Capstone Fundamentals Study Guide

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Sample questions from Capstone Fundamentals Study Guide

This material has 24 questions with answers and rationales. Here are the first 5.

1. 1.An older adult admitted with pneumonia was alert at the beginning of the shift. The patient is now restless, has a respiratory rate of 30/min, and has an oxygen saturation of 86% on room air. Which action should the nurse take first?

   • A.Complete a detailed pain assessment before intervening.
   • B.Raise the head of the bed, apply oxygen according to protocol, and promptly summon assistance.
   • C.Encourage oral fluids to help thin respiratory secretions.
   • D.Document the change and reassess after the patient rests for 30 minutes.

   Rationale: New restlessness, tachypnea, and hypoxemia indicate possible respiratory deterioration. Positioning, oxygen, and prompt assistance address the immediate breathing priority; the nurse should reassess the response. A detailed pain assessment must not delay treatment. Oral fluids do not correct acute hypoxemia and may be unsafe during respiratory distress. Documentation is necessary, but waiting 30 minutes delays urgent care.

2. 2.A patient scheduled for surgery has received no sedating medication. When the nurse brings the consent form, the patient says, "I do not understand the risks, and I am not sure I want this operation." What is the nurse's best response?

   • A.Explain the surgical risks independently and ask the patient to sign.
   • B.Ask the patient's spouse to sign because the patient is uncertain.
   • C.Witness the signature now and tell the patient to ask questions in the operating room.
   • D.Pause the consent process and notify the clinician responsible for explaining the procedure.

   Rationale: Informed consent requires adequate information and a voluntary decision. The nurse should pause signing and contact the responsible clinician to address unanswered questions. The nurse may reinforce teaching but should not substitute for the clinician's procedure-specific consent discussion. Uncertainty does not remove a capable patient's decision-making authority or permit a spouse to sign instead. Witnessing a signature before concerns are resolved does not establish informed consent.

3. 3.A hospitalized patient with frequent watery diarrhea has suspected Clostridioides difficile infection. Which infection-prevention plan is most appropriate while diagnostic testing is pending?

   • A.Initiate contact precautions, use gown and gloves, dedicate equipment, and use soap and water after care.
   • B.Use droplet precautions and wear a surgical mask whenever entering the room.
   • C.Use standard precautions alone until the laboratory confirms the infection.
   • D.Place the patient in an airborne isolation room and wear a fit-tested respirator.

   Rationale: Suspected C. difficile warrants prompt contact precautions rather than waiting for confirmation. Gown and gloves, dedicated equipment, and soap-and-water handwashing help reduce spread of spores; appropriate sporicidal environmental cleaning is also important. Droplet precautions target respiratory droplets, not this organism's main transmission route. Standard precautions alone are insufficient for suspected infectious diarrhea of this type. Airborne isolation and a respirator are not routinely indicated.

4. 4.A patient has an order for amoxicillin 500 mg by mouth. The suspension label reads 250 mg per 5 mL. After verifying the order, patient identity, and allergy history, how much should the nurse measure for one dose?

   • A.2.5 mL
   • B.5 mL
   • C.10 mL
   • D.20 mL

   Answer and rationale are in the full material.

5. 5.Ten minutes after a packed red blood cell transfusion begins, a patient develops chills, lower back pain, and shortness of breath. Which action should the nurse take first?

   • A.Reduce the transfusion rate and reassess the symptoms in 15 minutes.
   • B.Stop the transfusion and maintain IV access with normal saline using new tubing.
   • C.Administer an ordered as-needed antipyretic while continuing the transfusion.
   • D.Collect a urine specimen before changing the transfusion.

   Answer and rationale are in the full material.