RN ATI Capstone Proctored Comprehensive Assessment Form A - Nurselytic

Correct Answer: A

Rationale: When a patient is exhibiting signs of acute myocardial infarction (AMI), the priority action is to call for emergency assistance immediately. This ensures that the patient receives prompt and appropriate care, including interventions such as administering oxygen, nitroglycerin, and monitoring cardiac rhythm. Administering nitroglycerin should only be done if prescribed by a healthcare provider after assessment and confirmation of AMI. Monitoring the patient's cardiac rhythm is important but not the initial action needed in this critical situation. Administering oxygen and preparing for an ECG are important interventions but should follow the immediate step of calling for emergency assistance.

Correct Answer: C

Rationale: Lentils are an excellent source of protein, suitable for a vegan diet, and promote wound healing. Brown rice (
Choice
A) is a carbohydrate-rich food and lacks sufficient protein for wound healing. Pureed avocado (
Choice
B) is a healthy fat source but low in protein. Orange juice (
Choice
D) is a source of vitamin C but lacks protein needed for wound healing.

Correct Answer: B

Rationale: The correct answer is B: Tremors and increased blood pressure. During opioid withdrawal, individuals commonly experience symptoms such as tremors, increased blood pressure, and restlessness.
Choice A, which suggests bradycardia and hypotension, is incorrect as opioid withdrawal often leads to tachycardia (rapid heart rate) and increased blood pressure.
Choice C, severe muscle weakness and fatigue, is not a typical manifestation of opioid withdrawal.
Choice D, severe hallucinations and delusions, is more characteristic of conditions like delirium tremens associated with alcohol withdrawal, rather than opioid withdrawal.

Correct Answer: B

Rationale: During a client's transition into a new role, the presence of suicidal or homicidal ideation should be assessed due to the increased risk associated with significant life changes. This finding could indicate a need for immediate intervention. While assessing the client's ability to express feelings of guilt is important, it may not be the most critical aspect during this specific assessment. Changes in coping skills over time are relevant but might not be the primary focus during a role transition assessment. The client's involvement in community activities, although beneficial for social support, is not directly related to the immediate concerns of assessing a client transitioning into a new role.

Correct Answer: B

Rationale: The correct answer is B because cleaning the hearing aids with alcohol wipes can damage them. It is important to use specialized cleaning tools or follow specific cleaning instructions provided by the manufacturer to prevent harm to the hearing aids.

Choices A, C, and D demonstrate good understanding and appropriate care for hearing aids, indicating that the client does not need further instruction in those areas.