ATI RN TEST BANK

ATI Capstone Comprehensive Assessment B

Which action by the nurse demonstrates effective infection control measures?

    A. Perform hand hygiene before and after patient contact.

    B. Wear gloves when administering medications.

    C. Dispose of used equipment in designated containers.

    D. Wear a mask when interacting with the patient.

Correct Answer: A
Rationale: The correct answer is A: Perform hand hygiene before and after patient contact. Effective hand hygiene is a fundamental infection control measure that helps prevent the spread of pathogens. Wearing gloves when administering medications (choice B) is important for protecting both the patient and the nurse but is not a direct demonstration of infection control. Disposing of used equipment in designated containers (choice C) is more related to proper waste management than infection control. Wearing a mask when interacting with the patient (choice D) is essential in certain situations, but hand hygiene is a more universal and critical practice for infection control.

The nurse is evaluating a client who had a cardiac catheterization with a left antecubital insertion site. Which of the following pulses should the nurse palpate?

  • A. Brachial pulse in the right arm
  • B. Radial pulse in the right arm
  • C. Brachial pulse in the left arm
  • D. Radial pulse in the left arm

Correct Answer: D
Rationale: The correct answer is to palpate the radial pulse in the left arm. When the antecubital insertion site is on the left side, it is important to assess the radial pulse on the same side to monitor circulation accurately. Palpating the brachial pulse in the right or left arm or the radial pulse in the right arm would not provide direct information about the circulation related to the catheterization site.

A patient with a history of hypertension is admitted for chest pain. What is the most appropriate action for the nurse to take first?

  • A. Obtain a detailed medical history
  • B. Administer nitroglycerin
  • C. Conduct an ECG
  • D. Administer morphine sulfate

Correct Answer: B
Rationale: The correct answer is to administer nitroglycerin. Nitroglycerin is the priority intervention for a patient presenting with chest pain as it helps dilate blood vessels, reduce chest pain, and improve oxygen supply to the heart. Obtaining a detailed medical history, conducting an ECG, or administering morphine sulfate are important steps in the assessment and treatment process but are secondary to the immediate need to address chest pain and potential cardiac ischemia.

Which principle is most important for maintaining medical asepsis in a healthcare setting?

  • A. Sterilize instruments only when visibly contaminated.
  • B. Use sterile gloves for all patient interactions.
  • C. Disinfect patient areas only at the end of the day.
  • D. Clean hands thoroughly before and after patient contact.

Correct Answer: D
Rationale: The correct answer is D: Clean hands thoroughly before and after patient contact. Hand hygiene is crucial for maintaining medical asepsis in a healthcare setting as it helps prevent the spread of infections between patients and healthcare workers. Choice A is incorrect because instruments should be sterilized regularly, not just when visibly contaminated. Choice B is incorrect as sterile gloves are not required for all patient interactions, only for specific procedures. Choice C is incorrect because patient areas should be disinfected regularly throughout the day, not just at the end of the day.

Which question is essential during screening for alcohol use disorder?

  • A. What is your current employment status?
  • B. Have you experienced any blackouts or loss of consciousness?
  • C. Have you been sleeping well over the past month?
  • D. Do you have a family history of substance use?

Correct Answer: B
Rationale: The essential question during screening for alcohol use disorder is asking about blackouts or loss of consciousness, which can be indicative of excessive drinking and related to alcohol use disorder. Choices A, C, and D are not as directly related to screening for alcohol use disorder. Employment status (Choice A) is not a primary question in alcohol use disorder screening. Sleep quality (Choice C) and family history of substance use (Choice D) may be relevant but are not as crucial as inquiring about blackouts or loss of consciousness.

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