ATI RN
ATI Capstone Adult Medical Surgical Assessment 2
1. A patient with a new diagnosis of diabetes insipidus is planning care. What should be included in the plan of care?
- A. Avoid alcohol
- B. Increase exercise to reduce stress
- C. Increase fluid intake
- D. Restrict sodium intake
Correct answer: A
Rationale: The correct answer is to avoid alcohol. In diabetes insipidus, excessive urination leads to fluid loss, so it is essential to avoid alcohol which can exacerbate dehydration. Choice B is incorrect as increasing exercise may not directly impact diabetes insipidus. Choice C is also incorrect because although increasing fluid intake may seem intuitive, it is not the primary concern in managing diabetes insipidus. Choice D is not directly related to managing diabetes insipidus; sodium restriction is more relevant in conditions like hypertension or heart failure.
2. What are the expected findings in a patient experiencing hypokalemia?
- A. Flattened T waves on an ECG
- B. Elevated ST segments
- C. Prominent U waves
- D. Bradycardia
Correct answer: A
Rationale: The correct answer is A: Flattened T waves on an ECG. Hypokalemia is characterized by flattened T waves on an ECG, which is an early indicator of low potassium levels. Elevated ST segments (Choice B) are associated with conditions like myocardial infarction, not hypokalemia. Prominent U waves (Choice C) are typically seen in hypokalemia, but flattened T waves are more specific. Bradycardia (Choice D) can be a manifestation of severe hypokalemia but is not as specific as flattened T waves on an ECG.
3. What are the priority lab values to monitor in a patient with HIV?
- A. CD4 T-cell count below 180 cells/mm3
- B. White blood cell count
- C. Hemoglobin levels
- D. Serum albumin levels
Correct answer: A
Rationale: The correct answer is A: CD4 T-cell count below 180 cells/mm3. Monitoring the CD4 T-cell count is crucial in patients with HIV as it indicates the level of immunocompromise. A CD4 count below 180 cells/mm3 is considered severe immunocompromise and requires close monitoring and intervention. Choices B, C, and D are not the priority lab values to monitor in HIV patients. While white blood cell count, hemoglobin levels, and serum albumin levels can provide valuable information about the patient's health status, they are not as specific or indicative of HIV disease progression and management as the CD4 T-cell count.
4. What dietary recommendation should be given to a patient with GERD?
- A. Avoid mint and spicy foods
- B. Eat large meals before bedtime
- C. Consume liquids with meals
- D. Eat three large meals per day
Correct answer: A
Rationale: The correct recommendation for a patient with GERD is to avoid mint and spicy foods. Mint and spicy foods can aggravate GERD symptoms by relaxing the lower esophageal sphincter and increasing stomach acid production, leading to acid reflux. Choices B, C, and D are incorrect. Eating large meals before bedtime can worsen GERD symptoms as lying down can promote acid reflux. Consuming liquids with meals can also exacerbate GERD by increasing stomach distension and pressure on the lower esophageal sphincter. Eating three large meals per day can overload the stomach and trigger acid reflux episodes in patients with GERD.
5. What is the first medication to administer to a patient experiencing wheezing due to an allergic reaction?
- A. Albuterol via nebulizer
- B. Methylprednisolone 100 mg IV
- C. Cromolyn 20 mg via nebulizer
- D. Aminophylline 500 mg IV
Correct answer: A
Rationale: The correct answer is A, Albuterol via nebulizer. Albuterol is the first-choice medication for wheezing due to its fast-acting bronchodilatory effect, which helps in relieving the symptoms quickly. Choice B, Methylprednisolone 100 mg IV, is a corticosteroid used for its anti-inflammatory effects and would be beneficial in reducing inflammation in allergic reactions but is not the first-line treatment for wheezing. Choice C, Cromolyn 20 mg via nebulizer, is a mast cell stabilizer used to prevent asthma attacks but is not the immediate treatment for wheezing during an allergic reaction. Choice D, Aminophylline 500 mg IV, is a bronchodilator but is not typically the initial medication of choice for wheezing in an allergic reaction.
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