ATI RN Capstone Proctored Post Assessment

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Sample questions from ATI RN Capstone Proctored Post Assessment

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 67-year-old client on a medical unit has pneumonia and becomes confused. Temperature is 39.1 C, heart rate is 124/min, respirations are 30/min, BP is 82/46 mm Hg, oxygen saturation is 89% on room air, and lactate is 4.8 mmol/L. Which action should the nurse take first?

   • A.Obtain a sputum specimen before initiating treatment.
   • B.Apply supplemental oxygen and activate the rapid response team.
   • C.Administer the prescribed oral antipyretic.
   • D.Reassess the blood pressure after the client rests for 15 minutes.

   Rationale: Hypoxemia, hypotension, altered mentation, and elevated lactate indicate possible septic shock requiring immediate oxygenation support and emergency escalation. A sputum specimen can help guide therapy but must not delay stabilization. An antipyretic does not correct impaired perfusion, and waiting to reassess delays treatment of an unstable client. Prioritize breathing and circulation when infection is accompanied by organ dysfunction.

2. 2.A 58-year-old client in the emergency department reports crushing chest pain for 40 minutes. The ECG shows ST elevation in leads II, III, and aVF; BP is 86/54 mm Hg and heart rate is 52/min. Aspirin has been given, and the cardiac catheterization team has been activated. Which prescription should the nurse question?

   • A.Establish a second peripheral IV line.
   • B.Initiate continuous cardiac monitoring.
   • C.Administer sublingual nitroglycerin 0.4 mg.
   • D.Prepare the client for emergency percutaneous coronary intervention.

   Rationale: Nitroglycerin can worsen this client's significant hypotension and should be withheld while the prescription is clarified. A second IV line and continuous cardiac monitoring support safe emergency management. Emergency percutaneous coronary intervention addresses the coronary occlusion and should not be delayed. Evaluate blood pressure and contraindications before administering nitrates.

3. 3.A 72-year-old client arrives at a stroke center 50 minutes after sudden right-sided weakness and difficulty speaking. BP is 174/96 mm Hg, glucose is 104 mg/dL, and the client takes no anticoagulants. Which action is the priority?

   • A.Prepare the client for immediate noncontrast head CT.
   • B.Administer oral aspirin before imaging.
   • C.Lower the systolic blood pressure to less than 140 mm Hg immediately.
   • D.Offer water to evaluate swallowing.

   Rationale: Immediate noncontrast head CT distinguishes hemorrhage from ischemia and guides time-sensitive treatment. Aspirin is withheld until intracranial hemorrhage has been excluded. Aggressive blood pressure reduction can impair cerebral perfusion, and this pressure is below the usual pretreatment threshold for IV thrombolysis. Keep the client NPO until a validated swallowing screen is completed.

4. 4.A 24-year-old client with type 1 diabetes is admitted to an intensive care unit with diabetic ketoacidosis. Glucose is 526 mg/dL, pH is 7.18, potassium is 2.9 mEq/L, and BP is 96/60 mm Hg. Isotonic IV fluid replacement has begun. Which prescribed intervention should the nurse implement next?

   • A.Start the continuous IV insulin infusion.
   • B.Administer IV sodium bicarbonate.
   • C.Change the infusion to dextrose 5% in water.
   • D.Administer IV potassium replacement using an infusion pump.

   Answer and rationale are in the full material.

5. 5.A 63-year-old client with chronic kidney disease presents to the emergency department with muscle weakness. Potassium is 6.8 mEq/L, and the monitor shows tall peaked T waves and widening QRS complexes. Which prescribed medication should the nurse administer first?

   • A.IV calcium gluconate.
   • B.IV regular insulin with dextrose.
   • C.Oral sodium zirconium cyclosilicate.
   • D.Nebulized albuterol.

   Answer and rationale are in the full material.