ATI RN
RN ATI Capstone Proctored Comprehensive Assessment A
1. Which of the following is a correct method of safely using a sterile dressing?
- A. Reuse a dressing that appears clean.
- B. Discard a dressing after 24 hours of use.
- C. Change a dressing only if there is visible drainage.
- D. Change a dressing every 4 hours regardless of condition.
Correct answer: B
Rationale: The correct method of safely using a sterile dressing is to discard it after 24 hours of use. This is important to prevent contamination and promote proper wound healing. Choice A is incorrect because reusing a dressing, even if it appears clean, can introduce contaminants. Choice C is incorrect as dressing changes should not be based solely on visible drainage; they should be done within the recommended time frame. Choice D is incorrect because changing a dressing every 4 hours, regardless of its condition, can lead to unnecessary wastage and disturbance to the wound healing process.
2. A client asks about becoming an organ donor. What information should the nurse provide?
- A. The process should be discussed with family first.
- B. The organ donation process should begin immediately.
- C. Organ donation can proceed even if the family disagrees.
- D. Donor cards must be signed in the presence of a witness.
Correct answer: D
Rationale: The correct answer is D. For organ donation to be legally valid, the donor must sign consent documents in the presence of a witness. Choice A is incorrect because while discussing with family is important, it is not a legal requirement for organ donation. Choice B is incorrect as the organ donation process involves various steps and procedures that cannot begin immediately. Choice C is incorrect because organ donation typically requires consent and cooperation from the family if the donor is unable to provide consent.
3. How can dehydration be assessed in an elderly patient?
- A. Checking skin turgor on the forearm
- B. Assessing for dry mucous membranes
- C. Checking for orthostatic hypotension
- D. Measuring daily weights
Correct answer: A
Rationale: Assessing skin turgor by gently pinching the skin on the forearm is a reliable method to check for dehydration in elderly patients. When the skin is slow to return to its original position, it indicates dehydration. While assessing for dry mucous membranes is also important, checking skin turgor is a more direct method for dehydration assessment. Checking for orthostatic hypotension is more related to circulation status than dehydration. Measuring daily weights is helpful to monitor fluid balance but may not be as immediate or direct in detecting dehydration in elderly patients.
4. A client is being prepared for discharge after a stroke. Which of the following interventions should be included in the discharge plan to prevent complications?
- A. Recommend physical therapy to improve mobility
- B. Teach the client how to use an incentive spirometer
- C. Encourage the client to ambulate daily
- D. Provide education on proper medication management
Correct answer: D
Rationale: The correct answer is to provide education on proper medication management. Proper medication management is crucial in reducing the risk of stroke recurrence and ensuring the client adheres to the treatment plan. While physical therapy, incentive spirometer use, and daily ambulation are important aspects of stroke rehabilitation, they are not directly related to preventing complications during the discharge phase.
5. What should be done to ensure safety during the transfer of a patient with limited mobility?
- A. Have the patient use a gait belt for support.
- B. Encourage the patient to hold onto a walker.
- C. Lock the wheels on the bed and wheelchair.
- D. Ask the patient to transfer independently.
Correct answer: C
Rationale: The correct answer is to lock the wheels on the bed and wheelchair. This action helps prevent accidents by stabilizing the equipment during the transfer process. Having the patient use a gait belt for support (choice A) can be helpful but is not directly related to equipment safety. Encouraging the patient to hold onto a walker (choice B) is beneficial for ambulation but does not address the safety of equipment. Asking the patient to transfer independently (choice D) can pose risks, especially for a patient with limited mobility, and may not ensure safety during the transfer.
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