ATI RN
ATI Capstone Week 10 Exam Questions
Extract:
Question 1 of 5
A nurse is providing teaching to the parent of a child undergoing tympanostomy tube insertion. Which of the following statements should the nurse include?
Correct Answer: D
Rationale: The correct answer is D: “The tubes will fall out on their own, usually.” This statement is accurate because tympanostomy tubes are designed to eventually come out on their own as the eardrum heals. The tubes typically stay in place for a certain period of time and then naturally extrude. This information is important for the parent to understand to avoid unnecessary worry or concern.
Choice A is incorrect because water exposure can lead to infections and complications with the tubes.
Choice B is incorrect as the tubes should not be removed daily.
Choice C is incorrect as the duration for tube replacement varies and is not always every 2 years.
Question 2 of 5
Thirty minutes after receiving meperidine, the client develops a temperature of 101°F and the skin is warm and flushed with a notable rash on the chest and back. The nurse contacts the primary health care provider and begins to document on an incident report. Which information should be included?
Correct Answer: D
Rationale: The correct answer is D because it directly addresses the key information related to the client's condition after receiving meperidine. Documenting the time of temperature elevation and the actual temperature is crucial for monitoring the client's response to the medication. This information helps in assessing for potential adverse reactions or side effects of meperidine.
Choice A is incorrect because attributing the reaction solely to an allergic response without concrete evidence is premature.
Choice B is incorrect as it focuses on the notification of the primary health care provider rather than the essential clinical data.
Choice C is incorrect as it mentions the physical findings but lacks the critical data of the temperature elevation. The other choices (E, F, G) are not relevant to the situation described.
In summary, documenting the specific temperature change after medication administration is essential for assessing the client's response and guiding further interventions.
Question 3 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 4 of 5
A nurse at an ophthalmology clinic is providing teaching to a client who has open-angle glaucoma and a new treatment regimen of timolol and pilocarpine eye drops. Which of the following instructions should the nurse provide?
Correct Answer: A
Rationale:
Correct Answer: A - Administer the medications 5 minutes apart.
Rationale: Timolol and pilocarpine are both used to treat glaucoma, but they work through different mechanisms. Timolol is a beta-blocker that reduces intraocular pressure, while pilocarpine is a cholinergic agent that increases drainage of aqueous humor. Administering these medications 5 minutes apart allows each medication to be absorbed properly and prevents potential interactions between the two drugs. Administering them too close together could lead to decreased efficacy or adverse effects.
Summary of Other
Choices:
B: Administering the medications by touching the tip of the dropper to the sclera of the eye is incorrect as it can introduce bacteria into the eye and increase the risk of infection.
C: Holding pressure on the conjunctival sac for 2 minutes following application of drops is unnecessary and not a standard practice for administering eye drops.
D: It is necessary to remove contact lenses before administering
Question 5 of 5
A nurse is caring for a client who has HIV. Which of the following laboratory values is the nurse’s priority?
Correct Answer: A
Rationale: The correct answer is A: CD4-T-cell count 180 cells/mm³. This is the priority because it indicates the client's immune status and progression of HIV. A low CD4 count indicates immunosuppression, increasing the risk of opportunistic infections. Monitoring CD4 levels guides treatment decisions. The other options are not as critical. B: Positive Western blot confirms HIV diagnosis but doesn't indicate disease progression. C: Platelets and D: WBC are important but not as immediate as monitoring immune function in HIV.