1 | P a g e NGN ATI CAPSTONE PROCTORED RN COMPREHENSIVE ASSESSMENT 2019 LATEST UPDATE 2024 -2026 QUESTIONS WITH CORRECT ANSWERS GRADED A+ A nurse is assisting a provider with the removal of a chest tube. Which of the following actions should the nurse take? a. Instruct the client to lie prone with arms by the sides b. Complete a surgical checklist on the client c. Remind the client that there is minimal discomfort during the removal process d. Place an occlusive dressing over the site once the tube is removed - CORRECT ANSWER >>>d. Place an occlusive dressing over the site once the tube is removed Observe the site for drainage. A nurse is caring for a client who is scheduled for a thoracen tesis. Which of the following supplies should the nurse ensure are in the clients room? SATA a. Oxygen equipment b. Incentive spirometer c. Pulse oximeter d. Sterile dressing 2 | P a g e e. Suture removal kit - CORRECT ANSWER >>>a, c, d a. Oxygen equipment for SOB b. Pulse ox to monitor ox sat during procedure d. Sterile dressing to apply to the puncture site Associated manifestation of Hypokalemia - CORRECT ANSWER >>>Hypoactive bowel sounds The nurse is assessing the client for Chvostek's sign. Which of the follo wing actions should the nurse take? a. Apply a BP cuff to the client's arm b. Place a stethoscope bell over the client's carotid artery c. Ask the client to lower their chin to their chest d. Tap lightly on the client's cheek - CORRECT ANSWER >>>d. Tap l ightly on the client's cheek Tap over the facial nerve just below and anterior to the ear to elicit Chvostek's sign. A positive sign = Facial twitching on the side of the face The nurse is assessing the client who reports nausea, vomiting, and weakness. Which of the following findings are manifestations of hypocalcemia? SATA a. Tingling in fingers b. Poor skin turgor c. Abdominal pain d. Elevated temperature e. Muscle twitching - CORRECT ANSWER >>>a, c, e Numbness and tingling in fingers and toes, abdominal cramps and diarrhea, and muscle twitching are manifestations of hypocalcemia. 3 | P a g e Associated manifestation of Hypocalcemia - CORRECT ANSWER >>>Positive Trousseau's sign Respiratory Diagnostic Procedures: P lanning Care for a Client Who Is Scheduled for a Thoracentesis - CORRECT ANSWER >>>Preprocedure: - Percussion, auscultation, radiography, or sonography is used to locate the effusion and needle insertion site. - Assist the older client to maintain still fo r the procedure - Position the client sitting upright with arms and shoulders raised and supported on pillows and/or an overbed table and with feet and legs well-supported. - Remain stills, no coughing or talking Intraprocedure: - Aseptic technique - Monitor VS, skin color, and ox sat - Amount of fluid removed is limited to 1L at a time to prevent re -
expansion pulmonary edema Postprocedure: - Apply dressing over puncture site - Assess for bleeding or drainage - Monitor VS and respiratory status hourl y for the first several hours - Encourage deep breathe to assist with lung expansion - Obtain a postprocedure cxr Thoracentesis - CORRECT ANSWER >>>Thoracentesis is the surgical perforation of the chest wall and pleural space with a large -bore needle. It is performed to obtain specimens for diagnostic evaluation, instill medication into the pleural space, and remove fluid or air from the pleural space for therapeutic relief of pleural pressure . 4 | P a g e Associated manifestation of Hyponatremia - CORRECT ANSWER >>>Bounding pulse Electrolyte Imbalances: Identifying Manifestations of a Calcium Imbalance - CORRECT ANSWER >>>Hypocalcemia: - Level: <9 mg/dL - Risk factors: Calcium deficit, diarrhea, end -stage kidney disease, wound drainage; alkalosis, acute pancreatitis, immobility, parathyroid removal/damage - S&S: Tetany (most common manifestation), paresthesia of the fingers and lips, muscle twitches, seizure, muscle spasms, hyperactive DTRs, positive Chvostek's sign (facial twitching), positive Trousseau's sign (hand/finger spasms with BP cuff inflation), cardiovascular irregularities, diarrhea, abdominal cramps - Tx: Vitamin D supplements - Complications : Cardiac arrest A nurse is reviewing information with a client who is scheduled for pulmonary function tests. Which of the following statements should the nurse make? a. "Do not use inhaler medications for 6 hr following the test." b. "Do not smoke tobac co for 6 -8 hr prior to the test." c. "You will be asked to bear down and hold your breath during the test." d. "The arterial blood flow to your hand will be evaluated as part of the test." - CORRECT ANSWER >>>b. "Do not smoke tobacco for 6 -8 hr prior to th e test." To ensure accurate results A nurse is caring for a client who is scheduled for a thoracentesis. Prior to the procedure, which of the following actions should the nurse take? a. Position the client upright, leaning over the bedside table
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