ATI Proctored Capstone Comprehensive
Assessment A
A nurse is teaching a client who has a new prescription for metformin extended release
tablets. Which
... [Show More] of the following statements by the client indicates an understanding of
the teaching?
I will avoid crushing this medication
I'll switch to a lactose-free formula Correct answer- I will avoid crushing this medication
A nurse is assessing a client who is receiving enteral feeding via an NG tube. The client
has developed hyperosmolar dehydration. Which of the following actions should the
nurse take when administering the client's findings?
Empty your ostomy pouch when it is half full
Switch to a lactose-free formula. Correct answer- Switch to a lactose-free formula.
A nurse is teaching the parents of a school-age child who has sickle cell anemia about
managing the disease at home which of the following instructions should the nurse
include?
Apply cold compresses too painful areas
I should boil tap water for 2 minutes and call it before I mix it with powdered formula
Correct answer- Apply cold compresses too painful areas
A nurse is teaching about Safe Handling of formula to a client who is postpartum and
chooses to bottle feed her newborn. Which of the following statements by the client
indicates an understanding of the teaching?
I should boil tap water for 2 minutes before I mix it with powdered formula
I should use sterile water when I mix it with powdered formula Correct answer- I should
boil tap water for 2 minutes before I mix it with powdered formula
A nurse is assessing a child who is post-operative following a tonsillectomy. Which of
the following findings should the nurse identify as the priority?
During this test, I will punch a button if the baby moves
Frequent swallowing Correct answer- Frequent swallowing
A nurse is teaching a client who is pregnant about non-stress testing. Which of the
following statements by the client indicates an understanding of the teaching?
During this test, I will punch a button if the baby moves
During this test, I will punch a button if I feel stressed Correct answer- During this test, I
will punch a button if the baby moves
A nurse is monitoring a client who is receiving a transfusion of packed RBC's. The client
reports chills, headaches, low back pain, and a feeling of tightness in his chest. The
nurse should identify that the client has developed which of the following types of
transfusion reactions?
Pudendal nerve block
Acute hemolytic Correct answer- Acute hemolytic
A nurse is caring for a client who is in the latent phase of Labor and reports severe back
pain. The vaginal examination reveals that the cervix is dilated two centimeters, 25%
effaced and -2 station. Which of the following interventions should the nurse implement?
You should wear a snug fitting bra continuously for 72 hours
Request the provider prescribe a pudendal nerve block Correct answer- Request the
provider prescribe a pudendal nerve block
A nurse is teaching about how to suppress lactation with a client who is postpartum and
bottle feeding her newborn. Which of the following instructions should the nurse include
in the teaching?
You should wear a snug fitting bra continuously for 72 hours
Room number Correct answer- You should wear a snug fitting bra continuously for 72
hours
A nurse is preparing to administer medication to a client. What are the following
identifiers should the nurse use to identify the client?
Room number
MRN Correct answer- Room number
A nurse is caring for a client who is taking antihypertensive medication and is moving
from a supine to a seated position. Which of the following findings should indicate to the
nurse that the client is experiencing orthostatic hypotension?
The clients systolic blood pressure decreases by 25 mmHg
The clients systolic blood pressure increases by 35 mmHg Correct answer- The clients
systolic blood pressure decreases by 25 mmHg
While a nurse is caring for a client who is receiving mechanical ventilation via an
endotracheal tube, the high-pressure alarm of the ventilator sounds. Which of the
following actions should the nurse take?
Look for a block in the tubes cuff
Look for a leak in the tubes cuff Correct answer- Look for a leak in the tubes cuff
A nurse is preparing to insert an indwelling urinary catheter for a client. Which of the
following actions should the nurse take first?
Monitor Vital Signs every hour throughout the transfusion
Position the sterile drape leaving the perineum exposed Correct answer- Position the
sterile drape leaving the perineum exposed
A nurse is planning to administer packed RBC's to an older adult client who has a low
hemoglobin level. Which of the following actions should the nurse plan to take? [Show Less]