ATI RN
ATI Capstone Week 9 Exam Questions
Extract:
Question 1 of 5
A nurse is caring for a client who is 5 hr postoperative following a transurethral resection of the prostate (TURP). The nurse notes that the client's indwelling urinary catheter has not drained in the past hour. Which of the following actions should the nurse take first?
Correct Answer: D
Rationale: The correct answer is D: Check the tubing for kinks. The first step should be to assess for any possible obstructions in the catheter tubing, as a kink may be preventing proper drainage. Checking for kinks is a basic troubleshooting step that can quickly resolve the issue. If a kink is found and corrected, the catheter should begin draining normally. This action is within the nurse's scope of practice and can be done immediately without needing to involve the provider. Adjusting the rate of bladder irrigation (
A) may exacerbate the issue if there is an obstruction. Ambulating the client (
B) is not appropriate until the catheter issue is resolved. Notifying the provider (
C) should be done after assessing and addressing the immediate problem.
Question 2 of 5
A nurse is reviewing the medication record for a client who has chronic kidney disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?
Correct Answer: C
Rationale: The correct answer is C: Gentamicin. Gentamicin is an aminoglycoside antibiotic known to cause nephrotoxicity, particularly in patients with chronic kidney disease due to its potential to accumulate in the kidneys. This can lead to kidney damage and impaired renal function. Ondansetron (
A) and Diphenhydramine (
B) are not typically associated with nephrotoxicity. Omeprazole (
D) is a proton pump inhibitor used for acid-related disorders and is not known to cause nephrotoxicity.
Question 3 of 5
A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD). The client tells the nurse, 'I can feel the congestion in my lungs, and I certainly cough a lot, but I can't seem to bring anything up.' Which of the following actions should the nurse take to help this client with tenacious bronchial secretions?
Correct Answer: D
Rationale:
Rationale: The correct answer is D. Encouraging the client to drink 2 to 3 L of water daily is essential in helping with tenacious bronchial secretions in COPD. Adequate hydration thins mucus, making it easier to expectorate. Options A, B, and C do not directly address the issue of thinning secretions. Administering oxygen helps with oxygenation, low-salt diet is for managing hypertension, and semi-Fowler's position aids with breathing but doesn't directly address secretions.
Question 4 of 5
A nurse is teaching a client who has type 1 diabetes mellitus about foot care. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: C
Rationale:
Correct Answer: C - "I’ll check my feet every day for sores and bruises."
Rationale: Daily foot checks are crucial for early detection of any issues in diabetic patients, as they are at a higher risk of developing foot ulcers. By checking for sores and bruises, the client shows an understanding of the importance of preventive care to avoid complications like infections or amputations.
Summary of Other
Choices:
A: Soaking feet in cool water can lead to maceration and increase the risk of skin breakdown, not recommended.
B: Putting lotion between toes can create a moist environment, potentially leading to fungal infections, not ideal.
D: Wearing sandals in warm weather is a good practice, but it doesn't directly address foot care concerns for diabetic patients.
Question 5 of 5
A nurse is teaching a client who has asthma how to use a metered-dose inhaler (MDI). The nurse identifies the sequence of steps the client should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all steps.)
Correct Answer: A,B,E,C,D,F
Rationale: Action to Take: Inhale deeply and then exhale completely, Place her lips firmly around the mouthpiece, Breathe in deeply over 2 to 3 seconds while pushing down on the canister, Hold her breath for 10 seconds, Exhale slowly through pursed lips, Wait 60 seconds between each puff; Potential Condition: Asthma; Parameter to Monitor: Inhalation technique, Breath holding duration.
Rationale: The correct sequence ensures optimal delivery of medication. Inhaling deeply allows the medication to reach the lungs. Placing lips firmly ensures a good seal. Breathing in slowly while pushing down delivers the medication. Holding breath allows absorption. Exhaling slowly reduces irritation. Waiting between puffs prevents overdose. Asthma requires careful monitoring of inhalation technique and breath holding for effectiveness and safety.