ATI RN
ATI Capstone Week 10 Exam Questions
Extract:
Question 1 of 5
A nurse is caring for a toddler who has otitis media. Which of the following assessment findings should the nurse expect?
Correct Answer: C
Rationale: The correct answer is C: Tugging on the affected ear lobe. This is a common sign of otitis media in toddlers, indicating pain or discomfort. Tugging on the ear is often a way for the child to relieve pressure and discomfort caused by the infection. It is important for the nurse to recognize this sign as it can help in the diagnosis and management of otitis media.
A: Erythema and edema of the affected ear may be present but are not specific to otitis media.
B: Pain when manipulating the affected ear lobe is possible but not as indicative as tugging.
D: Clear drainage from the affected ear is more commonly seen in cases of otitis externa, not otitis media.
Question 2 of 5
A client calls the health care clinic and asks the nurse to describe the first signs of Lyme disease. The nurse informs the client to watch for which signs/symptoms of stage I Lyme disease?
Correct Answer: C
Rationale: The correct answer is C: Rash symptoms. In stage I Lyme disease, a characteristic symptom is a circular rash called erythema migrans. This rash typically appears at the site of the tick bite and expands over time. It is important for the client to watch for this specific rash as it is a hallmark sign of early Lyme disease. Headaches and blurred vision (choice
A) are not typically associated with early Lyme disease. Tremors and weakness (choice
B) are more commonly seen in later stages of the disease. Painful joints (choice
D) may occur in later stages as well but are not specific to stage I Lyme disease.
Question 3 of 5
A nurse is reviewing discharge instructions with a client following a right cataract extraction. Which of the following instructions should the nurse include?
Correct Answer: C
Rationale: The correct answer is C: Avoid lifting anything heavier than 4.5 kg (10 lb) for 1 week. This instruction is important post-cataract surgery to prevent strain on the eye and promote proper healing. Lifting heavy objects can increase intraocular pressure, potentially causing complications. The other choices are incorrect: A is not relevant to post-cataract surgery care, B is incorrect as sleeping on the abdomen can put pressure on the eye, D is incorrect as bending at the waist can also increase intraocular pressure.
Question 4 of 5
A home health nurse is assessing an older adult client in the home who has decreased vision due to a history of glaucoma. Which of the following findings should the nurse identify as a safety risk?
Correct Answer: B
Rationale: The correct answer is B: Scatter rugs are present in the kitchen. Scatter rugs can pose a safety risk to an older adult with decreased vision as they can easily trip over them. The uneven surface and lack of secure attachment make them a hazard. Electrical cords along the walls (
A) can be easily avoided if noticed. Handrails in the bathroom (
C) provide support and enhance safety. Using a microwave for cooking (
D) is a safe and convenient method for individuals with visual impairments.
Question 5 of 5
A nurse is admitting a client who has a partial hearing loss. Which of the following is the priority action by the nurse?
Correct Answer: B
Rationale: The correct answer is B because determining if the client uses hearing aids is crucial to facilitate effective communication and ensure the client's needs are met. By knowing if the client uses hearing aids, the nurse can adjust communication strategies accordingly. Rephrasing statements (
A) is helpful but not the priority. Speaking directly in front of the client (
C) may not be sufficient for optimal communication. Using hand gestures (
D) may not be effective if the client relies on hearing aids.