ATI RN
ATI RN Capstone Proctored Comprehensive Assessment Exam A Questions
Extract:
Nurses' Notes
2000:
Client is 38-year-old, G4 P3 at 38 weeks of gestation. Presents for evaluation of labor and spontaneous rupture of membranes (SROM). Client states, "My water broke a couple of hours ago and is a greenish color." Client also reports contractions began about 4 hr ago and have become consistently stronger and closer together.
Electronic fetal monitor applied. Small amount of thin green fluid noted on perineal pad. Contraction palpated, lasted 40 seconds, moderate in intensity. Fetal heart rate (FHR) 165/min. Vaginal examination performed: cervix 4 cm dilated, 70% effaced, 0 station, vertex presentation.
Client reports a history of chronic hypertension that has been well-controlled during this pregnancy. Also states was diagnosed with gestational diabetes at 28 weeks of gestation.
Question 1 of 5
A nurse in an antepartum unit is caring for a client., For each potential assessment finding, click to specify if the finding is consistent with chorioamnionitis or preeclampsia: A. Purulent amniotic fluid, B. Elevated uric acid level, C. Fever, D. Decreased platelet count, E. Blurred vision.
Correct Answer: A,C,B,D,E
Rationale: Purulent amniotic fluid and fever are consistent with chorioamnionitis, indicating infection. Elevated uric acid level, decreased platelet count, and blurred vision are consistent with preeclampsia, related to endothelial dysfunction and organ involvement. Each finding is correctly categorized based on disease pathology.
Extract:
Question 2 of 5
A nurse is assessing a client who has a calcium level of 7.6 mg/dL. Which of the following findings should the nurse expect?
Correct Answer: B
Rationale: Muscle twitching. Hypocalcemia increases neuromuscular excitability, causing twitching or tetany. Hypotension, weak pulses, and normal urine output are more likely than hypertension, bounding pulse, or polyuria.
Question 3 of 5
A nurse is assessing a client who has schizophrenia prior to administering the client's next dose of clozapine. Which of the following findings should the nurse report to the provider?
Correct Answer: B
Rationale: Fever. Clozapine can cause agranulocytosis, a serious condition that suppresses white blood cell production. Fever may indicate infection, which requires immediate evaluation. Polyuria, diarrhea, and diaphoresis are less urgent side effects.
Question 4 of 5
A nurse is planning care for a client who is scheduled for a thoracentesis. Which of the following actions should the nurse include in the plan?
Correct Answer: B
Rationale: Place the client leaning forward over the overbed table. This position allows for optimal lung expansion and access to the pleural space. An MRI is not needed, deep breathing risks lung injury, and NPO status is not required.
Question 5 of 5
A nurse is caring for a preschooler who is in an acute care facility. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: Encourage the child to play with toys such as a pounding board. This allows preschoolers to express emotions and relieve stress safely. New routines, medical terms, and excluding parents increase anxiety.