RN ATI capstone proctored
comprehensive assessment 2019 B
EXAM
1. A charge nurse is assigning tasks to an LPN. Which task should
the charge nurse delegate to the LPN?
Answer: Administer a dose of metoprolol to a stable client with
hypertension.
Rationale: LPNs can administer oral medications to stable clients.
RNs retain responsibility for initial assessments, unstable clients,
and IV push meds.
2. A client with a DNR order is pulseless and not breathing. The
family demands that the nurse “do everything.” What should the
nurse do first?
Answer: Gently remind the family of the DNR order and continue
supportive care without CPR.
Rationale: A valid DNR order must be respected; the nurse
should support the family while following the legal directive.
3. A nurse on a medical-surgical unit is overwhelmed with
admissions. Which task can be delegated to an AP?
Answer: Obtain a clean-catch urine specimen from a client.
Rationale: AP can collect non-sterile specimens. RN must teach,
assess, and interpret results.
4. A nurse suspects a colleague is impaired due to alcohol odor.
What is the priority action?
Answer: Notify the nursing supervisor immediately.
,Rationale: Patient safety is paramount; reporting to supervisor
follows chain of command and legal/ethical duties.
5. A client refuses a blood transfusion for religious reasons. The
nurse’s best response is to:
Answer: Document the refusal and notify the provider.
Rationale: Respect autonomy; do not coerce. Provider can discuss
alternatives.
6. Which situation requires an incident report?
Answer: A client falls when getting out of bed unassisted despite
bed alarm being on.
Rationale: Incident reports are for unexpected events (falls,
medication errors). They are not placed in the chart.
7. A nurse is teaching about advance directives. Which statement
indicates understanding?
Answer: “I can change my living will at any time.”
Rationale: Advance directives can be updated or revoked by a
competent adult.
8. A nurse manager is discussing just culture. Which statement
reflects this concept?
Answer: “We analyze system failures, not just individual mistakes.”
Rationale: Just culture balances accountability and learning from
errors without punitive blame for honest mistakes.
9. A nurse is triaging after a disaster. Which client should be seen
first?
Answer: A client with a sucking chest wound and stridor.
Rationale: This is emergent (red tag) – airway/breathing
compromise takes priority over minor injuries.
, 10. A client with capacity asks to leave the hospital AMA. What
must the nurse do?
Answer: Have the client sign the AMA form, document teaching
about risks, and notify provider.
Rationale: Patient has right to leave; nurse must ensure client
understands risks but cannot detain.
11–20: Safety & Infection Control
11. A client with active tuberculosis is being discharged. Which
instruction is most important?
Answer: “Take all prescribed rifampin for the full 6–9 months.”
Rationale: Nonadherence leads to drug resistance. Rifampin turns
secretions orange – teach that.
12. A nurse is caring for a client with C. diff. Which PPE is
essential?
Answer: Gown and gloves.
Rationale: C. diff requires contact precautions; alcohol hand
sanitizer is ineffective – use soap and water.
13. A client on neutropenic precautions asks for fresh fruit. What
should the nurse do?
Answer: Provide canned or cooked fruit only.
Rationale: Raw fruits may contain bacteria that can cause life-
threatening infection in neutropenic clients.
14. A nurse discovers a small fire in a client’s trash can. What
action first?
comprehensive assessment 2019 B
EXAM
1. A charge nurse is assigning tasks to an LPN. Which task should
the charge nurse delegate to the LPN?
Answer: Administer a dose of metoprolol to a stable client with
hypertension.
Rationale: LPNs can administer oral medications to stable clients.
RNs retain responsibility for initial assessments, unstable clients,
and IV push meds.
2. A client with a DNR order is pulseless and not breathing. The
family demands that the nurse “do everything.” What should the
nurse do first?
Answer: Gently remind the family of the DNR order and continue
supportive care without CPR.
Rationale: A valid DNR order must be respected; the nurse
should support the family while following the legal directive.
3. A nurse on a medical-surgical unit is overwhelmed with
admissions. Which task can be delegated to an AP?
Answer: Obtain a clean-catch urine specimen from a client.
Rationale: AP can collect non-sterile specimens. RN must teach,
assess, and interpret results.
4. A nurse suspects a colleague is impaired due to alcohol odor.
What is the priority action?
Answer: Notify the nursing supervisor immediately.
,Rationale: Patient safety is paramount; reporting to supervisor
follows chain of command and legal/ethical duties.
5. A client refuses a blood transfusion for religious reasons. The
nurse’s best response is to:
Answer: Document the refusal and notify the provider.
Rationale: Respect autonomy; do not coerce. Provider can discuss
alternatives.
6. Which situation requires an incident report?
Answer: A client falls when getting out of bed unassisted despite
bed alarm being on.
Rationale: Incident reports are for unexpected events (falls,
medication errors). They are not placed in the chart.
7. A nurse is teaching about advance directives. Which statement
indicates understanding?
Answer: “I can change my living will at any time.”
Rationale: Advance directives can be updated or revoked by a
competent adult.
8. A nurse manager is discussing just culture. Which statement
reflects this concept?
Answer: “We analyze system failures, not just individual mistakes.”
Rationale: Just culture balances accountability and learning from
errors without punitive blame for honest mistakes.
9. A nurse is triaging after a disaster. Which client should be seen
first?
Answer: A client with a sucking chest wound and stridor.
Rationale: This is emergent (red tag) – airway/breathing
compromise takes priority over minor injuries.
, 10. A client with capacity asks to leave the hospital AMA. What
must the nurse do?
Answer: Have the client sign the AMA form, document teaching
about risks, and notify provider.
Rationale: Patient has right to leave; nurse must ensure client
understands risks but cannot detain.
11–20: Safety & Infection Control
11. A client with active tuberculosis is being discharged. Which
instruction is most important?
Answer: “Take all prescribed rifampin for the full 6–9 months.”
Rationale: Nonadherence leads to drug resistance. Rifampin turns
secretions orange – teach that.
12. A nurse is caring for a client with C. diff. Which PPE is
essential?
Answer: Gown and gloves.
Rationale: C. diff requires contact precautions; alcohol hand
sanitizer is ineffective – use soap and water.
13. A client on neutropenic precautions asks for fresh fruit. What
should the nurse do?
Answer: Provide canned or cooked fruit only.
Rationale: Raw fruits may contain bacteria that can cause life-
threatening infection in neutropenic clients.
14. A nurse discovers a small fire in a client’s trash can. What
action first?
