ATI RN
ATI Capstone Adult Medical Surgical Assessment 1
1. A healthcare provider is assessing a client who reports a possible exposure to HIV. Which of the following findings should the healthcare provider identify as an early manifestation of HIV infection?
- A. Stomatitis
- B. Fatigue
- C. Wasting syndrome
- D. Lipodystrophy
Correct answer: B
Rationale: The correct answer is 'B: Fatigue.' Early manifestations of HIV infection often include symptoms like fatigue, fever, and rash, which are typical of viral infections. Stomatitis (choice A) refers to inflammation of the mouth and lips, which can occur in HIV but is not specific to early infection. Wasting syndrome (choice C) and lipodystrophy (choice D) are more commonly associated with later stages of HIV infection rather than early manifestations.
2. A nurse is caring for a client with rheumatoid arthritis who has been taking prednisone. Which of the following findings should the nurse identify as an adverse effect of this medication?
- A. Weight loss
- B. Hypoglycemia
- C. Hypertension
- D. Hyperkalemia
Correct answer: C
Rationale: The correct answer is C, 'Hypertension.' Prednisone, a corticosteroid, can lead to hypertension as an adverse effect. Prednisone can cause sodium retention and potassium loss, leading to increased blood pressure. Weight loss (choice A) is not a common adverse effect of prednisone; in fact, weight gain is more common. Hypoglycemia (choice B) is not typically associated with prednisone use; instead, hyperglycemia is a common concern. Hyperkalemia (choice D) is also unlikely with prednisone use; instead, hypokalemia is a potential electrolyte imbalance.
3. What should the healthcare provider do first when a patient is admitted with chest pain and possible acute coronary syndrome?
- A. Administer sublingual nitroglycerin
- B. Get IV access
- C. Auscultate heart sounds
- D. Obtain cardiac enzymes
Correct answer: A
Rationale: Administering sublingual nitroglycerin is the priority intervention when a patient presents with chest pain and suspected acute coronary syndrome. Nitroglycerin helps dilate blood vessels, improve blood flow to the heart, and relieve chest pain. It is crucial to address the pain and potential ischemia promptly to prevent further cardiac tissue damage. Getting IV access, auscultating heart sounds, and obtaining cardiac enzymes are important assessments and interventions, but administering nitroglycerin takes precedence in managing acute coronary syndrome.
4. What is a typical symptom of a hemorrhagic stroke in a patient?
- A. Sudden, severe headache
- B. Gradual onset of numbness
- C. Loss of consciousness
- D. Loss of speech ability
Correct answer: A
Rationale: A sudden, severe headache is a common symptom of a hemorrhagic stroke due to brain bleeding. This headache is often described as the worst headache of one's life. Gradual onset of numbness (choice B) is more characteristic of an ischemic stroke, where a blood clot blocks an artery in the brain. Loss of consciousness (choice C) can occur in severe cases of stroke but is not specific to hemorrhagic strokes. Loss of speech ability (choice D) is more associated with ischemic strokes affecting language centers of the brain.
5. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following findings should the nurse identify as a possible complication of TPN administration?
- A. Pitting edema of bilateral lower extremities
- B. Hypoactive bowel sounds in all four quadrants
- C. Weight is the same as the day before
- D. Bilateral posterior lung sounds are diminished
Correct answer: A
Rationale: The correct answer is A: Pitting edema of bilateral lower extremities. Pitting edema can indicate fluid overload, which is a potential complication of TPN administration. Choice B, hypoactive bowel sounds, is more indicative of a gastrointestinal issue rather than a complication of TPN. Choice C, weight remaining the same, is expected to remain stable with proper TPN administration. Choice D, diminished lung sounds, is not directly related to TPN administration and is more suggestive of a respiratory issue.
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