RN ATI CAPSTONE PROCTORED COMPREHENSIVE
ASSESSMENT FORM A,B&C EACH FORM WITH QUESTIONS
AND ANSWERS|AGRADE
FORM A
A nurse is providing teaching for a client who has a fracture of the right fibula with a short leg cast in
place and a new prescription for crutches. The client is non-weight-bearing for 6 weeks. Which of the
following instructions should the nurse include in the teaching?
A. Adjust the crutches for comfort as needed
B. Use a three-point gait.
C. Wear leather soled shoes
D. Advance the affected leg first when walking upstairs
B
A nurse is preparing to initiate IV access for an older adult client. Which of the following sites should the
nurse select when initiating the IV for this client?
A. Radial vein of the inner arm
B. Great saphenous vein of the leg
C. Dorsal plexus vein of the foot
D. Basilic vein of the hand
A
A nurse is planning to delegate client care tasks to an assistive personnel. Which of the following tasks
should the nurse plan to delegate to the AP?
A. Perform gastrostomy feedings through a clients established gastrostomy tube
B. Administer glycerin suppository to a client who is constipated
C. Provide instructions about client care to a family member over the telephone D. Teach a client how to
measure their own blood pressure
A
A nurse is caring for a newborn immediately after delivery. Which of the following interventions should
the nurse implement to prevent heat loss by conduction?
,A. Dry the newborn immediately after birth
B. Maintain an ambient room temp of 24 celcius
C. Use a protective cover on the scale when weighing the infant
D. Place the newborns bassinet away from outside windows
C
Conduction is the process of losing heat through physical contact with another object or body. For
example, if you were to sit on a metal chair, the heat from your body would transfer to the cold metal
chair.
Convection is the process of losing heat through the movement of air or water molecules across the skin
A nurse is caring for a client who is receiving a continuous heparin infusion. Which of the following lab tests
should the nurse review prior to adjusting the client's heparin?
A. aPTT
B. PT
C. INR
D. WBC count
A
A nurse administers an incorrect dose of medication to a client. The nurse recognizes the error immediately
and completes an incident report. Which of the following facts related to the incident should the nurse
document in the client's medical record?
A. Completion of the incident report
B. Time the medication was given
C. Reason for the medication error
D. Notification of the pharmacist
B
A nurse is providing education to the parent of a school-age child who has asthma. Which of the following
statements by the parent indicates an understanding of the teaching?
A. "I will administer aspirin to my child to treat pain or fever"
B. "I will record an average of three readings from my child's peak expiratory flow meter"
C. "I will place carpet in my child's bedroom to control allergens"
D. "I will make sure my child receives a yearly influenza immunization."
D
,-- Children who have asthma should be immunized and protected from infections.
A nurse is caring for a client who has type 1 diabetes mellitus and reports severe ankle pain after falling off
a stepstool at home. Which of the following prescriptions should the nurse clarify with the provider?
A. Obtain capillary blood glucose level every 2 hours
B. Check the neurovascular status of the client's lower extremities every hour
C. Apply a cold pack to the client's ankle for 30 min every hour.
D. Maintain the affected ankle elevated and immobilized
C
A nurse is assessing a client who has major depressive disorder and is taking amitriptyline. Which of the
following findings should the nurse identify as an adverse effect of the medication?
A. Diarrhea
B. Frequent urination
C. Excessive salivation
D. Blurred vision D
The nurse should identify blurred vision as an adverse effect of amitriptyline and notify the provider.
Other adverse effects include constipation, urinary retention, and dry mouth.
A nurse is caring for a client who has signed an informed consent form to receive electroconvulsive therapy
(ECT). The client states to the nurse, "I'm not sure about this now. I'm afraid it's too risky." Which of the
following responses should the nurse make?
A. "Perhaps you think the ECT is dangerous, but I've seen it have good results"
B. "You have the right to change your mind about this procedure at any time."
C. "Everyone gets a little nervous about this procedure as the time for it approaches" D. "Your doctor
wouldn't have suggested ECT if they didn't think it would help you" B
A nurse is preparing to administer mannitol 0.2 g/kg IV bolus over 5 min as a test dose to a client who has
severe oliguria. The client weighs 198 lbs. What is the amount in grams the nurse should administer?
18g
A nurse is preparing to administer an IM injection to a client who is obese. Which of the following actions
should the nurse plan to take?
A. Select a 1 inch needle
B. Use a 45 degree angle when inserting the needle
C. Use the ventrogluteal site
D. Pinch the skin up during injection
, C
A nurse is providing discharge teaching to a client who is to receive home oxygen therapy. Which of the
following instructions should the nurse include in the teaching
A. Check the functioning of oxygen equipment once each week
B. Wear clothing made with cotton fabrics while oxygen is in use
C. Apply petroleum-based lubricant to the nares as needed
D. Store full oxygen tanks on their side
B
A nurse is providing teaching to the guardians of a newborn about measures to prevent SIDS. Which of the
following guardian statements indicates an understanding of the teaching?
A. "I will not allow anyone to smoke near my baby."
B. "I will place bumper pads in my baby's crib"
C. "My baby's head should be placed on a pillow for sleeping"
D. "My baby should sleep in a side-lying position"
A
-- This statement by the guardian indicates an understanding of the nurse's instructions. Research indicates
a strong correlation between exposure to cigarettes smoke and the occurrence of SIDS.
A nurse is assessing a client following a vaginal delivery and notes heavy loch and a boggy fundus. Which
of the following medications should the nurse expect to administer?
A. Nalbuphine
B. Terbutaline
C. Oxytocin
D. Magnesium sulfate
C
A nurse on a medical-surgical unit is caring for a client who has a new diagnosis of terminal cancer. The
client tells the nurse that they would like to go home to be with family and loved ones. Which of the
following actions should the nurse take?
A. Contact the facility chaplain to visit with the client
B. Explain the process of leaving the facility against medical advice
C. Make a referral for social services
D. Encourage the client to continue with inpatient care
C
ASSESSMENT FORM A,B&C EACH FORM WITH QUESTIONS
AND ANSWERS|AGRADE
FORM A
A nurse is providing teaching for a client who has a fracture of the right fibula with a short leg cast in
place and a new prescription for crutches. The client is non-weight-bearing for 6 weeks. Which of the
following instructions should the nurse include in the teaching?
A. Adjust the crutches for comfort as needed
B. Use a three-point gait.
C. Wear leather soled shoes
D. Advance the affected leg first when walking upstairs
B
A nurse is preparing to initiate IV access for an older adult client. Which of the following sites should the
nurse select when initiating the IV for this client?
A. Radial vein of the inner arm
B. Great saphenous vein of the leg
C. Dorsal plexus vein of the foot
D. Basilic vein of the hand
A
A nurse is planning to delegate client care tasks to an assistive personnel. Which of the following tasks
should the nurse plan to delegate to the AP?
A. Perform gastrostomy feedings through a clients established gastrostomy tube
B. Administer glycerin suppository to a client who is constipated
C. Provide instructions about client care to a family member over the telephone D. Teach a client how to
measure their own blood pressure
A
A nurse is caring for a newborn immediately after delivery. Which of the following interventions should
the nurse implement to prevent heat loss by conduction?
,A. Dry the newborn immediately after birth
B. Maintain an ambient room temp of 24 celcius
C. Use a protective cover on the scale when weighing the infant
D. Place the newborns bassinet away from outside windows
C
Conduction is the process of losing heat through physical contact with another object or body. For
example, if you were to sit on a metal chair, the heat from your body would transfer to the cold metal
chair.
Convection is the process of losing heat through the movement of air or water molecules across the skin
A nurse is caring for a client who is receiving a continuous heparin infusion. Which of the following lab tests
should the nurse review prior to adjusting the client's heparin?
A. aPTT
B. PT
C. INR
D. WBC count
A
A nurse administers an incorrect dose of medication to a client. The nurse recognizes the error immediately
and completes an incident report. Which of the following facts related to the incident should the nurse
document in the client's medical record?
A. Completion of the incident report
B. Time the medication was given
C. Reason for the medication error
D. Notification of the pharmacist
B
A nurse is providing education to the parent of a school-age child who has asthma. Which of the following
statements by the parent indicates an understanding of the teaching?
A. "I will administer aspirin to my child to treat pain or fever"
B. "I will record an average of three readings from my child's peak expiratory flow meter"
C. "I will place carpet in my child's bedroom to control allergens"
D. "I will make sure my child receives a yearly influenza immunization."
D
,-- Children who have asthma should be immunized and protected from infections.
A nurse is caring for a client who has type 1 diabetes mellitus and reports severe ankle pain after falling off
a stepstool at home. Which of the following prescriptions should the nurse clarify with the provider?
A. Obtain capillary blood glucose level every 2 hours
B. Check the neurovascular status of the client's lower extremities every hour
C. Apply a cold pack to the client's ankle for 30 min every hour.
D. Maintain the affected ankle elevated and immobilized
C
A nurse is assessing a client who has major depressive disorder and is taking amitriptyline. Which of the
following findings should the nurse identify as an adverse effect of the medication?
A. Diarrhea
B. Frequent urination
C. Excessive salivation
D. Blurred vision D
The nurse should identify blurred vision as an adverse effect of amitriptyline and notify the provider.
Other adverse effects include constipation, urinary retention, and dry mouth.
A nurse is caring for a client who has signed an informed consent form to receive electroconvulsive therapy
(ECT). The client states to the nurse, "I'm not sure about this now. I'm afraid it's too risky." Which of the
following responses should the nurse make?
A. "Perhaps you think the ECT is dangerous, but I've seen it have good results"
B. "You have the right to change your mind about this procedure at any time."
C. "Everyone gets a little nervous about this procedure as the time for it approaches" D. "Your doctor
wouldn't have suggested ECT if they didn't think it would help you" B
A nurse is preparing to administer mannitol 0.2 g/kg IV bolus over 5 min as a test dose to a client who has
severe oliguria. The client weighs 198 lbs. What is the amount in grams the nurse should administer?
18g
A nurse is preparing to administer an IM injection to a client who is obese. Which of the following actions
should the nurse plan to take?
A. Select a 1 inch needle
B. Use a 45 degree angle when inserting the needle
C. Use the ventrogluteal site
D. Pinch the skin up during injection
, C
A nurse is providing discharge teaching to a client who is to receive home oxygen therapy. Which of the
following instructions should the nurse include in the teaching
A. Check the functioning of oxygen equipment once each week
B. Wear clothing made with cotton fabrics while oxygen is in use
C. Apply petroleum-based lubricant to the nares as needed
D. Store full oxygen tanks on their side
B
A nurse is providing teaching to the guardians of a newborn about measures to prevent SIDS. Which of the
following guardian statements indicates an understanding of the teaching?
A. "I will not allow anyone to smoke near my baby."
B. "I will place bumper pads in my baby's crib"
C. "My baby's head should be placed on a pillow for sleeping"
D. "My baby should sleep in a side-lying position"
A
-- This statement by the guardian indicates an understanding of the nurse's instructions. Research indicates
a strong correlation between exposure to cigarettes smoke and the occurrence of SIDS.
A nurse is assessing a client following a vaginal delivery and notes heavy loch and a boggy fundus. Which
of the following medications should the nurse expect to administer?
A. Nalbuphine
B. Terbutaline
C. Oxytocin
D. Magnesium sulfate
C
A nurse on a medical-surgical unit is caring for a client who has a new diagnosis of terminal cancer. The
client tells the nurse that they would like to go home to be with family and loved ones. Which of the
following actions should the nurse take?
A. Contact the facility chaplain to visit with the client
B. Explain the process of leaving the facility against medical advice
C. Make a referral for social services
D. Encourage the client to continue with inpatient care
C
