ATI Capstone Review 2024 Questions and Answers

4 T's of postpartum hemorrhage (main causes) - correct answer--Tone (uterine atony), Trauma (cervical, vaginal, perineal), Tissue (retained placenta, membranes), Thrombin (coagulopathies, DIC) A client expresses to the nurse that her husband is an alcoholic and has trouble keeping a job for longer than three months. Which of the following is the nurse's best response? Select one: a. "Have you tried to contact Al-Anon? I can help if you want." b. "I'm so sorry to hear that. Why do you think he drinks?" c. "What have you done in the past to help deal with this problem?" d. "This seems to worry you. May I contact the Hospital Chaplain?" - correct answer--c. "What have you done in the past to help deal with this problem?" Providing a broad opening allows the client to elaborate and gives the nurse the opportunity to assess problem-solving and coping skills of the client. A is incorrect- This is a potential solution, but not an opening which would allow the nurse to assess problem-solving and coping skills of the client. A client has just returned to the surgical unit after an open cholestectomy. A nurse notes the abdominal dressing is saturated with sanguineous drainage. Which of the following is the most appropriate intervention? a. Document the assessment findings. b. Outline the drainage size with a marker. c. Remove the dressing to assess the incision. d. Reinforce the dressing with additional gauze. - correct answer--Reinforce the dressing with additional gauze. Outline the drainage size with a marker is INCORRECT. While marking the area of drainage on a dressing may be an appropriate intervention, it is not the most appropriate intervention for a dressing that is saturated with sanguineous drainage. Hospital policies may vary on the acceptability of this intervention. A client in her first trimester is encouraged to increase intake of proteins and folic acid as essential nutrients for basic fetal growth. Which foods would the nurse identify as high in folic acid? Select one: a. Lentils b. Fish c. Tomatoes d. Avocados - correct answer--a. Lentils A client is admitted to the hospital for suspected infective endocarditis. The client is reporting chills, fatigue, myalgia and dyspnea upon exertion. When assessing the client the nurse notes a heart murmur and a temperature of 102.3 F (38.2 C). Which of the following orders should the nurse implement first? Select one: a. Obtain the blood cultures from three sites b. Administer acetaminophen 325 mg by mouth c. Administer IV Penicillin G, 2 million units d. Order the EKG - correct answer--a. Obtaining blood cultures is the priority intervention. Cultures must be drawn prior to initiation of antibiotics so sensitivity results are not influenced. Obtaining specimens from three sites increases the reliability of the results. Clients at risk for endocarditis should be treated with prophylactic antibiotics prior to dental procedures; respiratory and GI diagnostic procedures; GU and Cardiac surgeries. A client is hospitalized for multiple rib fractures following a motor vehicle accident (MVA). The results of an arterial blood gas (ABG's) are; pH 7.30, pCO2 48, HCO3 26 and pO2 91 on 2 L/min of oxygen per nasal cannula. Which of the following interventions has the highest priority? Select one: a. Increase the client's O2 delivery to 4 L/min. b. Notify the health care provider of the abnormal ABG's. c. Administer an anti-anxiety agent to calm the client. d. Assist the client to deep breathe, splinting with a pillow. - correct answer--d. Assist the client to deep breathe, splinting with a pillow. The client is experiencing respiratory acidosis from hypoventilation caused by painful respirations due to fractured ribs. Splinting the chest wall with a pillow will decrease pain associated with deep breathing. Deeper breaths will allow for better gas exchange, which will correct the acidosis. The client's pO2 is normal and while increasing available O2 may help, it does not correct the problem of hypoventilation. A client is seeking treatment for stress related to unexpected loss of employment and is engaging in the stress management technique of cognitive reframing. Which of the following statements would indicate to the nurse that the client understands this stress management technique? Select one: a. "I have excellent job skills; I just need to find a new employer." b. "I can visualize the perfect interview and being offered a new job." c. "When I do my daily yoga exercises, I feel so much better." d. "Once I decided what was most important to me, things got easier." - correct answer-- a. "I have excellent job skills; I just need to find a new employer." Cognitive reframing is a simple and effective technique for reducing stress by looking at things in a more positive light in order to experience them as less stressful.