ATI RN
RN ATI Capstone Proctored Comprehensive Assessment 2019 B with NGN Questions
Question 1 of 9
A nurse is assessing a client who has asthma. Which of the following areas should the nurse evaluate as the most reliable indicator of central cyanosis?
Correct Answer: A
Rationale: Central cyanosis is best assessed by examining the oral mucosa, as it is a more reliable indicator compared to other areas like the conjunctivae, soles of the feet, and ear lobes. The oral mucosa reflects the oxygen saturation levels of the blood more accurately. Conjunctivae and ear lobes may show cyanosis, but they are not as reliable as the oral mucosa. The soles of the feet are not typically used to assess central cyanosis.
Question 2 of 9
A nurse manager is teaching a group of staff members about proper body mechanics. Which of the following statements by a staff member indicates an understanding of the teaching?
Correct Answer: A
Rationale: Choice A is the correct answer because lifting more than 35 pounds without assistance can cause injury, so getting help is crucial for proper body mechanics. Choice B is incorrect as twisting at the waist can lead to back injuries. Choice C is incorrect as holding objects closer to the body, not 1 ft away, is recommended to reduce strain. Choice D is incorrect as rolling shoulders forward can increase strain on the back instead of reducing it.
Question 3 of 9
A nurse on a rehabilitation unit is creating a plan of care for a newly admitted client who has difficulty swallowing following a stroke. Which of the following inter-professional team members should the nurse anticipate consulting regarding the client's condition?
Correct Answer: A
Rationale: The correct answer is A, Speech-language pathologist. A speech-language pathologist specializes in evaluating and treating swallowing difficulties, known as dysphagia, which commonly occurs following a stroke. They are experts in developing strategies to help individuals improve their ability to swallow safely. Occupational therapists (B) focus on helping individuals regain independence in activities of daily living, not specifically addressing swallowing concerns. Dietitians (C) primarily work on developing appropriate nutrition plans but may not directly address swallowing issues. Pharmacy technicians (D) assist pharmacists in dispensing medications and are not directly involved in managing swallowing difficulties.
Question 4 of 9
A nurse is caring for a client who has not voided for 8 hours following the removal of an indwelling urinary catheter. Which of the following actions should the nurse take first?
Correct Answer: D
Rationale: Performing a bladder scan is the first step to assess bladder retention before any further interventions.
Question 5 of 9
A patient prescribed warfarin is being taught about dietary restrictions by a healthcare provider. Which of the following foods should the patient be instructed to limit?
Correct Answer: B
Rationale: The correct answer is B: Spinach. Spinach is high in vitamin K, which can interfere with the effectiveness of warfarin, an anticoagulant medication. Patients taking warfarin should limit foods high in vitamin K to maintain the medication's effectiveness and consistent dosage. Bananas, potatoes, and apples are not high in vitamin K and do not typically interfere with warfarin therapy.
Question 6 of 9
A nurse manager is implementing a quality improvement project to reduce the number of methicillin-resistant Staphylococcus aureus (MRSA) infections at the facility. Which of the following actions should the nurse manager take first?
Correct Answer: D
Rationale: Conducting a chart review to evaluate the precipitating factors of clients who develop MRSA is the initial step in reducing these infections. By identifying factors contributing to MRSA infections, the nurse manager can develop targeted interventions. Developing an MRSA protocol (choice A) and providing educational in-services (choice B) would be premature without understanding the specific factors at play. Evaluating outcomes (choice C) should come after implementing interventions based on the findings from the chart review.
Question 7 of 9
A nurse manager on an acute care unit is preparing a staff presentation about promoting cost-effective care. Which of the following strategies should the nurse plan to include in the presentation?
Correct Answer: D
Rationale: Teaching staff proper use of PPE helps reduce the spread of infections and promotes cost-effective care.
Question 8 of 9
A nurse is providing discharge instructions to a client who has a new prescription for codeine for cough suppression. What is the priority instruction?
Correct Answer: C
Rationale: The correct answer is to instruct the client to 'Move slowly when standing up.' Codeine can cause orthostatic hypotension, a drop in blood pressure when changing positions, leading to dizziness or fainting. By advising the client to move slowly when standing up, the nurse helps prevent falls or injuries due to sudden drops in blood pressure. Choices A, B, and D are important instructions as well but not the priority when considering the risk of orthostatic hypotension associated with codeine.
Question 9 of 9
When administering a subcutaneous injection of insulin to a client, what angle should the nurse use for the injection?
Correct Answer: C
Rationale: The correct angle for administering a subcutaneous injection, such as insulin, is 90 degrees. This angle allows for the medication to be delivered into the subcutaneous layer of tissue beneath the skin. A 45-degree angle is typically used for administering subcutaneous injections in infants or those with reduced adipose tissue, while a 60-degree angle is commonly used for intramuscular injections. A 30-degree angle is not a standard angle for subcutaneous injections.