ATI CAPSTONE FUNDAMENTALS PRE-ASSESSMENT
ALREADY GRADED A+
your medication plan can also include an antibiotic medication
you will need to take the medication for the rest of your life
which of the following factors should the nurse identify as an environmental factor in the
epidemiological triangle - anscrowded living conditions
which of the following can cause a low pulse oximetry reading?
Which of the following are appropriate references for the nurse to use to ensure safe
medication administration? (Select all that apply.) - ans- Published journals
what is the name of the legal document that instructs providers & family members about
what, if any, life sustaining tx an individual wants if at some time the individual is unable
to make decisions?
vomiting
Verbal (V) - The best verbal response, with responses ranging from 5 to 1
upon admission to the hospital it is required that all clients over 18 be questioned about
organ donation
unequal pupils
To decrease the risk of aspiration for a stroke client, ensure the clients position is
upright, that the upper back and head are supported during meals. Remind the client to
tuck their chin while swallowing, to guide the food's path. Avoid lowering the head of
bed during feedings. Oral care can improve the client's well-being and increase the
interest for eating, but does not help prevent the potential for aspiration.
This option meets the prescribed diet. It is high in calories and while chicken does
provide protein it is a low-fat source and can be eaten in moderation on a low-protein
diet. Spinach will provide additional vitamin K for this client at risk for bleeding due to
liver failure.
this is expected in school-age children 6-12 years
the pt was straight cathed for 350mL 2 hours ago
the pt has continuous IV of LR
The nurse should use extreme caution with clients who are very young, an older adult,
fair-skinned, who have impaired cognition, and have comorbidities because they are at
higher risk for fragile skin.
the nurse is providing teaching to a female pt for ciprofloxacin, what statement indicates
understanding of the teaching - ansi should wear protective clothing when I go outdoors
the client reports experiencing n/d, what should the nurse say - ansyour symptoms are
common AE of metformin and should decrease with time
teach the pt about proper latching on technique
take on empty stomach with glass of water, first thing in the morning 30-60min prior to
breakfast
take 2nd puff of albuterol
tachycardia
-staff must document type & location of the restraint and time applied
-staff must document type & location of the restraint and time applied
shred computer generated client worksheets after use
,ATI CAPSTONE FUNDAMENTALS PRE-ASSESSMENT
ALREADY GRADED A+
Restraints should be applied as a last resort after other measures have been used.
Thorough and timely documentation needs to be completed when restraints are applied,
following protocol and policy. Neurovascular and neurosensory status should be
assessed every 2 hours, along with frequent check ins to ensure the safety and comfort
of the client. Restraints should not be used as a way to contain the client when a unit is
short staffed. The type or technique of restraint used must be the least restrictive
intervention possible and should never interfere with treatment
Responses within each subscale are added, with the total score quantitatively
describing the client's level of consciousness. E + V + M = Total GCS
pt rests for one min
physician assistants
overweight BMI = 25-29.9
OT
opiates initially cause sedation but this effect subsides with maintenance pain control.
The pain mangement plan is working. There is no need to change or add additional
methods at this time.
obesity BMI = > or = to 30
nurse practitioners
Motor (M) - The best motor response, with responses ranging from 6 to 1
limiti alcohol, caffeine, & nicotine at least 4 hr before bedtime
it is encourage to stop smoking, reduce sodium intake, monitor fluid intake, restricting
intake to 2 L per day. it is also encouraged to increase protein intake to 1.12 g/kg and
consume small, frequent meals that are soft, easy to chew foods.
initiate bed rest with bathroom privileges
hydrating lotions are commonly prescribed to treat irradiated areas. the client should
avoid applying other lotions not prescribed by the radiologist to affected areas
hormone replacement therapy
high-fat diet
healthy wt BMI = 18.5-24.9
have pt take one puff of fluticasone
have pt rest for 5 min
have O2 equipment available
Glascow Coma Scale - ansEye opening (E) - The best eye response, with responses
ranging from 4 to 1 4 = Eye opening occurs spontaneously.
Following surgery, a client has a prescription for nalbuphine (Nubain) for moderate to
severe pain. The nurse caring for the client should check for possible adverse reactions
by assessing for which of the following findings? - ansBlurred vision
following med. diet, red meat should be limited to 2 times monthly
F. Use of aerosol hairspray is recommended - ansA, B, C
F. Restrain the client - ansA, B, C, D, E
F. Encourage the client to cough frequently - ansA, D, E
estrogen use and smoking increases the risk for TBE
,ATI CAPSTONE FUNDAMENTALS PRE-ASSESSMENT
ALREADY GRADED A+
estrogen therapy can cause break-through vaginal bleeding
encourage the pt to allow her nipples to air dry after feedings
encourage the father to touch and stroke the newborn's skin
E. Teach the client to swallow with her neck flexed - ansA, B, C, E
E. Straighten the client's flexed leg at the knee - ansA, C, D
E. Protect the client's head with padding
E. Occlusive dressing - ansA, B, C, E
E. Obtain a chest x-ray - ansA, B, E
E. Monitor for impaired extraocular movements
E. Limit episodes of hypoventilation
E. Lack of situational awareness - ansA, B, C, E
E. Keep the HOB flat - ansB, C, D
E. Keep the client well hydrated - ansB, D
E. Instruct the client to perform deep breathing exercises and coughing exercises -
ansB, C, D
E. Infuse warmed IV fluids - ansA, C, D, E
E. Infuse IV fluids - ansB, C, E
E. Hypotension - ansA, B, D
E. Give instructions one step at a time - ansA, B, E
E. Drainage system upright at chest level - ansB, C
E. Ataxia - ansA, B, E
E. "I ate a light breakfast this morning" - ansA, B, D, E
during an initial visit, a home health nurse is assessing a pt who has different cultural
beliefs than her own, what questions should the nurse ask to determine the pts beliefs
about environmental control - answhat do you think you can do to affect your health
status
drainage from the ear
documentation about giving permission or refusing to donate is placed in the EMR
do you have a history of gastric problems
dietician
demonstrate diapering and swaddling techniques for the father
D. Turn off room lights and television
D. The vaccine is initially given at 2 months of age - ansC
D. Respiratory compromise - ansD
D. Pupillary response - ansC
D. Provide client hygiene - ansA
D. Provide a urine sample to determine therapeutic levels of the medication - ansC
D. Prevention of postural hypotension when placing the client in a wheelchair - ansA
D. Place the wheelchair on the client's left side - ansB
D. Perform the Valsalva maneuver - ansD
D. Perform aerobic exercise
D. Perform a skin assessment
, ATI CAPSTONE FUNDAMENTALS PRE-ASSESSMENT
ALREADY GRADED A+
D. Oliguria - ansB
D. Muscle relaxants - ansD
D. Loss of depth perception - ansC
D. Loosen the client's clothing
D. Indwelling urinary catheter - ansA
D. Indwelling urinary catheter
D. Increased salivation
D. Hypertension - ansB
D. Flexion of the head - ansA
D. Exposed sutures without dressing
D. Establish IV access and start fluid replacement - ansA
D. Encourage the client to increase fluid intake
D. Elevate the client's lower extremities - ansC
D. E2 + V2 + M4 = 8 - ansB
D. Drooping eye lids - ansB
D. Decrease bright lights - ansB
D. Decorticate posturing
D. Complete sentences that the client cannot finish
D. Client who has dark red coloration of left toes and absent pedal pulse - ansB
D. Clamp the tube once a day
D. Bend client's head toward chest
D. Assign an AP to feed the client slowly
D. Assess respiratory status - ansB
D. Apply a heat lamp
D. Aphasia
D. Administer syrup of ipecac
D. Administer antihypertensive medication - ansB
D. Administer a stool softener
D. "You will need to lie flat for 4 hours after the procedure" - ansB
D. "This med may cause your skin to appear yellow in color" - ansD
D. "It is recommended that you use ultrasound diathermy for pain management" - ansC
D. "I am allergic to shrimp"
constipation
clients should avoid taking their medications with which of the following? - ansGrapefruit
juice
Clients prescribed potassium-wasting diurectics should be encouraged to eat foods high
in potassium. Oranges, dried fruits, tomatoes, avocados, dried peas, meats, broccoli,
and bananas are all good sources of potassium.
cleanse the insertion site with antiseptic swabs
change computer access passwords on a regular basis
C. The vaccine is recommended for adolescents before starting college
C. Take the medication at the same time every day
ALREADY GRADED A+
your medication plan can also include an antibiotic medication
you will need to take the medication for the rest of your life
which of the following factors should the nurse identify as an environmental factor in the
epidemiological triangle - anscrowded living conditions
which of the following can cause a low pulse oximetry reading?
Which of the following are appropriate references for the nurse to use to ensure safe
medication administration? (Select all that apply.) - ans- Published journals
what is the name of the legal document that instructs providers & family members about
what, if any, life sustaining tx an individual wants if at some time the individual is unable
to make decisions?
vomiting
Verbal (V) - The best verbal response, with responses ranging from 5 to 1
upon admission to the hospital it is required that all clients over 18 be questioned about
organ donation
unequal pupils
To decrease the risk of aspiration for a stroke client, ensure the clients position is
upright, that the upper back and head are supported during meals. Remind the client to
tuck their chin while swallowing, to guide the food's path. Avoid lowering the head of
bed during feedings. Oral care can improve the client's well-being and increase the
interest for eating, but does not help prevent the potential for aspiration.
This option meets the prescribed diet. It is high in calories and while chicken does
provide protein it is a low-fat source and can be eaten in moderation on a low-protein
diet. Spinach will provide additional vitamin K for this client at risk for bleeding due to
liver failure.
this is expected in school-age children 6-12 years
the pt was straight cathed for 350mL 2 hours ago
the pt has continuous IV of LR
The nurse should use extreme caution with clients who are very young, an older adult,
fair-skinned, who have impaired cognition, and have comorbidities because they are at
higher risk for fragile skin.
the nurse is providing teaching to a female pt for ciprofloxacin, what statement indicates
understanding of the teaching - ansi should wear protective clothing when I go outdoors
the client reports experiencing n/d, what should the nurse say - ansyour symptoms are
common AE of metformin and should decrease with time
teach the pt about proper latching on technique
take on empty stomach with glass of water, first thing in the morning 30-60min prior to
breakfast
take 2nd puff of albuterol
tachycardia
-staff must document type & location of the restraint and time applied
-staff must document type & location of the restraint and time applied
shred computer generated client worksheets after use
,ATI CAPSTONE FUNDAMENTALS PRE-ASSESSMENT
ALREADY GRADED A+
Restraints should be applied as a last resort after other measures have been used.
Thorough and timely documentation needs to be completed when restraints are applied,
following protocol and policy. Neurovascular and neurosensory status should be
assessed every 2 hours, along with frequent check ins to ensure the safety and comfort
of the client. Restraints should not be used as a way to contain the client when a unit is
short staffed. The type or technique of restraint used must be the least restrictive
intervention possible and should never interfere with treatment
Responses within each subscale are added, with the total score quantitatively
describing the client's level of consciousness. E + V + M = Total GCS
pt rests for one min
physician assistants
overweight BMI = 25-29.9
OT
opiates initially cause sedation but this effect subsides with maintenance pain control.
The pain mangement plan is working. There is no need to change or add additional
methods at this time.
obesity BMI = > or = to 30
nurse practitioners
Motor (M) - The best motor response, with responses ranging from 6 to 1
limiti alcohol, caffeine, & nicotine at least 4 hr before bedtime
it is encourage to stop smoking, reduce sodium intake, monitor fluid intake, restricting
intake to 2 L per day. it is also encouraged to increase protein intake to 1.12 g/kg and
consume small, frequent meals that are soft, easy to chew foods.
initiate bed rest with bathroom privileges
hydrating lotions are commonly prescribed to treat irradiated areas. the client should
avoid applying other lotions not prescribed by the radiologist to affected areas
hormone replacement therapy
high-fat diet
healthy wt BMI = 18.5-24.9
have pt take one puff of fluticasone
have pt rest for 5 min
have O2 equipment available
Glascow Coma Scale - ansEye opening (E) - The best eye response, with responses
ranging from 4 to 1 4 = Eye opening occurs spontaneously.
Following surgery, a client has a prescription for nalbuphine (Nubain) for moderate to
severe pain. The nurse caring for the client should check for possible adverse reactions
by assessing for which of the following findings? - ansBlurred vision
following med. diet, red meat should be limited to 2 times monthly
F. Use of aerosol hairspray is recommended - ansA, B, C
F. Restrain the client - ansA, B, C, D, E
F. Encourage the client to cough frequently - ansA, D, E
estrogen use and smoking increases the risk for TBE
,ATI CAPSTONE FUNDAMENTALS PRE-ASSESSMENT
ALREADY GRADED A+
estrogen therapy can cause break-through vaginal bleeding
encourage the pt to allow her nipples to air dry after feedings
encourage the father to touch and stroke the newborn's skin
E. Teach the client to swallow with her neck flexed - ansA, B, C, E
E. Straighten the client's flexed leg at the knee - ansA, C, D
E. Protect the client's head with padding
E. Occlusive dressing - ansA, B, C, E
E. Obtain a chest x-ray - ansA, B, E
E. Monitor for impaired extraocular movements
E. Limit episodes of hypoventilation
E. Lack of situational awareness - ansA, B, C, E
E. Keep the HOB flat - ansB, C, D
E. Keep the client well hydrated - ansB, D
E. Instruct the client to perform deep breathing exercises and coughing exercises -
ansB, C, D
E. Infuse warmed IV fluids - ansA, C, D, E
E. Infuse IV fluids - ansB, C, E
E. Hypotension - ansA, B, D
E. Give instructions one step at a time - ansA, B, E
E. Drainage system upright at chest level - ansB, C
E. Ataxia - ansA, B, E
E. "I ate a light breakfast this morning" - ansA, B, D, E
during an initial visit, a home health nurse is assessing a pt who has different cultural
beliefs than her own, what questions should the nurse ask to determine the pts beliefs
about environmental control - answhat do you think you can do to affect your health
status
drainage from the ear
documentation about giving permission or refusing to donate is placed in the EMR
do you have a history of gastric problems
dietician
demonstrate diapering and swaddling techniques for the father
D. Turn off room lights and television
D. The vaccine is initially given at 2 months of age - ansC
D. Respiratory compromise - ansD
D. Pupillary response - ansC
D. Provide client hygiene - ansA
D. Provide a urine sample to determine therapeutic levels of the medication - ansC
D. Prevention of postural hypotension when placing the client in a wheelchair - ansA
D. Place the wheelchair on the client's left side - ansB
D. Perform the Valsalva maneuver - ansD
D. Perform aerobic exercise
D. Perform a skin assessment
, ATI CAPSTONE FUNDAMENTALS PRE-ASSESSMENT
ALREADY GRADED A+
D. Oliguria - ansB
D. Muscle relaxants - ansD
D. Loss of depth perception - ansC
D. Loosen the client's clothing
D. Indwelling urinary catheter - ansA
D. Indwelling urinary catheter
D. Increased salivation
D. Hypertension - ansB
D. Flexion of the head - ansA
D. Exposed sutures without dressing
D. Establish IV access and start fluid replacement - ansA
D. Encourage the client to increase fluid intake
D. Elevate the client's lower extremities - ansC
D. E2 + V2 + M4 = 8 - ansB
D. Drooping eye lids - ansB
D. Decrease bright lights - ansB
D. Decorticate posturing
D. Complete sentences that the client cannot finish
D. Client who has dark red coloration of left toes and absent pedal pulse - ansB
D. Clamp the tube once a day
D. Bend client's head toward chest
D. Assign an AP to feed the client slowly
D. Assess respiratory status - ansB
D. Apply a heat lamp
D. Aphasia
D. Administer syrup of ipecac
D. Administer antihypertensive medication - ansB
D. Administer a stool softener
D. "You will need to lie flat for 4 hours after the procedure" - ansB
D. "This med may cause your skin to appear yellow in color" - ansD
D. "It is recommended that you use ultrasound diathermy for pain management" - ansC
D. "I am allergic to shrimp"
constipation
clients should avoid taking their medications with which of the following? - ansGrapefruit
juice
Clients prescribed potassium-wasting diurectics should be encouraged to eat foods high
in potassium. Oranges, dried fruits, tomatoes, avocados, dried peas, meats, broccoli,
and bananas are all good sources of potassium.
cleanse the insertion site with antiseptic swabs
change computer access passwords on a regular basis
C. The vaccine is recommended for adolescents before starting college
C. Take the medication at the same time every day
