ATI Capstone Fundamentals
a nurse is reviewing the lab report of a client who has been experiencing a fever for the last 3d, what lab
results indicates the client is experiencing FVD?
increased hematocrit (increased USG and BUN)
a nurse is updating a plan of care after an evaluation of a client who has dysphagia, which interventions should the nurse include in the plan?
have the client sit upright for 1 hr following meals (facilitates swallowing of undigested food and reduce risk of aspiration)
a nurse is caring for a client who reports burning around the peripheral IV site, which finding should the nurse identify as a manifestation of infiltration?
edema (leakage of the IV solution into the extravascular tissue)
a charge nurse is making assignments for the upcoming shift, what assignments should the charge nurse assign to a LPN?
a client who has dehydration and IBD
(does not require complex med admin or assessment)
a nurse is in an ED monitoring the hydration status of a client receiving oral rehydration, what should the intervene for?
heart rate 120/min
(initiate IV fluid replacement) a nurse is documenting client care, which of the following entries should the nurse identify as an example of implementation of client care?
contacted the provider to report client findings
a charge nurse discovers that a nurse did not notify the provider that a client's condition had changed. the charge nurse should identify that the nurse is accountable for which of the following torts?
negligence
a nurse is completing an admission assessment for a client who has hearing lsos, what action should the nurse take?
use written communication to assist with communication
a nurse is caring for a client who has dementia and frequently tries to get out of bed, which of the following actions should the nurse take? (SATA)
turn on the bed alarm maintain the bed in the lowest position encourage the family to stay with the pt
a nurse is preparing a client for transfer to another unit? which finding does the nurse include in the transfer report?
response to pain medication review of ongoing discharge plan recent physical changes
nurse in a providers office is assessing the motor skill development of a 15 month old toddler during a well-child visit, what gross motor skills should the nurse expect?
walks without assistance using a wide stance
a nurse is admitting a client who has recently developed fever, confusion, and a decreased level of consciousness. which of the following actions should the nurse take first after obtaining the client's history and assessment?
identify the client's needs
a nurse is reviewing the lab report of a client who has been experiencing a fever for the last 3d, what lab
results indicates the client is experiencing FVD?
increased hematocrit (increased USG and BUN)
a nurse is updating a plan of care after an evaluation of a client who has dysphagia, which interventions should the nurse include in the plan?
have the client sit upright for 1 hr following meals (facilitates swallowing of undigested food and reduce risk of aspiration)
a nurse is caring for a client who reports burning around the peripheral IV site, which finding should the nurse identify as a manifestation of infiltration?
edema (leakage of the IV solution into the extravascular tissue)
a charge nurse is making assignments for the upcoming shift, what assignments should the charge nurse assign to a LPN?
a client who has dehydration and IBD
(does not require complex med admin or assessment)
a nurse is in an ED monitoring the hydration status of a client receiving oral rehydration, what should the intervene for?
heart rate 120/min
(initiate IV fluid replacement) a nurse is documenting client care, which of the following entries should the nurse identify as an example of implementation of client care?
contacted the provider to report client findings
a charge nurse discovers that a nurse did not notify the provider that a client's condition had changed. the charge nurse should identify that the nurse is accountable for which of the following torts?
negligence
a nurse is completing an admission assessment for a client who has hearing lsos, what action should the nurse take?
use written communication to assist with communication
a nurse is caring for a client who has dementia and frequently tries to get out of bed, which of the following actions should the nurse take? (SATA)
turn on the bed alarm maintain the bed in the lowest position encourage the family to stay with the pt
a nurse is preparing a client for transfer to another unit? which finding does the nurse include in the transfer report?
response to pain medication review of ongoing discharge plan recent physical changes
nurse in a providers office is assessing the motor skill development of a 15 month old toddler during a well-child visit, what gross motor skills should the nurse expect?
walks without assistance using a wide stance
a nurse is admitting a client who has recently developed fever, confusion, and a decreased level of consciousness. which of the following actions should the nurse take first after obtaining the client's history and assessment?
identify the client's needs