ATI RN
ATI Capstone Adult Medical Surgical Assessment 2
1. What are the early signs of hypokalemia on an ECG?
- A. Flattened T waves
- B. Elevated ST segments
- C. Prominent U waves
- D. Widened QRS complex
Correct answer: A
Rationale: Flattened T waves are an early sign of hypokalemia on an ECG. In hypokalemia, the T waves may flatten and eventually invert. Elevated ST segments are not typically associated with hypokalemia. Prominent U waves are seen in conditions like hypokalemia, but they are not considered an early sign. A widened QRS complex is more commonly associated with hyperkalemia rather than hypokalemia.
2. A healthcare provider writes a medication order that seems excessively high for the patient's condition. What is the nurse's first step?
- A. Administer the medication immediately.
- B. Hold the medication and consult the provider.
- C. Reduce the dose without consulting the provider.
- D. Administer the medication after double-checking with another nurse.
Correct answer: B
Rationale: The correct first step for the nurse when encountering a medication order that appears excessively high for the patient's condition is to hold the medication and consult the provider. Administering the medication immediately (Choice A) without clarification could pose a risk to the patient's safety. Reducing the dose without consulting the provider (Choice C) is not recommended as it may lead to suboptimal treatment. Administering the medication after double-checking with another nurse (Choice D) is not sufficient; consulting the provider directly is crucial to ensure the accuracy and safety of the medication order.
3. A toddler is being admitted to the hospital after an Acetaminophen overdose. Which of the following medications should the nurse anticipate administering to this patient?
- A. Acetylcysteine
- B. Pegfilgrastim
- C. Misoprostol
- D. Naltrexone
Correct answer: A
Rationale: In cases of Acetaminophen overdose, acetylcysteine is the antidote of choice. Acetylcysteine helps prevent liver damage by replenishing depleted glutathione levels, which is essential for detoxifying acetaminophen metabolites. Pegfilgrastim is a medication used to stimulate white blood cell production, Misoprostol is a medication for preventing stomach ulcers, and Naltrexone is used for treating opioid addiction and alcoholism, but none of these are indicated for Acetaminophen overdose.
4. Which part of your brain is active when you get cues about being hungry, thirsty, or sleepy?
- A. Hippocampus
- B. Thalamus
- C. Hypothalamus
- D. Amygdala
Correct answer: C
Rationale: The correct answer is the Hypothalamus (Choice C). The hypothalamus plays a crucial role in regulating basic bodily functions such as hunger, thirst, and sleep. It receives cues related to these needs and helps to maintain homeostasis in the body. The Hippocampus (Choice A) is primarily involved in memory formation and spatial navigation, not in regulating physiological needs. The Thalamus (Choice B) acts as a relay station for sensory information but is not the main center for hunger, thirst, or sleep regulation. The Amygdala (Choice D) is more associated with emotions, particularly fear and pleasure, rather than physiological needs like hunger, thirst, or sleep.
5. When developing a care plan for a client with generalized anxiety disorder (GAD), which of the following interventions should not be included?
- A. Encourage the client to avoid anxiety-provoking situations.
- B. Teach the client relaxation techniques.
- C. Encourage the client to express their feelings.
- D. Provide a structured daily routine.
Correct answer: A
Rationale: Avoiding anxiety-provoking situations is not a recommended intervention in caring for a client with generalized anxiety disorder (GAD) as it can reinforce the client's anxiety. Exposing the client gradually to feared situations can help reduce anxiety in the long term through techniques like cognitive-behavioral therapy. Teaching relaxation techniques helps the client manage stress and anxiety effectively. Encouraging the client to express their feelings promotes emotional processing and reduces internal tension. Providing a structured daily routine can offer predictability and stability, which are beneficial for individuals with GAD.
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