RN ATI CAPSTONE FINAL PAPER 2026
CLINICAL JUDGMENT AND PATIENT CARE
MANAGEMENT FULL ANSWERS AND EXAM
INSIGHT
◉ Coagulation Disorders: Laboratory Values Associated with
Heparin-Induced Thrombocytopenia (RM AMS RN 10.0 Chp 42,
Active Learning Template - System Disorder)
Answer: Decreased platelet levels
Other s/s: redness, pain, warmth and swelling of lower extremities,
excessive bleeding, tachycardia, hypotension, diaphoresis, oliguria,
decreased LOC
◉ Kidney Transplant: Indications of Transplant Rejection (Active
Learning Template - System Disorder, RM AMS RN 10.0 Chp 58)
Answer: *Hyperacute*: within 48 hr
cause: small blood clots form in transplanted kidney that block
vessels and lead to massive cellular destruction, irreversible
s/s: fever, hypertension, pain at transplant site
treatment: immediate removal of the donor kidney
,*Acute*: occurs 1 week - 2 years after surgery
cause: vasculitis in the donor kidney and cellular destruction begins
with inflammation that can cause lysis of the donor kidney
s/s: oliguria, anuria, low-grade fever, hypertension, tenderness over
the transplanted kidney, lethargy, azotemia, and fluid retention
treatment: involves increased doses of immunosuppressive meds
*Chronic*: occurs gradually over months to years
cause: blood vessel injury from overgrowth of smooth muscles of the
blood vessels causing fibrotic tissue to replace normal tissue
resulting in a nonfunctioning donor kidney
s/s: gradual return of azotemia, fluid retention, electrolyte
imbalance, fatigue
treatment: conservative (monitor kidney status, continue
immunosuppressive therapy) until dialysis is required
◉ Multiple Sclerosis: Teaching Client About Visual Changes (RM
AMS RN 10.0 Chp 10, Active Learning Template - System Disorder)
Answer: Patient may be double (diplopia)
Teach scanning techniques.
Instruct client to visually can his environment by moving his head
from side to side
, ◉ Pacemakers: Indication of Malfunction (RM AMS RN 10.0 Chp 29,
Active Learning Template - Therapeutic Procedure)
Answer: Causes: insufficient pacemaker settings, lead wire
placement and function, battery function, myocardial damage and
electrolyte imbalance
Monitor ECG to ensure heart rate is within programmed parameters.
Pace spikes should be adequate in number and occur directly before
P or QRS complexes
Pacer spikes that occur on the T wave can cause life-threatening
arrhythmias.
Treatment of complications is related to identifying the cause
Pacemaker settings should be manipulated only as prescribed
◉ Pneumothorax, Hemothorax, and Flail Chest: Clinical
Manifestations of a Tension Pneumothorax (Active Learning
Template - System Disorder, RM AMS RN 10.0 Chp 25)
Answer: Expected findings: anxiety, pleuritic pain
Physical assessment findings:
signs of respiratory distress (Tachypnea, tachycardia, cyanosis,
dyspnea and use of accessory muscles)
-Tracheal deviation to the unaffected side
- Reduce/absent breath on affect side
CLINICAL JUDGMENT AND PATIENT CARE
MANAGEMENT FULL ANSWERS AND EXAM
INSIGHT
◉ Coagulation Disorders: Laboratory Values Associated with
Heparin-Induced Thrombocytopenia (RM AMS RN 10.0 Chp 42,
Active Learning Template - System Disorder)
Answer: Decreased platelet levels
Other s/s: redness, pain, warmth and swelling of lower extremities,
excessive bleeding, tachycardia, hypotension, diaphoresis, oliguria,
decreased LOC
◉ Kidney Transplant: Indications of Transplant Rejection (Active
Learning Template - System Disorder, RM AMS RN 10.0 Chp 58)
Answer: *Hyperacute*: within 48 hr
cause: small blood clots form in transplanted kidney that block
vessels and lead to massive cellular destruction, irreversible
s/s: fever, hypertension, pain at transplant site
treatment: immediate removal of the donor kidney
,*Acute*: occurs 1 week - 2 years after surgery
cause: vasculitis in the donor kidney and cellular destruction begins
with inflammation that can cause lysis of the donor kidney
s/s: oliguria, anuria, low-grade fever, hypertension, tenderness over
the transplanted kidney, lethargy, azotemia, and fluid retention
treatment: involves increased doses of immunosuppressive meds
*Chronic*: occurs gradually over months to years
cause: blood vessel injury from overgrowth of smooth muscles of the
blood vessels causing fibrotic tissue to replace normal tissue
resulting in a nonfunctioning donor kidney
s/s: gradual return of azotemia, fluid retention, electrolyte
imbalance, fatigue
treatment: conservative (monitor kidney status, continue
immunosuppressive therapy) until dialysis is required
◉ Multiple Sclerosis: Teaching Client About Visual Changes (RM
AMS RN 10.0 Chp 10, Active Learning Template - System Disorder)
Answer: Patient may be double (diplopia)
Teach scanning techniques.
Instruct client to visually can his environment by moving his head
from side to side
, ◉ Pacemakers: Indication of Malfunction (RM AMS RN 10.0 Chp 29,
Active Learning Template - Therapeutic Procedure)
Answer: Causes: insufficient pacemaker settings, lead wire
placement and function, battery function, myocardial damage and
electrolyte imbalance
Monitor ECG to ensure heart rate is within programmed parameters.
Pace spikes should be adequate in number and occur directly before
P or QRS complexes
Pacer spikes that occur on the T wave can cause life-threatening
arrhythmias.
Treatment of complications is related to identifying the cause
Pacemaker settings should be manipulated only as prescribed
◉ Pneumothorax, Hemothorax, and Flail Chest: Clinical
Manifestations of a Tension Pneumothorax (Active Learning
Template - System Disorder, RM AMS RN 10.0 Chp 25)
Answer: Expected findings: anxiety, pleuritic pain
Physical assessment findings:
signs of respiratory distress (Tachypnea, tachycardia, cyanosis,
dyspnea and use of accessory muscles)
-Tracheal deviation to the unaffected side
- Reduce/absent breath on affect side
