ATI RN
ATI Capstone Adult Medical Surgical Assessment 2
1. What are the dietary recommendations for a patient with GERD?
- A. Avoid mint and spicy foods
- B. Eat large meals before bedtime
- C. Consume liquids with meals
- D. Avoid NSAIDs
Correct answer: A
Rationale: The correct answer is to avoid mint and spicy foods for a patient with GERD. These foods can increase gastric acid secretion and worsen symptoms of GERD. Choice B is incorrect because eating large meals before bedtime can exacerbate GERD symptoms due to increased gastric pressure when lying down. Choice C is also incorrect as consuming liquids with meals can lead to increased gastric distention, potentially triggering GERD symptoms. Choice D, avoiding NSAIDs, though important for some patients with GERD due to their potential to irritate the stomach lining, is not a general dietary recommendation for all GERD patients.
2. 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.
3. A client is being taught about fecal occult blood testing (FOBT) for colorectal cancer screening. Which of the following statements should the nurse include in the teaching?
- A. Your provider will use a stool sample obtained during a digital rectal examination to perform the test.
- B. Your provider will recommend a stimulant laxative before the test to empty the bowel.
- C. You should start annual fecal occult blood testing for colorectal cancer screening at the age of 40.
- D. You should avoid corticosteroids before the test.
Correct answer: D
Rationale: The correct answer is D because the nurse should advise the client to avoid corticosteroids, anti-inflammatory medications, and vitamin C before fecal occult blood testing to prevent false-positive results. Choice A is incorrect as stool samples for FOBT are usually collected using a kit at home. Choice B is incorrect because stimulant laxatives are not typically used before FOBT. Choice C is incorrect as guidelines recommend starting colorectal cancer screening at the age of 50, not 40.
4. What are the expected signs of increased intracranial pressure (IICP)?
- A. Restlessness, confusion, irritability
- B. Severe headache and confusion
- C. Elevated blood pressure and bradycardia
- D. Bradycardia and altered pupil response
Correct answer: A
Rationale: The correct answer is A: Restlessness, confusion, irritability. These are early signs of increased intracranial pressure (IICP) and require prompt intervention. Restlessness, confusion, and irritability are indicative of the brain's attempt to compensate for the rising pressure. Choice B is incorrect because severe headache alone is not specific to IICP and can be present in various conditions. Choice C is incorrect because elevated blood pressure is not a common sign of IICP; instead, hypertension may be present in the compensatory stage. Choice D is incorrect as bradycardia and altered pupil response are signs of advanced IICP, not early signs. Monitoring and recognizing these early signs are crucial for timely intervention and preventing further complications.
5. What are the dietary recommendations for a patient with pre-dialysis end-stage kidney disease?
- A. Reduce phosphorus intake to 700 mg/day
- B. Limit sodium intake to 1,500 mg/day
- C. Restrict protein intake to 0.55-0.60 g/kg/day
- D. Increase protein intake
Correct answer: A
Rationale: The correct recommendation for a patient with pre-dialysis end-stage kidney disease is to reduce phosphorus intake to 700 mg/day. High phosphorus levels can be harmful to individuals with kidney disease as the kidneys may not be able to filter it effectively. While limiting sodium intake to 1,500 mg/day and restricting protein intake to 0.55-0.60 g/kg/day are important in managing kidney disease, the primary concern for this patient population is to control phosphorus levels. Increasing protein intake is not recommended as it can put additional strain on the kidneys. Therefore, option A is the most appropriate recommendation in this scenario.
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