ATI RN
ATI Capstone Exam 1 Questions
Extract:
Question 1 of 5
A nurse is caring for a client whose family member requests to view the client’s medical record. Which of the following responses should the nurse make?
Correct Answer: D
Rationale: The correct response is D: The client must provide permission to share the records with you. This is the correct answer because under HIPAA regulations, a client's medical records are confidential and can only be shared with the client's explicit permission. The nurse cannot disclose the records to a family member without the client's consent. Option A is incorrect because the ethics committee does not handle individual requests for medical records. Option B is incorrect as the nursing supervisor cannot release medical records without proper authorization. Option C is incorrect as the healthcare provider cannot share the information without the client's consent.
Question 2 of 5
A nurse is planning care for a client who is 2 hours postoperative following a transurethral resection of the prostate. The client is receiving continuous bladder irrigation. Which of the following interventions should the nurse include?
Correct Answer: B
Rationale: The correct answer is B: Remind the client he might feel a constant urge to void. After a transurethral resection of the prostate, continuous bladder irrigation is often used to prevent blood clots and ensure urine output. This procedure can cause the client to feel a constant urge to void due to the bladder being continuously filled and emptied.
Therefore, reminding the client about this sensation can help alleviate anxiety and discomfort.
Choice A: Restricting the client's oral fluid intake is incorrect because maintaining hydration is essential postoperatively to prevent complications such as dehydration and urinary retention.
Choice C: Weighing the client every evening is unnecessary and not directly related to the care of a client post transurethral resection of the prostate.
Choice D: Monitoring the client's urine output every 6 hours is important, but reminding the client about the sensation of constant urge to void takes priority in this scenario.
Question 3 of 5
A nurse is caring for a client who has hypertension and has a potassium level of 6.8 mEq/L. Which of the following actions should the nurse take?
Correct Answer: A
Rationale: The correct answer is A: Obtain a 12-lead ECG. A potassium level of 6.8 mEq/L is significantly elevated (normal range is 3.5-5.0 mEq/L) and can lead to serious cardiac complications, such as arrhythmias.
Therefore, obtaining an ECG is crucial to assess the client's cardiac status.
Choice B (salt substitute) is incorrect as it can further elevate potassium levels.
Choice C (citrus juices and bananas) is incorrect as these are high-potassium foods that should be avoided.
Choice D (serum sodium level) is irrelevant to the client's elevated potassium level.
Question 4 of 5
A nurse is caring for a client who suspects recent exposure to inhalation anthrax. Which of the following findings indicate possible exposure?
Correct Answer: B
Rationale: The correct answer is B: Respiratory failure. Inhalation anthrax primarily affects the respiratory system, causing symptoms such as difficulty breathing, cough, and chest discomfort. Respiratory failure can occur in severe cases. Vesicles on the skin (
A) are not typically associated with inhalation anthrax. Flu-like symptoms (
C) are nonspecific and can be seen with various infections. Coughing of blood (
D) is not a common symptom of inhalation anthrax.
Therefore, the most indicative finding of possible exposure to inhalation anthrax is respiratory failure.
Question 5 of 5
A nurse is caring for a child who is admitted with suspected acute appendicitis. Which of the following manifestations should indicate to the nurse that the child’s appendix is perforated?
Correct Answer: A
Rationale: The correct answer is A: Sudden decrease in abdominal pain. A sudden decrease in abdominal pain can indicate a perforated appendix due to the release of pressure and inflammation. This sudden relief occurs when the appendix ruptures, causing the abdominal pain to subside temporarily. This is a critical sign that the appendix has perforated and requires immediate medical attention. The other choices are incorrect because: B: Absence of Rovsing’s sign is not specific to a perforated appendix. C: Low-grade fever is commonly seen in uncomplicated appendicitis and may not necessarily indicate perforation. D: A rigid abdomen is a sign of peritonitis, which can occur with a perforated appendix, but it is not as specific as the sudden decrease in pain.