ATI RN
ATI Capstone Adult Medical Surgical Assessment 2
1. What medication should be given first to a patient experiencing wheezing and coughing due to an allergic reaction?
- A. Albuterol 3 ml via nebulizer
- B. Cromolyn via nebulizer
- C. Aminophylline IV
- D. Methylprednisolone 100 mg IV
Correct answer: A
Rationale: The correct answer is Albuterol 3 ml via nebulizer. Albuterol is a bronchodilator that helps relieve wheezing and coughing by opening up the airways, making it the first-line treatment for allergic reactions presenting with these symptoms. Cromolyn and aminophylline are not typically used as first-line treatments for acute allergic reactions with wheezing and coughing. Methylprednisolone, a corticosteroid, may be beneficial for inflammation in the setting of an allergic reaction but is not the initial medication of choice to address wheezing and coughing.
2. What are the expected ECG changes in hypokalemia?
- A. Flattened T waves
- B. ST elevation
- C. Wide QRS complex
- D. Tall T waves
Correct answer: A
Rationale: Flattened T waves are the most common ECG change seen in patients with hypokalemia. Hypokalemia leads to a decrease in serum potassium levels, affecting the repolarization phase of the cardiac action potential. This results in T wave flattening or inversion. ST elevation is typically seen in conditions like myocardial infarction, not in hypokalemia. Wide QRS complex is more associated with hyperkalemia than hypokalemia. Tall T waves are often seen in hyperkalemia, not hypokalemia.
3. What are the expected signs in a patient with compartment syndrome?
- A. Unrelieved pain, pallor, and pulselessness
- B. Fever and infection
- C. Localized redness and swelling
- D. Loss of sensation in the affected area
Correct answer: A
Rationale: In a patient with compartment syndrome, the classic signs include unrelieved pain, pallor, and pulselessness. These signs indicate compromised circulation and neurovascular function in the affected compartment. Fever and infection (Choice B) are not typical signs of compartment syndrome. Localized redness and swelling (Choice C) can be seen in other conditions like cellulitis but are not specific to compartment syndrome. Loss of sensation in the affected area (Choice D) may occur in some cases but is not as specific or consistent as unrelieved pain, pallor, and pulselessness in diagnosing compartment syndrome.
4. What intervention should be done if continuous bubbling is seen in the chest tube water seal chamber?
- A. Tighten the connections of the chest tube system
- B. Replace the chest tube system
- C. Clamp the chest tube
- D. Continue monitoring the chest tube
Correct answer: A
Rationale: When continuous bubbling is observed in the chest tube water seal chamber, the appropriate intervention is to tighten the connections of the chest tube system. This step helps address an air leak in the system, which could compromise its effectiveness. Choice B (Replace the chest tube system) is not the initial step and may be unnecessary if the issue can be resolved by tightening connections. Choice C (Clamp the chest tube) is incorrect as clamping the chest tube could lead to a dangerous increase in pressure within the system. Choice D (Continue monitoring the chest tube) is also not the best immediate action to take when continuous bubbling is present, as prompt intervention is needed to prevent complications.
5. 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.
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