ATI RN
ATI Capstone Adult Medical Surgical Assessment 1
1. A nurse is teaching a client who has type 1 DM about hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching?
- A. Exercise reduces the risk for hypoglycemia.
- B. I can skip my insulin when I don't eat.
- C. I can drink 4 oz of soda if my blood sugar is low.
- D. Diabetic pills don't cause hypoglycemia; only insulin does.
Correct answer: C
Rationale: The client can correct any development of hypoglycemia with a quick intake of glucose. The client should have 15 g carbohydrates on hand to treat hypoglycemic episodes, like 4 oz of regular soda.
2. 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.
3. A patient is receiving discharge instructions for GERD. Which of the following statements by the patient demonstrates an understanding of the teaching?
- A. I should take my medication with orange juice.
- B. Having a bedtime snack will prevent heartburn.
- C. I will lie down after meals.
- D. I will limit activities that require bending at the waist.
Correct answer: D
Rationale: The correct answer is D. Patients with GERD should avoid activities that increase intra-abdominal pressure, such as bending at the waist, as this can lead to reflux. Choice A is incorrect because medications for GERD are usually taken with water, not citrus juices. Choice B is incorrect as having a bedtime snack can worsen GERD symptoms. Choice C is incorrect because lying down after meals can also exacerbate reflux due to the effects of gravity.
4. What is the first intervention for a patient admitted with unstable angina?
- A. Administer nitroglycerin
- B. Obtain cardiac enzymes
- C. Start IV fluids
- D. Monitor for chest pain
Correct answer: A
Rationale: The correct first intervention for a patient admitted with unstable angina is to administer nitroglycerin. Nitroglycerin helps to relieve chest pain by dilating blood vessels and increasing blood flow to the heart, thereby reducing cardiac workload. This intervention aims to alleviate symptoms and prevent further cardiac damage. Obtaining cardiac enzymes (Choice B) is important for diagnosing a myocardial infarction but is not the initial intervention for unstable angina. Starting IV fluids (Choice C) may be indicated in specific cases like hypovolemia but is not the primary intervention for unstable angina. Monitoring for chest pain (Choice D) is essential but taking action to alleviate the pain, like administering nitroglycerin, is the primary focus in the initial management of unstable angina.
5. What precaution should be advised to patients following cataract surgery?
- A. Wear dark glasses while outdoors
- B. Use warm compresses
- C. Avoid NSAIDs
- D. Avoid bright lights
Correct answer: A
Rationale: Patients who have undergone cataract surgery should wear dark glasses when outdoors to shield their eyes from light exposure, which can be uncomfortable or harmful during the recovery period. Using warm compresses (choice B) is not typically recommended after cataract surgery as it's more relevant for certain eye conditions. Avoiding NSAIDs (choice C) is advised to prevent bleeding complications, but it is not directly related to eye protection post-surgery. While avoiding bright lights (choice D) is crucial, wearing dark glasses provides a practical solution to achieve this, making choice A the most appropriate precaution.
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