ATI RN
ATI Capstone Adult Medical Surgical Assessment 2
1. 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.
2. What is the priority lab value for monitoring a patient with HIV?
- A. CD4 T-cell count below 180 cells/mm3
- B. Serum albumin levels
- C. White blood cell count
- D. Hemoglobin 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 serves as a key indicator of immune function. A count below 180 cells/mm3 indicates severe immunocompromise and an increased risk of opportunistic infections. Choice B, serum albumin levels, though important for assessing nutritional status, is not the priority lab value for HIV monitoring. Choice C, white blood cell count, is a nonspecific measure of immune function and may not accurately reflect the status of the immune system in HIV patients. Choice D, hemoglobin levels, are essential for evaluating anemia but are not the primary lab value for monitoring HIV.
3. 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.
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 is the expected finding in a patient with compartment syndrome?
- A. Unrelieved pain, pallor, and pulselessness
- B. Localized swelling and redness
- C. Numbness and tingling
- D. Fever and infection
Correct answer: A
Rationale: In a patient with compartment syndrome, the expected finding includes unrelieved pain, pallor, and pulselessness. These are classic signs of compartment syndrome and indicate compromised blood flow and tissue perfusion, necessitating urgent intervention. Choices B, C, and D are incorrect because localized swelling and redness, numbness and tingling, as well as fever and infection, are not typical findings associated with compartment syndrome.
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