RN ATI CAPSTONE PROCTORED COMPREHENSIVE ASSESSMENT 2019 B |
150 NGN-STYLE PRACTICE QUESTIONS WITH DETAILED RATIONALES
TABLE OF CONTENTS
NGN Partial Credit Cheat Sheet (Below)
Case Study 1: Management of Care - Questions 1-20
Case Study 2: Safety and Infection Control - Questions 21-35
Case Study 3: Health Promotion and Maintenance - Questions 36-50
Case Study 4: Psychosocial Integrity - Questions 51-65
Case Study 5: Basic Care and Comfort - Questions 66-75
Case Study 6: Pharmacological and Parenteral Therapies - Questions 76-90
Case Study 7: Reduction of Risk Potential - Questions 91-105
Case Study 8: Physiological Adaptation - Questions 106-130
Case Study 9: Prioritization, Delegation, and Leadership - Questions 131-145
Case Study 10: Comprehensive Review - Questions 146-150
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CASE STUDY 1: MANAGEMENT OF CARE
QUESTION 1: SATA - PACKED RED BLOOD CELL TRANSFUSION EFFECTIVENESS
• Question: A nurse is assessing a client who received 2 units of packed RBCs 48
hours ago. Which of the following findings should indicate to the nurse that the
therapy has been effective?
• Options:
A. Hemoglobin 14.9 g/dL
B. Hematocrit 28%
C. Blood pressure 110/70 mmHg
D. Client reports increased energy
E. Heart rate 110 bpm
• Zero-Flip Premium Rationale Box:
o Correct Answers: A, D
o Pathophysiology Summary: Packed red blood cells are administered to
clients who have a decreased level of hemoglobin or hematocrit. A
hemoglobin level within the expected reference range of 14 to 18 g/dL for
males and 12 to 16 g/dL for females indicates the therapy has been effective.
The client reporting increased energy is also a sign of improved oxygen-
carrying capacity.
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o Distractor Pitfalls: Option B (hematocrit 28%) remains low and would not
indicate effectiveness. Option C (blood pressure) is a vital sign that could be
affected by many factors. Option E (tachycardia) suggests the client is still
hemodynamically compromised.
QUESTION 2: SATA - TRIAGE PRIORITY
• Question: A nurse working in an emergency department is triaging four clients.
Which of the following clients should the nurse recommend for treatment first?
• Options:
A. A middle adult client who has unstable vital signs
B. An older adult client who has a fractured hip and is crying
C. A young adult client who has a laceration and is bleeding
D. A child who has a fever and is crying
• Zero-Flip Premium Rationale Box:
o Correct Answer: A
o Pathophysiology Summary: Using the stable versus unstable approach to
client care, the nurse should recommend priority treatment for the client
who has unstable vital signs because this client requires immediate
treatment to reduce the risk of further injury or possible death. The client
with a fractured hip, laceration, or fever is stable and can wait.
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o Distractor Pitfalls: Options B, C, and D are stable clients who do not require
immediate life-saving interventions. The client with unstable vital signs is the
priority.
QUESTION 3: SATA - DELEGATION TO ASSISTIVE PERSONNEL
• Question: A nurse is caring for a client who has fluid volume overload. Which of the
following tasks should the nurse delegate to an assistive personnel (AP)?
• Options:
A. Measure the client's daily weight
B. Assess the client's lung sounds
C. Administer furosemide IV push
D. Evaluate the client's intake and output
E. Provide oral care to the client
• Zero-Flip Premium Rationale Box:
o Correct Answers: A, E
o Pathophysiology Summary: It is within the AP's range of function to
measure a client's daily weight, so the nurse should delegate this task to
them. Providing oral care is also within the AP's scope of practice. The RN is
responsible for assessment, medication administration, and evaluation.