before meals can assist with dyspnea, and having several small meals a day can help reduce bloating. However, fibrous foods can lead to gas production, causing abdominal bloating and potentially worsening shortness of breath. Increasing calorie and protein intake is essential to prevent malnourishment. It is also important to avoid excessive carbohydrate intake, as it can increase carbon dioxide production and the risk of acidosis in COPD patients.
4. A healthcare professional is preparing to assess a 2-week-old newborn. Which of the following actions should the professional plan to take?
- A. Obtain the newborn's body temperature using a tympanic thermometer.
- B. FACES pain scale.
- C. Auscultate the newborn's apical pulse for 60 seconds.
- D. Measure the newborn's head circumference over the eyebrows and below the occipital prominence.
Correct answer: C: Auscultate the newborn's apical pulse for 60 seconds.
Rationale: Assessing the apical pulse in newborns is important to evaluate their cardiac function. The normal heart rate for a newborn is typically between 100-160 beats per minute. Auscultating the apical pulse for a full 60 seconds allows for an accurate assessment of the newborn's heart rate. This is a crucial component of the newborn assessment to ensure the baby's cardiovascular system is functioning within the expected range.
5. A client is admitted to a medical-surgical unit after six hours in the emergency room. He requests that his AM care be delayed to allow him to rest. The nurse complies with his request. This is an example of which type of management philosophy?
- A. Continuous quality improvement
- B. Total quality management
- C. Six Sigma
- D. Quality management
Correct answer: B
Rationale: Total Quality Management (TQM) emphasizes meeting customer needs and satisfaction. In this scenario, by honoring the client's request to delay care to allow for rest, the nurse is aligning with the customer-focused approach of TQM. TQM seeks to continuously improve processes and services to enhance customer experiences and outcomes. Continuous Quality Improvement focuses on incremental improvements in processes and outcomes over time. Six Sigma is a data-driven approach to process improvement that aims to reduce defects and errors. Quality Management is a broader concept that encompasses various strategies to ensure quality standards are met.
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