ATI RN
ATI Capstone Adult Medical Surgical Assessment 2
1. What dietary recommendations should be given to a patient with GERD?
- A. Avoid mint and spicy foods
- B. Eat large meals before bed
- C. Increase fluid intake during meals
- D. Drink milk as a snack
Correct answer: A
Rationale: The correct dietary recommendation for a patient with GERD is to avoid mint and spicy foods. These foods can trigger symptoms of GERD and lead to acid reflux. Choice B is incorrect because eating large meals before bed can exacerbate GERD symptoms by increasing the likelihood of acid reflux during sleep. Choice C is incorrect as increasing fluid intake during meals can worsen GERD symptoms by distending the stomach, leading to increased pressure on the lower esophageal sphincter. Choice D is also incorrect because while milk may provide temporary relief for some individuals, it is not a recommended long-term solution for managing GERD.
2. When caring for a patient with a burn injury, what is the priority intervention?
- A. Monitor the burn area for infection
- B. Administer IV fluids
- C. Debride the burn area
- D. Apply a dry dressing
Correct answer: A
Rationale: The priority intervention when caring for a patient with a burn injury is to monitor the burn area for infection. This is crucial to prevent further complications such as sepsis. While administering IV fluids is important for fluid resuscitation, it is not the top priority compared to preventing infection. Debriding the burn area and applying a dry dressing are necessary interventions for wound care, but ensuring there is no infection takes precedence to avoid sepsis and other serious complications.
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 lab value is a priority in monitoring a patient with HIV?
- A. CD4 T-cell count below 180 cells/mm3
- B. Hemoglobin levels
- C. Serum albumin levels
- D. White blood cell count
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 reflects the status of the immune system. A CD4 T-cell count below 180 cells/mm3 indicates severe immunocompromise and an increased risk of opportunistic infections. This value guides the initiation of prophylaxis for infections and the timing of antiretroviral therapy initiation. Choices B, C, and D are not the priority lab values in monitoring patients with HIV. Hemoglobin levels primarily assess for anemia, serum albumin levels reflect nutritional status, and white blood cell count is more generalized and may not specifically indicate the severity of immunocompromise in HIV patients.
5. 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.
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