ATI CAPSTONE PROCTORED
COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
Electrolyte b4Imbalances: b4Identifying b4Manifestations b4of b4a b4Calcium b4Imbalance
b4- b4ANSWERS--Hypocalcemia:
- b4Level: b4<9 b4mg/dL
- b4Risk b4factors: b4Calcium b4deficit, b4diarrhea, b4end-stage b4kidney b4disease,
b4wound b4drainage; b4alkalosis, b4acute b4pancreatitis, b4immobility, b4parathyroid
b4removal/damage
- b4S&S: b4Tetany b4(most b4common b4manifestation), b4paresthesia b4of b4the b4fingers
b4and b4lips, b4muscle b4twitches, b4
seizure, b4muscle b4spasms, b4hyperactive b4DTRs, b4positive b4Chvostek's b4sign
b4(facial b4twitching), b4positive b4Trousseau's b4sign b4(hand/finger b4spasms b4with
b4BP b4cuff b4inflation), b4cardiovascular b4irregularities, b4diarrhea, b4abdominal
b4cramps
- b4Tx: b4Vitamin b4D b4supplements
- b4Complications: b4Cardiac b4arrest
Associated b4manifestation b4of b4Hypocalcemia b4- b4ANSWERS--Positive
b4Trousseau's b4sign
Associated b4manifestation b4of b4Hyperkalemia b4- b4ANSWERS--ECG b4with b4tall,
b4peaked b4t-waves
Associated b4manifestation b4of b4Hyponatremia b4- b4ANSWERS--Bounding b4pulse
Associated b4manifestation b4of b4Hypokalemia b4- b4ANSWERS--Hypoactive b4bowel
b4sounds
The b4nurse b4is b4assessing b4the b4client b4for b4Chvostek's b4sign. b4Which b4of b4the
b4following b4actions b4should b4the b4nurse b4take?
a. b4Apply b4a b4BP b4cuff b4to b4the b4client's b4arm b4
b. b4Place b4a b4stethoscope b4bell b4over b4the b4client's b4carotid b4artery b4
c. b4Ask b4the b4client b4to b4lower b4their b4chin b4to b4their b4chest
d. b4Tap b4lightly b4on b4the b4client's b4cheek b4- b4ANSWERS--d. b4Tap b4lightly b4on
b4the b4client's b4cheek
Tap b4over b4the b4facial b4nerve b4just b4below b4and b4anterior b4to b4the b4ear b4to
b4elicit b4Chvostek's b4sign. b4
A b4positive b4sign b4= b4Facial b4twitching b4on b4the b4side b4of b4the b4face
, The b4nurse b4is b4assessing b4the b4client b4who b4reports b4nausea, b4vomiting, b4and
b4weakness. b4Which b4of b4the b4following b4findings b4are b4manifestations b4of
b4hypocalcemia? b4SATA
a. b4Tingling b4in b4fingers
b. b4Poor b4skin b4turgor b4
c. b4Abdominal b4pain b4
d. b4Elevated b4temperature b4
e. b4Muscle b4twitching b4- b4ANSWERS--a, b4c, b4e
Numbness b4and b4tingling b4in b4fingers b4and b4toes, b4abdominal b4cramps b4and
b4diarrhea, b4and b4muscle b4twitching b4are b4manifestations b4of b4hypocalcemia.
Respiratory b4Diagnostic b4Procedures: b4Planning b4Care b4for b4a b4Client b4Who b4Is
b4Scheduled b4for b4a b4Thoracentesis b4- b4ANSWERS--Preprocedure:
- b4Percussion, b4auscultation, b4radiography, b4or b4sonography b4is b4used b4to
b4locate b4the b4effusion b4and b4needle b4insertion b4site.
- b4Assist b4the b4older b4client b4to b4maintain b4still b4for b4the b4procedure
- b4Position b4the b4client b4sitting b4upright b4with b4arms b4and b4shoulders b4raised
b4and b4supported b4on b4pillows b4and/or b4an b4overbed b4table b4and b4with b4feet
b4and b4legs b4well-supported.
- b4Remain b4stills, b4no b4coughing b4or b4talking b4
Intraprocedure:
- b4Aseptic b4technique b4
- b4Monitor b4VS, b4skin b4color, b4and b4ox b4sat
- b4Amount b4of b4fluid b4removed b4is b4limited b4to b41L b4at b4a b4time b4to b4prevent b4re-
expansion b4pulmonary b4edema b4
Postprocedure:
- b4Apply b4dressing b4over b4puncture b4site b4
- b4Assess b4for b4bleeding b4or b4drainage b4
- b4Monitor b4VS b4and b4respiratory b4status b4hourly b4for b4the b4first b4several b4hours
b4
- b4Encourage b4deep b4breathe b4to b4assist b4with b4lung b4expansion
- b4Obtain b4a b4postprocedure b4cxr
Thoracentesis b4- b4ANSWERS--Thoracentesis b4is b4the b4surgical b4perforation b4of
b4the b4chest b4wall b4and b4pleural b4space b4with b4a b4large-bore b4needle. b4It b4is
b4performed b4to b4obtain b4specimens b4for b4diagnostic b4evaluation, b4instill
b4medication b4into b4the b4pleural b4space, b4and b4remove b4fluid b4or b4air b4from b4the
b4pleural b4space b4for b4therapeutic b4relief b4of b4pleural b4pressure.
A b4nurse b4is b4reviewing b4information b4with b4a b4client b4who b4is b4scheduled b4for
b4pulmonary b4function b4tests. b4Which b4of b4the b4following b4statements b4should
b4the b4nurse b4make?
a. b4"Do b4not b4use b4inhaler b4medications b4for b46 b4hr b4following b4the b4test."
b. b4"Do b4not b4smoke b4tobacco b4for b46-8 b4hr b4prior b4to b4the b4test."
c. b4"You b4will b4be b4asked b4to b4bear b4down b4and b4hold b4your b4breath b4during
b4the b4test."
COMPREHENSIVE EXAM
QUESTIONS AND ANSWERS
Electrolyte b4Imbalances: b4Identifying b4Manifestations b4of b4a b4Calcium b4Imbalance
b4- b4ANSWERS--Hypocalcemia:
- b4Level: b4<9 b4mg/dL
- b4Risk b4factors: b4Calcium b4deficit, b4diarrhea, b4end-stage b4kidney b4disease,
b4wound b4drainage; b4alkalosis, b4acute b4pancreatitis, b4immobility, b4parathyroid
b4removal/damage
- b4S&S: b4Tetany b4(most b4common b4manifestation), b4paresthesia b4of b4the b4fingers
b4and b4lips, b4muscle b4twitches, b4
seizure, b4muscle b4spasms, b4hyperactive b4DTRs, b4positive b4Chvostek's b4sign
b4(facial b4twitching), b4positive b4Trousseau's b4sign b4(hand/finger b4spasms b4with
b4BP b4cuff b4inflation), b4cardiovascular b4irregularities, b4diarrhea, b4abdominal
b4cramps
- b4Tx: b4Vitamin b4D b4supplements
- b4Complications: b4Cardiac b4arrest
Associated b4manifestation b4of b4Hypocalcemia b4- b4ANSWERS--Positive
b4Trousseau's b4sign
Associated b4manifestation b4of b4Hyperkalemia b4- b4ANSWERS--ECG b4with b4tall,
b4peaked b4t-waves
Associated b4manifestation b4of b4Hyponatremia b4- b4ANSWERS--Bounding b4pulse
Associated b4manifestation b4of b4Hypokalemia b4- b4ANSWERS--Hypoactive b4bowel
b4sounds
The b4nurse b4is b4assessing b4the b4client b4for b4Chvostek's b4sign. b4Which b4of b4the
b4following b4actions b4should b4the b4nurse b4take?
a. b4Apply b4a b4BP b4cuff b4to b4the b4client's b4arm b4
b. b4Place b4a b4stethoscope b4bell b4over b4the b4client's b4carotid b4artery b4
c. b4Ask b4the b4client b4to b4lower b4their b4chin b4to b4their b4chest
d. b4Tap b4lightly b4on b4the b4client's b4cheek b4- b4ANSWERS--d. b4Tap b4lightly b4on
b4the b4client's b4cheek
Tap b4over b4the b4facial b4nerve b4just b4below b4and b4anterior b4to b4the b4ear b4to
b4elicit b4Chvostek's b4sign. b4
A b4positive b4sign b4= b4Facial b4twitching b4on b4the b4side b4of b4the b4face
, The b4nurse b4is b4assessing b4the b4client b4who b4reports b4nausea, b4vomiting, b4and
b4weakness. b4Which b4of b4the b4following b4findings b4are b4manifestations b4of
b4hypocalcemia? b4SATA
a. b4Tingling b4in b4fingers
b. b4Poor b4skin b4turgor b4
c. b4Abdominal b4pain b4
d. b4Elevated b4temperature b4
e. b4Muscle b4twitching b4- b4ANSWERS--a, b4c, b4e
Numbness b4and b4tingling b4in b4fingers b4and b4toes, b4abdominal b4cramps b4and
b4diarrhea, b4and b4muscle b4twitching b4are b4manifestations b4of b4hypocalcemia.
Respiratory b4Diagnostic b4Procedures: b4Planning b4Care b4for b4a b4Client b4Who b4Is
b4Scheduled b4for b4a b4Thoracentesis b4- b4ANSWERS--Preprocedure:
- b4Percussion, b4auscultation, b4radiography, b4or b4sonography b4is b4used b4to
b4locate b4the b4effusion b4and b4needle b4insertion b4site.
- b4Assist b4the b4older b4client b4to b4maintain b4still b4for b4the b4procedure
- b4Position b4the b4client b4sitting b4upright b4with b4arms b4and b4shoulders b4raised
b4and b4supported b4on b4pillows b4and/or b4an b4overbed b4table b4and b4with b4feet
b4and b4legs b4well-supported.
- b4Remain b4stills, b4no b4coughing b4or b4talking b4
Intraprocedure:
- b4Aseptic b4technique b4
- b4Monitor b4VS, b4skin b4color, b4and b4ox b4sat
- b4Amount b4of b4fluid b4removed b4is b4limited b4to b41L b4at b4a b4time b4to b4prevent b4re-
expansion b4pulmonary b4edema b4
Postprocedure:
- b4Apply b4dressing b4over b4puncture b4site b4
- b4Assess b4for b4bleeding b4or b4drainage b4
- b4Monitor b4VS b4and b4respiratory b4status b4hourly b4for b4the b4first b4several b4hours
b4
- b4Encourage b4deep b4breathe b4to b4assist b4with b4lung b4expansion
- b4Obtain b4a b4postprocedure b4cxr
Thoracentesis b4- b4ANSWERS--Thoracentesis b4is b4the b4surgical b4perforation b4of
b4the b4chest b4wall b4and b4pleural b4space b4with b4a b4large-bore b4needle. b4It b4is
b4performed b4to b4obtain b4specimens b4for b4diagnostic b4evaluation, b4instill
b4medication b4into b4the b4pleural b4space, b4and b4remove b4fluid b4or b4air b4from b4the
b4pleural b4space b4for b4therapeutic b4relief b4of b4pleural b4pressure.
A b4nurse b4is b4reviewing b4information b4with b4a b4client b4who b4is b4scheduled b4for
b4pulmonary b4function b4tests. b4Which b4of b4the b4following b4statements b4should
b4the b4nurse b4make?
a. b4"Do b4not b4use b4inhaler b4medications b4for b46 b4hr b4following b4the b4test."
b. b4"Do b4not b4smoke b4tobacco b4for b46-8 b4hr b4prior b4to b4the b4test."
c. b4"You b4will b4be b4asked b4to b4bear b4down b4and b4hold b4your b4breath b4during
b4the b4test."
