ATI RN
ATI RN Capstone Proctored Comprehensive Assessment A Questions
Extract:
Question 1 of 5
A charge nurse is observing an assistive personnel perform delegated tasks. Which of the following actions by the AP requires the charge nurse to intervene?
Correct Answer: D
Rationale: The correct answer is D because washing hands with alcohol-based hand rub after bathing a client with Clostridium difficile is not sufficient to remove spores. Handwashing with soap and water is necessary to effectively remove C. difficile spores.
Choice A is correct because wearing clean gloves is appropriate when emptying a urinary catheter bag.
Choice B is correct because performing a simple dressing change is within the scope of practice for an AP.
Choice C is correct because providing postmortem care is a necessary task after a client's death.
Question 2 of 5
A nurse is assessing a client who is receiving enteral feedings via an NG tube. The client has developed hyperosmolar dehydration. Which of the following actions should the nurse take when administering the client's feedings?
Correct Answer: D
Rationale:
Correct Answer: D - Add water to the formula
Rationale: Hyperosmolar dehydration occurs when there is an excessive concentration of solutes in the body. By adding water to the formula, the nurse can dilute the concentration of solutes in the enteral feeding, helping to rehydrate the client and prevent further dehydration.
Summary of other choices:
A: Switching to a lactose-free formula is not directly related to treating hyperosmolar dehydration.
B: Repositioning the NG tube is important for preventing complications but does not address the dehydration issue.
C: Increasing the rate of formula delivery may worsen the dehydration by overwhelming the client's system.
E, F, G: No other choices are provided, but they would likely not be relevant to treating hyperosmolar dehydration.
Question 3 of 5
A nurse is teaching a class of newly licensed nurses about infectious diseases that nurses are required to report to the health department. Which of the following diseases should the nurse include in the teaching?
Correct Answer: B
Rationale: The correct answer is B: Pulmonary tuberculosis. Tuberculosis is a highly contagious infectious disease that is required to be reported to the health department due to its potential for rapid spread in the community. Reporting helps in controlling the spread of the disease and initiating timely treatment for affected individuals. Methicillin-resistant Staphylococcus aureus (
A) is an antibiotic-resistant bacterium that may not require mandatory reporting. Herpes simplex virus (
C) is a common viral infection that is not typically reportable to the health department. Fibromyalgia syndrome (
D) is a chronic pain condition and not an infectious disease that requires reporting.
Question 4 of 5
A community health nurse is developing a plan of care for an older adult client who has type 2 diabetes mellitus and lives independently in a rural area. Which of the following interventions should the nurse include?
Correct Answer: D
Rationale: The correct answer is D: Instruct the client about the use of telehealth services. This is the most appropriate intervention as it allows the nurse to monitor the client's diabetes management remotely, provide education, and support without the need for the client to travel to a healthcare facility frequently. This intervention promotes independent living while ensuring the client receives necessary care.
A: Discussing a long-term care referral may not be appropriate as the client is still living independently.
B: Reviewing assisted living accommodations is premature and not necessary.
C: Suggesting adult day care may not be relevant for a client who is independent and needs diabetes management.
Overall, option D is the best intervention for this scenario.
Question 5 of 5
A nurse is preparing regular and NPH insulin in the same syringe for a client who has diabetes mellitus. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Administer the mixture within 5 min of preparing it. This is important because regular insulin should always be drawn up before NPH insulin due to the risk of contaminating the regular insulin with NPH. Administering the mixture promptly ensures the insulin remains stable and effective.
Choice A is incorrect because shaking the vials can cause air bubbles and lead to inaccurate dosing.
Choice C is incorrect as NPH insulin should be drawn up after regular insulin to avoid contamination.
Choice D is incorrect as air should be injected into the vial after withdrawing insulin to prevent creating a vacuum.