Review ATI RN Capstone Proctored-Post Assessment

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ATI RN Capstone Proctored-Post Assessment

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Total Questions : 63

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Question 1:

A nurse is planning care for a client who has sciatica and a prescription for a transcutaneous electrical nerve stimulation (TENS) unit. Which of the following referrals should the nurse anticipate for this client?

A. Occupational therapist B. Physical therapist C. Acupuncturist D. Chiropractor

Answer and Explanation

Choice A:

Occupational therapists focus on functional tasks and adaptive equipment, not pain management or sciatica-specific interventions like TENS unit application or therapeutic exercises. Their role is less relevant for addressing sciatic nerve pain, making this an incorrect referral choice.

Choice B:

Physical therapists are trained to manage sciatica through exercises, posture correction, and TENS unit application, targeting pain relief and mobility. They develop tailored plans to reduce nerve compression, making this the appropriate referral for comprehensive sciatica care.

Choice C:

Acupuncturists provide alternative pain relief, but their role is not standard for TENS unit management or sciatica treatment in conventional care. Physical therapy is more aligned with evidence-based practice for this condition, making this referral less appropriate.

Choice D:

Chiropractors focus on spinal adjustments, which may not be suitable for all sciatica cases, especially with TENS unit prescriptions. Physical therapists offer targeted, evidence-based interventions, making them the preferred referral for managing sciatica and TENS therapy.

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Question 2:

A nurse is documenting admission data for a client in an acute care facility. Which of the following actions should the nurse take?

A. Begin charting with an evaluation of the data. B. Document the client’s vital signs obtained by an assistive personnel. C. Chart a summary of the data at the change of shift. D. Note whether the client has a living will.

Answer and Explanation

Choice A:

Beginning charting with an evaluation skips the initial step of collecting and documenting raw data, such as health history and vital signs, which is critical for accurate admission records. This approach risks incomplete documentation, potentially leading to misinformed care plans and overlooking advance directives like a living will, essential for patient-centered care.

Choice B:

Documenting vital signs from assistive personnel is routine but not the priority during admission. Noting a living will is more critical to ensure legal and ethical care preferences are addressed. Relying solely on delegated data risks missing comprehensive admission details, potentially compromising care coordination and patient autonomy in acute settings.

Choice C:

Charting a summary at shift change is not specific to admission documentation, which requires detailed initial data, including advance directives like a living will. Summarizing later risks delaying critical information, such as legal preferences, potentially leading to care decisions that conflict with the patient’s wishes in acute care scenarios.

Choice D:

Noting whether the client has a living will is a priority during admission to ensure advance directives are documented, guiding ethical and legal care decisions. This ensures patient autonomy, especially in acute settings where critical decisions arise. Addressing this upfront prevents oversight, aligning care with the client’s wishes and regulatory standards.

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Question 3:

A nurse is creating an incident report due to an accidental omission of a client's dressing change during the previous shift. Which of the following statements should the nurse document on the incident report form?

A. Prescribed dressing change was accidentally omitted during the previous shift. B. A nurse accidentally omitted a prescribed dressing change. Will notify the provider tomorrow. C. Incident report completed. A copy will be placed in the client's medical record. D. Unable to complete a prescribed dressing change. However, dressing did not appear to be soiled.

Answer and Explanation

Choice A:

This statement factually reports the omission of a prescribed dressing change without speculation or irrelevant details, adhering to incident report standards. It ensures clarity for follow-up actions, like wound assessment, to prevent infection or delayed healing, making it the appropriate documentation.

Choice B:

Delaying provider notification until tomorrow is inappropriate, as omissions require prompt reporting to assess risks like infection. This statement includes unnecessary future actions, deviating from objective incident reporting, making it incorrect for proper documentation standards.

Choice C:

Stating the report’s completion and placement in the medical record is procedural, not descriptive of the incident. Incident reports focus on the event (omission), not administrative actions, and are kept separate from medical records, making this statement incorrect.

Choice D:

Justifying the omission with an unsoiled dressing is speculative and irrelevant. Incident reports require objective facts about the error, not assumptions about its impact, as wound status needs professional assessment, making this an inappropriate statement.

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Question 4:

A nurse is providing discharge teaching to a client who has a new ostomy. Which of the following instructions should the nurse include?

A. Apply sterile gloves when changing your ostomy pouch. B. Empty your ostomy pouch when it is half full. C. Use a moisturizing soap to cleanse your stoma. D. Notify the provider if your stoma becomes pink and moist.

Answer and Explanation

Choice A:

Sterile gloves are unnecessary for ostomy pouch changes, as the procedure requires clean gloves to prevent infection. Sterile technique is reserved for invasive procedures, so this instruction is overly stringent and incorrect for routine ostomy care.

Choice B:

Emptying the ostomy pouch when half full prevents leakage, skin irritation, and pouch detachment. This practical instruction ensures proper ostomy management, maintaining skin integrity and patient comfort, making it the correct teaching point for discharge.

Choice C:

Moisturizing soap can leave residue, irritating the peristomal skin and affecting pouch adhesion. Plain soap or water is recommended to keep the area clean and dry, so this instruction is incorrect for safe stoma care practices.

Choice D:

A pink, moist stoma is normal and healthy, not a cause for concern. Notifying the provider for this is unnecessary and may cause alarm, so this instruction reflects a misunderstanding of normal stoma appearance.

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Question 5:

A nurse is teaching a client about using transdermal scopolamine to treat motion sickness. Which of the following instructions should the nurse include?

A. Apply the patch prior to traveling. B. Replace a dislodged patch onto the same location. C. Store unused patches in the refrigerator. D. Place the patch on your upper arm.

Answer and Explanation

Choice A:

Applying the scopolamine patch 4-6 hours before traveling ensures therapeutic levels to prevent motion sickness by blocking acetylcholine in the vestibular system. This proactive timing is critical for efficacy, reducing nausea and vertigo. Proper instruction enhances client compliance, ensuring comfort during travel and preventing symptoms that impair quality of life.

Choice B:

Replacing a dislodged patch in the same location risks reduced adhesion and drug absorption, as skin oils or residue may interfere. A new site, like behind the ear, is recommended. Incorrect instruction could lead to ineffective treatment, increasing motion sickness symptoms and client discomfort during travel.

Choice C:

Scopolamine patches are stored at room temperature, not refrigerated, to maintain stability. Refrigeration may alter efficacy or adhesion. Misinstructing on storage risks patch degradation, reducing effectiveness against motion sickness, potentially causing nausea or dizziness, and compromising client safety and comfort during travel activities.

Choice D:

Scopolamine patches are applied behind the ear, not the upper arm, for optimal drug delivery near the vestibular system. Incorrect placement reduces efficacy, risking motion sickness symptoms. Misguiding the client could lead to treatment failure, increasing discomfort and impairing travel enjoyment, necessitating proper site instruction for effective management.

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Question 6:

A nurse is teaching the guardian of a newborn about car seat safety. Which of the following statements by the guardian indicates an understanding of the teaching?

A. I will place the retainer clip on my baby's upper abdomen. B. I will turn the car seat forward facing when my baby is 1 year old. C. I will position the shoulder harness straps 3 inches above my baby's shoulders. D. I will position my baby at a 45-degree angle in the car seat.

Answer and Explanation

Choice A:

The retainer clip should be at chest level, not the upper abdomen, to secure the harness and prevent injury. An abdominal position risks strap slippage, reducing safety, so this statement reflects incorrect car seat safety understanding.

Choice B:

Car seats should remain rear-facing until at least age 2, not 1, per AAP guidelines, to protect the neck and spine. Turning forward-facing too early increases injury risk, making this statement incorrect for safe car seat use.

Choice C:

Shoulder harness straps should be at or below the shoulders in rear-facing seats, not 3 inches above, to ensure proper restraint. This positioning risks poor fit, so the statement indicates a misunderstanding of car seat safety.

Choice D:

Positioning the newborn at a 45-degree angle in a rear-facing car seat ensures airway patency and spinal alignment, per safety guidelines. This statement correctly reflects proper car seat installation, indicating accurate understanding of newborn car seat safety.

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Question 7:

A nurse is teaching the guardian of a newborn about car seat safety. Which of the following statements by the guardian indicates an understanding of the teaching?

Answer and Explanation

Choice A:

Blood drawn from the right antecubital area 1 hour ago is unlikely to affect blood pressure accuracy, as transient effects resolve quickly. Measuring on the left arm is unnecessary unless the right arm is compromised, like with a PICC. Assuming this requires switching risks unnecessary caution, delaying efficient care.

Choice B:

A right peripherally inserted central catheter (PICC) contraindicates blood pressure measurement on that arm due to risks of occlusion or dislodgement. Measuring on the left arm ensures safety and accuracy. This instruction prevents complications, critical for maintaining catheter function and client safety in those with vascular access devices.

Choice C:

A right hemisphere stroke may cause left-sided weakness, not necessarily affecting right arm blood pressure measurement unless motor function is severely impaired. Left arm use is not mandatory. Assuming this requires switching risks overcomplicating the procedure, potentially delaying accurate monitoring in clients with neurological conditions.

Choice D:

An arteriovenous shunt in the left forearm contraindicates blood pressure measurement on that arm due to risks of vascular damage or inaccurate readings. The right arm is appropriate. Measuring on the left risks shunt thrombosis, compromising dialysis access and client safety, necessitating right arm use instead.

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Question 8:

A nurse is assessing a client who is postoperative following orthopedic surgery. Which of the following findings should the nurse identify as an indication of paralytic ileus?

A. Dizziness. B. Watery stool. C. Abdominal distention. D. Oliguria.

Answer and Explanation

Choice A:

Dizziness is unrelated to paralytic ileus, which involves impaired bowel motility post-surgery, causing distention. Dizziness may indicate hypovolemia or anesthesia effects. Assuming dizziness indicates ileus risks misdiagnosis, delaying interventions like nasogastric suction for ileus, potentially worsening bowel obstruction and client discomfort in postoperative care.

Choice B:

Watery stool suggests diarrhea, not paralytic ileus, which causes absent bowel sounds and constipation due to motility loss. Misidentifying watery stool as ileus risks overlooking infectious causes, delaying appropriate treatments like antidiarrheals, while neglecting ileus interventions, critical for restoring bowel function post-orthopedic surgery.

Choice C:

Abdominal distention is a hallmark of paralytic ileus, resulting from postoperative bowel motility cessation, leading to gas and fluid accumulation. Recognizing this guides interventions like bowel rest or decompression, critical for preventing complications like perforation, ensuring timely recovery, and reducing discomfort in clients post-orthopedic surgery.

Choice D:

Oliguria (low urine output) indicates renal issues, not paralytic ileus, which presents with distention and absent bowel sounds. Assuming oliguria is ileus-related risks missing dehydration or kidney injury, delaying fluid management, while neglecting ileus treatments, critical for addressing postoperative bowel dysfunction and client recovery.

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Question 9:

A community health nurse is planning an educational program on Lyme disease for the general public. Which of the following statements should the nurse include in the program?

A. Remove embedded ticks by squeezing the body with tweezers. B. If bitten by a tick, testing for Lyme disease should occur within 2 weeks. C. Symptoms of Lyme disease appear 2 days after being bitten by an infected tick. D. Use a product with DEET on your skin and clothes when you are walking in a wooded area.

Answer and Explanation

Choice A:

Peanut butter is sticky and thick, posing a choking risk for dysphagia clients due to difficulty swallowing. Soft, moist foods like scrambled eggs are safer. Recommending peanut butter risks aspiration, potentially causing pneumonia, critical to avoid in stroke patients with impaired swallowing to ensure safe nutrition.

Choice B:

Soda crackers are dry and crumbly, increasing aspiration risk in dysphagia clients with impaired swallowing from stroke. Scrambled eggs, being soft and moist, are safer. Recommending crackers risks choking or lung injury, delaying safe nutritional intake, essential for recovery and preventing complications in stroke patients.

Choice C:

Crispy rice bars are hard and crunchy, difficult to swallow for dysphagia clients post-stroke, risking aspiration. Scrambled eggs are soft and safe. Recommending rice bars risks choking or pneumonia, compromising nutritional safety, critical for supporting recovery and preventing respiratory complications in clients with swallowing difficulties.

Choice D:

Scrambled eggs are soft, moist, and easy to swallow, ideal for dysphagia clients post-stroke, reducing aspiration risk. This choice aligns with speech therapy recommendations, ensuring safe nutrition. Recommending eggs supports recovery, prevents complications like pneumonia, and maintains nutritional status, critical for stroke clients with swallowing impairments.

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Question 10:

A nurse is reviewing the medical record of a client who has a prescription for misoprostol for induction of labor. Which of the following findings is a contraindication for administration of this medication?

A. Preeclampsia. B. Transverse fetal lie. C. Intrauterine growth restriction. D. Postterm pregnancy.

Answer and Explanation

Choice A:

Preeclampsia is not a contraindication for misoprostol; it may be used cautiously for labor induction in such cases under close monitoring. Transverse lie is a contraindication. Assuming preeclampsia contraindicates misoprostol risks unnecessary avoidance, potentially delaying necessary induction, critical for maternal and fetal safety in labor management.

Choice B:

Transverse fetal lie is a contraindication for misoprostol, as it increases risks of uterine rupture or cord prolapse during labor induction due to improper fetal positioning. Cesarean delivery is preferred. Recognizing this prevents complications, ensuring maternal and fetal safety, critical in labor induction planning for malpresented fetuses.

Choice C:

Intrauterine growth restriction is not an absolute contraindication for misoprostol; it may be used with caution if induction is indicated. Transverse lie is a clearer contraindication. Assuming restriction contraindicates risks delaying induction, potentially compromising fetal well-being, critical for timely labor management in growth-restricted pregnancies.

Choice D:

Postterm pregnancy is an indication, not a contraindication, for misoprostol to induce labor and prevent fetal risks. Transverse lie is the contraindication. Assuming postterm contraindicates misoprostol risks delaying necessary induction, increasing risks like stillbirth, critical for ensuring safe delivery in prolonged pregnancies.

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Total Questions : 63

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ATI RN Capstone Proctored-Post Assessment

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