ATI RN
ATI Capstone Adult Medical Surgical Assessment 1
1. A patient with chronic kidney disease may require dietary restrictions. Which of the following diets should the healthcare provider prescribe?
- A. Low sodium diet
- B. Potassium restricted diet
- C. High phosphorus diet
- D. High protein diet
Correct answer: B
Rationale: Patients with chronic kidney disease often require a potassium-restricted diet to help manage their electrolyte levels. Excessive potassium intake can be harmful to individuals with compromised kidney function. While monitoring sodium intake is also important for these patients, a low sodium diet is not specifically indicated in the question. High phosphorus diet and high protein diet are not recommended for individuals with chronic kidney disease as they can further stress the kidneys and worsen the condition.
2. What should the nurse monitor for in a patient with hypokalemia?
- A. Monitor for muscle weakness
- B. Check deep tendon reflexes (DTRs)
- C. Monitor for seizures
- D. Monitor for bradycardia
Correct answer: A
Rationale: The correct answer is to monitor for muscle weakness in a patient with hypokalemia. Hypokalemia, which is low potassium levels, can lead to muscle weakness due to its effects on neuromuscular function. Checking deep tendon reflexes (Choice B) is not typically associated with hypokalemia. Seizures (Choice C) are more commonly associated with low calcium levels rather than low potassium levels. Bradycardia (Choice D) is a symptom of hyperkalemia (high potassium levels) rather than hypokalemia.
3. What is the priority intervention when a patient experiences abdominal cramping during enema administration?
- A. Lower the height of the enema solution container
- B. Stop the procedure and remove the tubing
- C. Continue the enema at a slower rate
- D. Increase the flow of the enema solution
Correct answer: A
Rationale: The correct answer is to lower the height of the enema solution container. This action can help relieve abdominal cramping by slowing the flow of the enema, reducing discomfort for the patient. Choice B, stopping the procedure and removing the tubing, is not the priority as adjusting the height of the container can often resolve the issue without needing to stop the procedure completely. Choice C, continuing the enema at a slower rate, may not address the immediate discomfort experienced by the patient. Choice D, increasing the flow of the enema solution, can exacerbate the cramping and should be avoided.
4. A nurse is caring for a client who has a new diagnosis of tuberculosis. Which of the following precautions should the nurse initiate to prevent transmission of the disease?
- A. Contact precautions
- B. Airborne precautions
- C. Droplet precautions
- D. Protective environment
Correct answer: B
Rationale: Tuberculosis is spread through small droplets measuring less than 5 microns, which can remain airborne for extended periods. The nurse should place a client who has TB under airborne precautions to prevent the spread of microbes. Choice A, contact precautions, are used for diseases spread by direct or indirect contact. Choice C, droplet precautions, are for diseases spread by larger droplets. Choice D, protective environment, is used for immunocompromised clients to protect them from environmental pathogens.
5. Which lab value is a priority for a patient with HIV?
- A. CD4 T-cell count 180 cells/mm3
- B. Albumin levels below 3.5 g/dL
- C. Potassium levels below 3.5 mEq/L
- D. White blood cell count below 5000/mm3
Correct answer: A
Rationale: A CD4 T-cell count of less than 180 cells/mm3 is a priority for a patient with HIV because it indicates severe immunocompromise and an increased risk for opportunistic infections. Monitoring CD4 levels helps in assessing the immune status and guiding treatment decisions in patients with HIV. Albumin levels (choice B) are important for assessing nutritional status but are not a direct indicator of immune function in HIV patients. Potassium levels (choice C) and white blood cell count (choice D) are also important, but the CD4 T-cell count is specifically crucial for evaluating the immune function in individuals with HIV.
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