ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 B with NGN
1. Which intervention should be prioritized for a client experiencing panic-level anxiety?
- A. Postpone health teaching until anxiety subsides
- B. Encourage participation in group therapy
- C. Monitor vital signs every 5 minutes
- D. Provide reassurance and remain with the client
Correct answer: D
Rationale: During panic-level anxiety, the priority is to provide reassurance and remain with the client. This intervention helps to offer immediate support, comfort, and a sense of safety to the client. Postponing health teaching until anxiety subsides (Choice A) is not appropriate as the client's immediate emotional needs are more critical. Encouraging participation in group therapy (Choice B) may be beneficial in the long term but is not the priority during a panic attack. While monitoring vital signs (Choice C) is important, providing reassurance and support take precedence in managing panic-level anxiety.
2. A nurse is caring for a client who has septic shock. Which of the following findings should the nurse report to the provider?
- A. Temperature of 38°C (100.4°F).
- B. Urinary output of 40 mL/hr.
- C. Heart rate of 92/min.
- D. Capillary refill time of 2 seconds.
Correct answer: B
Rationale: The correct answer is B. A urinary output of 40 mL/hr is below the expected range and should be reported to the provider as it may indicate impaired kidney function, which is crucial to monitor in a client with septic shock. Choices A, C, and D are within acceptable ranges for a client with septic shock and do not indicate immediate concerns. A temperature of 38°C (100.4°F) is slightly elevated but can be expected in septic shock. A heart rate of 92/min is within the normal range for an adult. A capillary refill time of 2 seconds is also normal, indicating adequate peripheral perfusion.
3. Which is NOT one of the functions of challenging behaviors?
- A. Avoiding a situation
- B. Escaping from an undesired object or event
- C. Obtaining a desired object or event
- D. Sensory functions
Correct answer: E
Rationale: Challenging behaviors often serve functions related to avoiding, escaping, obtaining, or sensory needs. The question is asking for the function that does not typically apply to challenging behaviors. Choices A, B, C, and D align with the common functions associated with challenging behaviors. Therefore, 'E' is the correct answer as it does not represent a typical function of challenging behaviors.
4. A patient with diabetes should be advised to avoid which type of carbohydrate?
- A. Simple carbohydrates
- B. Complex carbohydrates
- C. Fiber-rich carbohydrates
- D. All carbohydrates
Correct answer: A
Rationale: The correct answer is A: Simple carbohydrates. Simple carbohydrates can cause rapid spikes in blood glucose levels, which can be problematic for patients with diabetes. These carbohydrates are quickly broken down and absorbed by the body, leading to sharp increases in blood sugar levels. In contrast, complex carbohydrates and fiber-rich carbohydrates are generally better choices for individuals with diabetes because they are digested more slowly, resulting in a more gradual rise in blood glucose levels. Choice B, complex carbohydrates, are a better option for diabetic patients compared to simple carbohydrates. Choice C, fiber-rich carbohydrates, can also be beneficial for individuals with diabetes as they help in regulating blood sugar levels. Choice D, all carbohydrates, is too broad of a statement as not all carbohydrates have the same impact on blood glucose levels.
5. The patient taking spironolactone (Aldactone) makes a statement indicating effective teaching. Which statement shows understanding of the teaching?
- A. I will use salt substitutes to lower my sodium intake
- B. I will increase my intake of foods that are high in potassium
- C. I will call my doctor if I begin having menstrual irregularities
- D. I will take this medication at bedtime each evening
Correct answer: C
Rationale: The correct answer is C because spironolactone is a potassium-sparing diuretic that can cause endocrine effects like menstrual irregularities. Therefore, the patient recognizing the need to report such changes indicates effective teaching. Choices A and B are incorrect as salt substitutes and high-potassium foods should be avoided with spironolactone. Choice D is also incorrect because diuretics, including spironolactone, are ideally taken in the morning to prevent disturbances in sleep due to nocturia.
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