which action by the nurse will help reduce the risk of venous thromboembolism vte in a postoperative patient

ATI RN

RN ATI Capstone Proctored Comprehensive Assessment A

1. Which action by the nurse will help reduce the risk of venous thromboembolism (VTE) in a postoperative patient?

A. Encourage early ambulation and leg exercises.
B. Apply compression stockings to the patient's legs.
C. Administer anticoagulants as prescribed.
D. Elevate the patient's legs to promote circulation.

Correct answer: A

Rationale: The correct answer is to encourage early ambulation and leg exercises. By promoting early ambulation and leg exercises, blood flow is enhanced, reducing the risk of venous thromboembolism (VTE) in postoperative patients. Choice B, applying compression stockings, helps prevent VTE but is not as effective as early ambulation and exercises. Choice C, administering anticoagulants, is important in VTE prevention but does not directly address improving circulation through physical activity. Choice D, elevating the patient's legs, may be beneficial for circulation in specific cases but is not as effective in preventing VTE as early ambulation and leg exercises.

2. Which of the following is the correct method to reduce the risk of infection when handling a urinary catheter?

A. Clean the catheter tubing with soap and water.
B. Maintain sterile technique when inserting the catheter.
C. Insert the catheter using clean gloves and a clean technique.
D. Flush the catheter tubing regularly with sterile water.

Correct answer: B

Rationale: The correct method to reduce the risk of infection when handling a urinary catheter is to maintain sterile technique when inserting the catheter. Sterile technique helps prevent introducing pathogens into the urinary system, reducing the risk of infection. Choice A is incorrect because cleaning the catheter tubing with soap and water is not sufficient for preventing infection. Choice C is incorrect as clean gloves and technique are not enough; sterile technique is necessary. Choice D is incorrect as flushing the catheter tubing with sterile water, though important for maintaining catheter patency, does not address the need for sterile technique during insertion to prevent infection.

3. A nurse is planning preoperative care for a client who will undergo surgery. Which of the following is the priority action by the nurse?

A. Discuss whether family members will assist with postoperative care
B. Review the client's current home environment
C. Identify the client's usual coping mechanisms
D. Determine what the client knows about the surgery

Correct answer: D

Rationale: In the preoperative phase, determining what the client knows about the surgery is the priority. This action helps address misconceptions, provide necessary information, and ensure the client's understanding and cooperation. Choices A, B, and C are important aspects of preoperative care but assessing the client's knowledge about the surgery takes precedence to alleviate fears, enhance communication, and optimize outcomes.

4. Which of the following is an example of professional negligence?

A. Following facility guidelines at all times
B. Using equipment in a knowledgeable manner
C. Communicating effectively with clients
D. Documenting client interactions accurately

Correct answer: A

Rationale: Professional negligence involves failing to meet the standard of care expected in a particular profession, which can lead to harm. In this case, not following facility guidelines can result in lapses in safety or quality of care, potentially causing harm to clients. Choices B, C, and D all represent essential aspects of professional conduct and do not directly relate to negligence.

5. Which patient should the nurse see first?

A. A 1-month-old infant looking at a shiny, round battery just out of arm's reach.
B. A 56-year-old patient with oxygen and a lighter on the bedside table.
C. A 56-year-old patient with oxygen using an electric razor for grooming.
D. A bedridden patient who has a reddened area on the buttocks and needs to be turned.

Correct answer: B

Rationale: The correct answer is B because the patient with oxygen and a lighter on the bedside table is at immediate risk of fire. Oxygen promotes combustion, and having a lighter nearby poses a serious safety hazard. This situation requires urgent attention to prevent a potential disaster. Choices A, C, and D do not present immediate life-threatening risks compared to the patient with oxygen and a lighter nearby.