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ATI Capstone Medical Surgical Assessment 2 Quizlet

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.

What symptoms are expected in a patient with compartment syndrome?

  • A. Unrelieved pain, pallor, and pulselessness
  • B. Localized swelling and numbness
  • C. Fever and infection
  • D. Weakness and fatigue

Correct Answer: A
Rationale: In a patient with compartment syndrome, the key symptoms include unrelieved pain, pallor, and pulselessness. These symptoms indicate reduced circulation in the affected compartment. Choice B is incorrect as localized swelling and numbness are not typically associated with compartment syndrome. Choice C is incorrect as fever and infection are not primary symptoms of compartment syndrome. Choice D is incorrect as weakness and fatigue are not typically seen in compartment syndrome.

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.

What intervention is needed for continuous bubbling in the chest tube water seal chamber?

  • A. Tighten the connections of the chest tube system
  • B. Clamp the chest tube
  • C. Replace the chest tube system
  • D. Continue monitoring the chest tube

Correct Answer: A
Rationale: The correct intervention for continuous bubbling in the chest tube water seal chamber is to tighten the connections of the chest tube system. Continuous bubbling indicates an air leak in the system, and tightening the connections can help resolve this issue. Clamping the chest tube (Choice B) is not appropriate and can lead to complications by obstructing the drainage system. Similarly, replacing the entire chest tube system (Choice C) may not be necessary if the issue can be resolved by tightening the connections. Continuing to monitor the chest tube (Choice D) without taking action to address the continuous bubbling may delay necessary interventions to prevent complications.

A nurse is teaching a client who has hypertension about dietary modifications to help control blood pressure. Which of the following food choices should the nurse recommend as the best choice for the client to include in their diet?

  • A. 1 packet of reconstituted dry onion soup
  • B. 3 oz of lean cured ham
  • C. 3 oz of chicken breast
  • D. ½ cup of canned baked beans

Correct Answer: C
Rationale: For a client with hypertension, a low sodium diet is recommended to help control blood pressure. Among the food choices provided, the best option is 3 oz of chicken breast. Chicken breast is lean protein with lower sodium content compared to other choices. It is a healthier option for managing hypertension. Reconstituted dry onion soup (Choice A) and canned baked beans (Choice D) typically contain higher amounts of sodium, which can be detrimental for blood pressure management. Lean cured ham (Choice B) also tends to have a higher sodium content, making it less suitable for a client with hypertension.

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