ATI RN
ATI Capstone Adult Medical Surgical Assessment 2
1. What is the preferred electrical intervention for a patient with ventricular tachycardia and a pulse?
- A. Synchronized cardioversion
- B. Defibrillation
- C. Medication administration
- D. Pacing
Correct answer: A
Rationale: In a patient with ventricular tachycardia and a pulse, synchronized cardioversion is the preferred electrical intervention. Synchronized cardioversion is used to treat unstable tachyarrhythmias like ventricular tachycardia with a pulse. Choice B, defibrillation, is used for pulseless ventricular tachycardia or ventricular fibrillation. Choice C, medication administration, may not provide immediate correction for unstable ventricular tachycardia. Choice D, pacing, is not the first-line treatment for ventricular tachycardia with a pulse.
2. A nurse is caring for a client who has increased intracranial pressure (ICP). Which of the following interventions should the nurse implement?
- A. Place several pillows behind the client's head
- B. Place the client in a Sim's position
- C. Keep the client's neck in a midline position
- D. Maintain flexion of the client's hips at a 90° angle
Correct answer: C
Rationale: Keeping the client's neck in a midline position is crucial for managing increased intracranial pressure. This position helps optimize blood flow and minimizes the risk of further increasing ICP. Placing several pillows behind the client's head (Choice A) may inadvertently elevate the head, potentially worsening ICP. Placing the client in a Sim's position (Choice B) or maintaining flexion of the client's hips at a 90° angle (Choice D) are not directly related to managing increased ICP.
3. What are the manifestations of increased intracranial pressure (IICP)?
- A. Restlessness, confusion, irritability
- B. Severe nausea and vomiting
- C. Elevated blood pressure and bradycardia
- D. Decreased heart rate and altered pupil response
Correct answer: A
Rationale: The correct manifestations of increased intracranial pressure (IICP) include restlessness, confusion, and irritability. These symptoms are a result of the brain being under pressure inside the skull. Severe nausea and vomiting (Choice B) are more commonly associated with increased intracranial pressure in children. Elevated blood pressure and bradycardia (Choice C) are not typical manifestations of increased intracranial pressure; instead, hypertension and bradycardia may be seen in Cushing's reflex, which is a late sign of increased IICP. Decreased heart rate and altered pupil response (Choice D) are also not primary manifestations of increased intracranial pressure, although altered pupil response, like a non-reactive or dilated pupil, can be seen in some cases.
4. What is the preferred electrical intervention for a patient with ventricular tachycardia with a pulse?
- A. Defibrillation
- B. Synchronized cardioversion
- C. Pacing
- D. Medication administration
Correct answer: B
Rationale: Synchronized cardioversion is the preferred electrical intervention for ventricular tachycardia with a pulse. In this scenario, the heart still has an organized rhythm, so synchronized cardioversion is used to deliver a shock at a specific point in the cardiac cycle, aiming to restore a normal rhythm. Defibrillation (Choice A) is used for pulseless ventricular tachycardia or ventricular fibrillation. Pacing (Choice C) may be used for bradycardias or certain types of heart blocks. Medication administration (Choice D) can be considered for stable ventricular tachycardia, but synchronized cardioversion is the primary intervention for ventricular tachycardia with a pulse.
5. What is the expected ECG finding in a patient with hypokalemia?
- A. Flattened T waves
- B. Elevated ST segments
- C. Widened QRS complexes
- D. Widened QRS complexes on the ECG
Correct answer: A
Rationale: The correct answer is A: Flattened T waves. In hypokalemia, there is a decrease in serum potassium levels, which can lead to various ECG changes. One of the classic ECG findings associated with hypokalemia is the presence of flattened T waves. These T wave abnormalities are typically seen in multiple leads. Choice B, elevated ST segments, is not a typical ECG finding in hypokalemia. Choice C, widened QRS complexes, is more commonly associated with hyperkalemia rather than hypokalemia. Choice D is redundant and not a standard way of describing ECG findings.
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