ATI RN
ATI RN Capstone Proctored Comprehensive Assessment Exam A Questions
Extract:
Question 1 of 5
A nurse is caring for a client who is 12 hr postoperative following a below-the-knee amputation. Which of the following interventions should the nurse implement?
Correct Answer: C
Rationale:
Rationale:
Choice C (Instruct the client to use an overbed trapeze to move around in bed) is correct because it promotes client independence and mobility without putting excessive pressure on the surgical site. This intervention helps prevent complications such as pressure ulcers and deep vein thrombosis. Turning the client every 4 hours (
Choice
A) may be too frequent and could disrupt wound healing. Placing the client on an air mattress (
Choice
B) may not be necessary and could potentially increase the risk of falls. Rewrapping the bandage every 8 hours in a circular pattern (
Choice
D) is incorrect as it can impede circulation and cause complications.
Question 2 of 5
A school nurse is using the Weber's test to check a child's hearing acuity. Which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Place a vibrating tuning fork on the top of the child's head. This is because the Weber's test involves placing a vibrating tuning fork on the midline of the patient's head to assess hearing acuity. In this test, the sound should be equally heard in both ears if the hearing is normal. Placing the tuning fork on the head allows for sound conduction through bone, which helps determine if there is a conductive or sensorineural hearing loss.
Choice A is incorrect as a выбираogram reading is not necessary for the Weber's test.
Choice C is incorrect as the tuning fork should be in contact with the head, not held away from the ears.
Choice D is incorrect as the Weber's test does not involve measuring how long the sound is heard.
Question 3 of 5
A nurse is planning care for a client who has a history of urinary tract infections (UTIs) and requires placement of an indwelling urinary catheter. Which of the following actions should the nurse take to help minimize the client's risk for acquiring a UTI?
Correct Answer: D
Rationale: The correct answer is D: Secure the catheter to the client's thigh. Securing the catheter to the client's thigh helps prevent tension on the catheter, reducing the risk of trauma to the urinary tract mucosa that can lead to UTIs. Placing the urinary bag at bladder level (choice
A) when ambulating does not directly minimize the risk of UTI. Looping the tubing lower than the collection bag (choice
B) can lead to backflow of urine, increasing the risk of infection. Obtaining urinary samples by disconnecting tubing connections (choice
C) poses a risk of contamination. Option D is the best choice for minimizing UTI risk.
Question 4 of 5
A nurse is teaching a client who has major depressive disorder about what to expect when undergoing electroconvulsive therapy. Which of the following information should the nurse give the client?
Correct Answer: C
Rationale: The correct answer is C: You might feel a bit confused for a few hours after the procedure. This is because confusion is a common side effect of electroconvulsive therapy (ECT) due to the temporary disruption of cognitive functions. The confusion typically resolves within a few hours post-procedure.
Choice A is incorrect because feeling pulsations in the neck is not a typical sensation experienced during ECT.
Choice B is incorrect as the client usually wakes up shortly after the procedure, not 30 minutes later.
Choice D is incorrect as changes in voice are not a common side effect of ECT.
Question 5 of 5
A nurse is caring for a client following a seizure. Which of the following actions should the nurse take?
Correct Answer: C
Rationale: The correct answer is C: Position the client on their side. This is crucial to prevent aspiration in case the client vomits post-seizure. Placing the client on their side helps maintain a clear airway and prevents choking. Restraints (
A) should not be used unless absolutely necessary for safety. Ambulating (
B) a client after a seizure is unsafe as they may be disoriented or weak. Raising all side rails (
D) can restrict access for emergency care.