ATI RN
ATI Capstone Adult Medical Surgical Assessment 2
1. A patient with GERD is being taught by a nurse. What should the patient avoid?
- A. Avoid mint and pepper
- B. Increase water intake during meals
- C. Eat frequent small meals
- D. Consume more spicy foods
Correct answer: A
Rationale: Patients with GERD should avoid mint and spicy foods as they can trigger reflux. Choice B ('Increase water intake during meals') is not recommended for GERD patients as it can worsen symptoms by distending the stomach. Choice C ('Eat frequent small meals') is beneficial for GERD patients to prevent excessive stomach distension. Choice D ('Consume more spicy foods') is incorrect as spicy foods can exacerbate GERD symptoms.
2. What is the first medication to give to a patient with 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-line treatment for wheezing caused by an allergic reaction because it is a fast-acting bronchodilator that helps to quickly open the airways, providing immediate relief of symptoms. Choice B, Methylprednisolone 100 mg IV, is a corticosteroid used for its anti-inflammatory effects but is not the initial medication for acute wheezing in an allergic reaction. Choice C, Cromolyn 20 mg via nebulizer, is a mast cell stabilizer that can be used for prevention but is not the first choice for acute symptom relief. Choice D, Aminophylline 500 mg IV, is a bronchodilator with a narrow therapeutic window and more side effects compared to Albuterol, making it a less preferred option as the initial treatment.
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 is the primary concern for a patient with a CD4 T-cell count below 180 cells/mm³?
- A. Increased risk of severe infection
- B. Increased risk of anemia
- C. Increased risk of bleeding
- D. Increased risk of dehydration
Correct answer: A
Rationale: A CD4 T-cell count below 180 cells/mm³ indicates a severely immunocompromised state, leading to an increased risk of severe infection. In individuals with low CD4 counts, the immune system is significantly weakened, making them more susceptible to opportunistic infections. Anemia (choice B), bleeding (choice C), and dehydration (choice D) are not the primary concerns associated with a low CD4 T-cell count. While these conditions may occur as secondary effects or complications, the primary focus is on preventing and managing severe infections in patients with severely compromised immune systems.
5. What are the expected signs in a patient with compartment syndrome?
- A. Unrelieved pain, pallor, and pulselessness
- B. Fever and infection
- C. Localized redness and swelling
- D. Loss of sensation in the affected area
Correct answer: A
Rationale: In a patient with compartment syndrome, the classic signs include unrelieved pain, pallor, and pulselessness. These signs indicate compromised circulation and neurovascular function in the affected compartment. Fever and infection (Choice B) are not typical signs of compartment syndrome. Localized redness and swelling (Choice C) can be seen in other conditions like cellulitis but are not specific to compartment syndrome. Loss of sensation in the affected area (Choice D) may occur in some cases but is not as specific or consistent as unrelieved pain, pallor, and pulselessness in diagnosing compartment syndrome.
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