ATI RN
ATI Capstone Exam 1 Questions
Extract:
Question 1 of 5
A nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: C
Rationale: The correct answer is C: "I’ll use my electric razor for shaving." This statement indicates an understanding of the teaching because warfarin is a blood thinner, increasing the risk of bleeding. Using an electric razor reduces the risk of nicks and cuts, which could lead to excessive bleeding.
Incorrect choices:
A: "I’ll be sure to eat more foods with vitamin K." - Eating more vitamin K-rich foods can interfere with the effectiveness of warfarin.
B: "I’ll take aspirin for my headaches." - Aspirin is a blood thinner and should not be taken along with warfarin.
D: "It’s okay to have a couple of glasses of wine with dinner each evening." - Alcohol can interact with warfarin and increase the risk of bleeding.
Choosing option C demonstrates the client's understanding of the importance of minimizing the risk of bleeding while on warfarin therapy.
Question 2 of 5
A charge nurse is making a room assignment for a client who has scabies. In which of the following rooms should the nurse place the client?
Correct Answer: B
Rationale: The correct answer is B: A private room. This is appropriate for a client with scabies to prevent the spread of the infestation to others. A private room allows for isolation and reduces the risk of transmission to other clients.
A: A negative-pressure isolation room is typically used for clients with airborne infections to prevent the spread of pathogens outside the room. Scabies is not transmitted through the air.
C: Placing the client in a semi-private room with a client who has pediculosis capitis (head lice) is not ideal as both conditions are caused by different parasites and may increase the risk of cross-contamination.
D: A positive-pressure isolation room is used for clients who need protection from outside pathogens, not for containing contagious conditions like scabies.
In summary, a private room is the best choice for a client with scabies to prevent transmission to others, while the other options are not appropriate due to the nature of scabies and the need for isolation.
Question 3 of 5
A nurse is caring for a client who is 1 day postoperative following a transsphenoidal hypophysectomy. While assessing the client, the nurse notes a large area of clear drainage seeping from the nasal packing. Which of the following should be the nurse’s initial action?
Correct Answer: A
Rationale: The correct initial action is to check the drainage for glucose (
Choice
A). This is crucial because clear drainage after a transsphenoidal hypophysectomy may indicate a cerebrospinal fluid leak, which can be confirmed by the presence of glucose in the drainage. If glucose is present, it suggests leakage of cerebrospinal fluid and requires immediate intervention to prevent complications such as infection and meningitis. The other options (B, C, and
D) are not the most appropriate initial actions. Notifying the provider, documenting the amount of drainage, or obtaining a culture can be important steps but should come after confirming the presence of glucose to address the immediate concern of a potential cerebrospinal fluid leak.
Question 4 of 5
A nurse is preparing to perform an abdominal assessment on a client. Identify the sequence of steps the nurse should take to conduct the assessment. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)
Correct Answer: A,B,C,D,E
Rationale: Action to Take: A, B; Potential Condition: None; Parameter to Monitor: C, E.
Rationale:
1. Inspecting for skin integrity (
A) allows the nurse to assess for any visible abnormalities or lesions.
2. Asking about abdominal pain history (
B) provides insight into potential underlying conditions.
3. Auscultating for bowel sounds (
C) helps assess gastrointestinal motility and function.
4. Percussing the abdomen (
D) helps identify areas of abnormal fluid or gas accumulation.
5. Palpating for tenderness (E) assesses for pain or masses in the abdomen.
Summary:
- Not inspecting the abdomen (
A) could miss skin abnormalities.
- Not asking about abdominal pain history (
B) could overlook important medical information.
- Skipping auscultation (
C) could lead to missing crucial gastrointestinal assessment.
- Not percussing (
D) may result in overlooking potential abdominal issues.
- Omitting palpation (E) could miss detecting tend
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.