ATI RN
RN ATI Capstone Proctored Comprehensive Assessment A
1. Which of the following is a critical nursing action when managing a patient with a chest tube?
- A. Keep the chest tube clamped at all times.
- B. Ensure the chest tube is connected to a closed drainage system.
- C. Empty the chest tube drainage system every 2 hours.
- D. Disconnect the chest tube when the patient is ambulating.
Correct answer: B
Rationale: The correct answer is B: "Ensure the chest tube is connected to a closed drainage system." This is a critical nursing action when managing a patient with a chest tube because it is essential for proper drainage and to prevent complications such as air leaks or infections. Option A is incorrect because keeping the chest tube clamped at all times would prevent proper drainage and could lead to complications. Option C is incorrect as emptying the chest tube drainage system should be done based on assessment findings rather than a fixed time interval. Option D is incorrect because disconnecting the chest tube when the patient is ambulating can lead to complications like a pneumothorax.
2. A family was referred to crisis intervention services after a natural disaster. One family member refuses to attend, stating, 'No way, I'm not crazy.' What is the nurse's best response?
- A. Don't worry now. The psychiatrists are well trained to help.
- B. Many times, disasters can create mental health problems, so you really should participate with your family.
- C. This will help your family communicate better.
- D. Seeking this kind of help does not mean that you have a mental illness; it is a short-term problem-solving technique.
Correct answer: D
Rationale: The nurse should reassure the family member that seeking help does not imply mental illness, but is part of coping with the disaster.
3. A patient has just undergone a tracheostomy. What is the nurse's priority intervention?
- A. Suction the tracheostomy to maintain a patent airway.
- B. Administer pain medication as prescribed.
- C. Change the tracheostomy dressing every 4 hours.
- D. Monitor the patient's oxygen saturation closely.
Correct answer: A
Rationale: The correct answer is to suction the tracheostomy to maintain a patent airway. After a tracheostomy, the priority intervention is to ensure a clear airway to prevent respiratory distress. Administering pain medication, changing the tracheostomy dressing, and monitoring oxygen saturation are important but are secondary to maintaining a patent airway in a patient who has just undergone a tracheostomy.
4. A client has urinary incontinence, and the nurse is caring for them. Which of the following actions should the nurse implement to prevent the development of skin breakdown?
- A. Request a prescription for the insertion of an indwelling urinary catheter
- B. Check the client's skin every 8 hours for signs of breakdown
- C. Apply a moisture barrier ointment to the client's skin
- D. Clean the client's skin and perineum with hot water after each episode of incontinence
Correct answer: C
Rationale: The correct action to prevent skin breakdown in a client with urinary incontinence is to apply a moisture barrier ointment to the skin. This ointment helps protect the skin from the harmful effects of moisture exposure, reducing the risk of breakdown. Requesting an indwelling urinary catheter (Choice A) should not be the first-line intervention for skin breakdown prevention. Checking the client's skin for signs of breakdown (Choice B) is important but not as effective as applying a moisture barrier. Cleaning the skin with hot water (Choice D) can actually be detrimental as hot water can strip the skin of its natural oils and worsen skin integrity.
5. A school nurse is providing care for students in an elementary education facility. Which of the following interventions by the nurse addresses the primary level of prevention?
- A. Design interventions for a student's individual education plan (IEP).
- B. Teach students about healthy food choices.
- C. Perform first aid for minor injuries.
- D. Perform scoliosis screenings for students.
Correct answer: B
Rationale: The correct answer is B because teaching students about healthy food choices is a primary prevention strategy that aims to prevent future health issues by promoting healthy behaviors. Choice A, designing interventions for an individual education plan (IEP), is more related to addressing specific educational needs rather than preventing health issues. Choice C, performing first aid for minor injuries, is a form of secondary prevention aimed at reducing the impact of existing health problems. Choice D, performing scoliosis screenings for students, falls under secondary prevention by detecting health issues early rather than preventing them.
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