ATI RN
RN ATI Capstone Proctored Comprehensive Assessment Form B
1. What are the nursing priorities when caring for a patient with a newly placed peripherally inserted central catheter (PICC)?
- A. Performing sterile dressing changes
- B. Educating the patient on PICC line care
- C. Flushing the PICC line as prescribed
- D. Inspecting the insertion site for signs of infection
Correct answer: A
Rationale: The correct answer is A: Performing sterile dressing changes. When caring for a patient with a newly placed PICC line, one of the nursing priorities is to ensure proper care of the insertion site by performing sterile dressing changes. This helps prevent infections and maintain the integrity of the line. While educating the patient on PICC line care, flushing the PICC line as prescribed, and inspecting the insertion site for signs of infection are important aspects of care, the priority immediately after insertion is to maintain the sterility of the site through proper dressing changes.
2. What should be done to manage a patient with contact precautions?
- A. Wear a mask, gown, and gloves for all patient interactions.
- B. Ensure that visitors wear protective equipment.
- C. Dedicate all patient care equipment to that patient.
- D. Disinfect shared equipment before use.
Correct answer: C
Rationale: When managing a patient with contact precautions, it is essential to dedicate all patient care equipment to that specific patient. This practice helps minimize the risk of spreading infections to other patients. Choice A, wearing protective gear for all patient interactions, is a general precaution but not specific to managing a patient with contact precautions. Choice B, ensuring visitors wear protective equipment, is important for infection control but not directly related to managing the patient with contact precautions. Choice D, disinfecting shared equipment before use, is a good practice for infection control in general but does not address the specific needs of a patient under contact precautions.
3. What are the signs of infection that should be monitored in a postoperative patient?
- A. Fever and chills
- B. All of the above
- C. Increased pain or tenderness
- D. Redness, swelling, and warmth at the surgical site
Correct answer: D
Rationale: The correct answer is D: 'Redness, swelling, and warmth at the surgical site.' These are specific signs of infection at the surgical site that a nurse should monitor for in a postoperative patient. While fever, chills, and increased pain can also indicate infection, the most direct signs are redness, swelling, and warmth at the surgical site. Therefore, 'D' is the best choice as it directly relates to the site of the surgery and is crucial to monitor for potential postoperative infections.
4. A client has bilateral eye patches following an injury. When the client's food tray arrives, which of the following interventions should the nurse take to promote independence in eating?
- A. Explain to the client that their tray is here and place their hands on it
- B. Ask the client if they would prefer a liquid diet
- C. Assign an assistive personnel to feed the client
- D. Describe to the client the location of the food on the tray
Correct answer: D
Rationale: Describing the location of food on the tray helps promote independence for the client with bilateral eye patches. By providing clear instructions on where the food is placed, the client can independently locate and consume their meal. Option A is incorrect as physically placing the client's hands on the tray does not encourage independence. Option B is unnecessary unless there are specific dietary restrictions indicated. Option C does not promote the client's independence and should be avoided unless absolutely necessary.
5. Which intervention is essential when caring for a patient with a nasogastric (NG) tube?
- A. Suction the NG tube every 4 hours.
- B. Check the placement of the NG tube before each feeding.
- C. Flush the NG tube with water before and after each medication administration.
- D. Remove the NG tube once the patient feels comfortable.
Correct answer: B
Rationale: Checking the placement of the NG tube before each feeding is crucial to ensure it is correctly positioned and safe to use. Option A is incorrect as routine suctioning can lead to complications and should only be done as needed. Option C is not necessary unless there are specific instructions for flushing. Option D is incorrect as the NG tube should only be removed by healthcare professionals based on medical criteria, not solely based on the patient's comfort.
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