RN ATI CAPSTONE PROCTORED COMPREHENSIVE ASSESSMENT 2019 A
Questions and Answers with Verified Answers and Rationales
QUESTION 1
A nurse is teaching a client who has a new prescription for metformin
extended-release tablets. Which of the following statements by the
client indicates an understanding of the teaching?
A. "I will crush the medication if I have trouble swallowing it"
B. "I will avoid crushing this medication"
C. "I will take this medication with a high-fat meal"
D. "I will stop taking this medication if I experience nausea"
VERIFIED ANSWER: B. "I will avoid crushing this medication"
Rationale: Extended-release tablets should not be crushed, chewed, or
cut, as this would release the entire dose at once, increasing the risk
of adverse effects and reducing the therapeutic effect. The coating is
designed to release medication slowly over time.
QUESTION 2
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
feedings?
A. Increase the rate of the feeding
B. Switch to a lactose-free formula
,C. Dilute the formula with water
D. Administer the formula at room temperature
VERIFIED ANSWER: B. Switch to a lactose-free formula
Rationale: Hyperosmolar dehydration can occur from formula that is
too concentrated or from formulas containing lactose. Switching to a
lactose-free formula may help reduce osmotic load. The nurse should
also ensure adequate water flushes and monitor electrolyte levels.
QUESTION 3
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?
A. Apply cold compresses to painful areas
B. Restrict fluid intake during crisis
C. Apply warm compresses to painful areas
D. Limit activity during painful episodes
VERIFIED ANSWER: C. Apply warm compresses to painful areas
Rationale: Warm compresses promote vasodilation and improve
circulation to painful areas during vaso-occlusive crisis. Cold
compresses cause vasoconstriction, which can worsen sickling and
pain. Hydration is essential, not restricted.
QUESTION 4
,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?
A. "I should boil tap water for 2 minutes before I mix it with powdered
formula"
B. "I can use well water without boiling it first"
C. "I should use sterile water when I mix it with powdered formula"
D. "I can store prepared formula at room temperature for 24 hours"
VERIFIED ANSWER: A. "I should boil tap water for 2 minutes before
I mix it with powdered formula"
Rationale: Tap water should be boiled for 2 minutes and cooled before
mixing with powdered formula to ensure it is sterile and safe for the
newborn. Prepared formula should be refrigerated and used within 24
hours.
QUESTION 5
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?
A. Mild throat pain
B. Frequent swallowing
C. Low-grade fever
D. Refusal to drink
, VERIFIED ANSWER: B. Frequent swallowing
Rationale: Frequent swallowing may indicate bleeding from the
surgical site, as blood irritates the throat and triggers the swallowing
reflex. This is a priority finding that requires immediate assessment for
hemorrhage.
QUESTION 6
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?
A. "During this test, I will punch a button if the baby moves"
B. "During this test, I will lie flat on my back"
C. "During this test, I will not eat or drink anything"
D. "During this test, I will punch a button if I feel stressed"
VERIFIED ANSWER: A. "During this test, I will punch a button if the
baby moves"
Rationale: In non-stress testing, the client presses a button when fetal
movement is felt, allowing the monitor to correlate movement with
fetal heart rate accelerations, which indicate fetal well-being.
QUESTION 7
A nurse is monitoring a client who is receiving a transfusion of packed
RBCs. The client reports chills, headache, low back pain, and a feeling of
Questions and Answers with Verified Answers and Rationales
QUESTION 1
A nurse is teaching a client who has a new prescription for metformin
extended-release tablets. Which of the following statements by the
client indicates an understanding of the teaching?
A. "I will crush the medication if I have trouble swallowing it"
B. "I will avoid crushing this medication"
C. "I will take this medication with a high-fat meal"
D. "I will stop taking this medication if I experience nausea"
VERIFIED ANSWER: B. "I will avoid crushing this medication"
Rationale: Extended-release tablets should not be crushed, chewed, or
cut, as this would release the entire dose at once, increasing the risk
of adverse effects and reducing the therapeutic effect. The coating is
designed to release medication slowly over time.
QUESTION 2
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
feedings?
A. Increase the rate of the feeding
B. Switch to a lactose-free formula
,C. Dilute the formula with water
D. Administer the formula at room temperature
VERIFIED ANSWER: B. Switch to a lactose-free formula
Rationale: Hyperosmolar dehydration can occur from formula that is
too concentrated or from formulas containing lactose. Switching to a
lactose-free formula may help reduce osmotic load. The nurse should
also ensure adequate water flushes and monitor electrolyte levels.
QUESTION 3
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?
A. Apply cold compresses to painful areas
B. Restrict fluid intake during crisis
C. Apply warm compresses to painful areas
D. Limit activity during painful episodes
VERIFIED ANSWER: C. Apply warm compresses to painful areas
Rationale: Warm compresses promote vasodilation and improve
circulation to painful areas during vaso-occlusive crisis. Cold
compresses cause vasoconstriction, which can worsen sickling and
pain. Hydration is essential, not restricted.
QUESTION 4
,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?
A. "I should boil tap water for 2 minutes before I mix it with powdered
formula"
B. "I can use well water without boiling it first"
C. "I should use sterile water when I mix it with powdered formula"
D. "I can store prepared formula at room temperature for 24 hours"
VERIFIED ANSWER: A. "I should boil tap water for 2 minutes before
I mix it with powdered formula"
Rationale: Tap water should be boiled for 2 minutes and cooled before
mixing with powdered formula to ensure it is sterile and safe for the
newborn. Prepared formula should be refrigerated and used within 24
hours.
QUESTION 5
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?
A. Mild throat pain
B. Frequent swallowing
C. Low-grade fever
D. Refusal to drink
, VERIFIED ANSWER: B. Frequent swallowing
Rationale: Frequent swallowing may indicate bleeding from the
surgical site, as blood irritates the throat and triggers the swallowing
reflex. This is a priority finding that requires immediate assessment for
hemorrhage.
QUESTION 6
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?
A. "During this test, I will punch a button if the baby moves"
B. "During this test, I will lie flat on my back"
C. "During this test, I will not eat or drink anything"
D. "During this test, I will punch a button if I feel stressed"
VERIFIED ANSWER: A. "During this test, I will punch a button if the
baby moves"
Rationale: In non-stress testing, the client presses a button when fetal
movement is felt, allowing the monitor to correlate movement with
fetal heart rate accelerations, which indicate fetal well-being.
QUESTION 7
A nurse is monitoring a client who is receiving a transfusion of packed
RBCs. The client reports chills, headache, low back pain, and a feeling of
