ATI RN
ATI Capstone Adult Medical Surgical Assessment 2
1. What lab value should be prioritized for monitoring in 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 CD4 T-cell count is crucial in patients with HIV as it reflects the status of their immune system. A CD4 count below 200 cells/mm3 is indicative of severe immunocompromise, necessitating close monitoring and potential intervention. Choices B, C, and D are less specific to HIV management and do not directly reflect the immune status in these patients. Hemoglobin levels are more relevant for assessing anemia, serum albumin levels for nutritional status, and white blood cell count for overall immune response, but none are as directly tied to HIV disease progression as the CD4 T-cell count.
2. 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.
3. What is the priority action for a patient with chest pain from acute coronary syndrome?
- A. Administer sublingual nitroglycerin
- B. Check the patient's cardiac enzymes
- C. Administer aspirin
- D. Obtain IV access
Correct answer: A
Rationale: The correct answer is to administer sublingual nitroglycerin. This medication helps dilate the blood vessels, reducing the workload of the heart and improving blood flow to the heart muscle, which is crucial in the management of acute coronary syndrome. Checking cardiac enzymes (choice B) is important for diagnosing a heart attack but is not the priority over providing immediate relief to the patient's chest pain. Administering aspirin (choice C) is also important in acute coronary syndrome to prevent further clot formation, but it is not the priority action for immediate pain relief. Obtaining IV access (choice D) is necessary for administering medications or fluids; however, in this scenario, providing sublingual nitroglycerin for prompt pain relief takes precedence.
4. What is the priority action when a healthcare professional misreads a glucose reading and administers excess insulin?
- A. Administer IV glucose
- B. Monitor for hyperglycemia
- C. Monitor for hypoglycemia
- D. Document the incident
Correct answer: C
Rationale: The priority action when a healthcare professional misreads a glucose reading and administers excess insulin is to monitor for hypoglycemia. Excess insulin can lead to dangerously low blood sugar levels (hypoglycemia), which can result in serious complications. Monitoring for hypoglycemia allows for timely identification and intervention to prevent harm. Administering IV glucose may be necessary if hypoglycemia occurs. Monitoring for hyperglycemia is not the priority in this situation, as excess insulin would lower blood sugar levels. Documenting the incident is important for reporting and quality improvement purposes but should not take precedence over ensuring patient safety by monitoring for hypoglycemia.
5. What should be monitored in a patient receiving insulin who is at risk for hypoglycemia?
- A. Monitor blood glucose levels
- B. Monitor for respiratory distress
- C. Monitor for hypertension
- D. Monitor for hyperkalemia
Correct answer: A
Rationale: Corrected Question: In a patient receiving insulin who is at risk for hypoglycemia, monitoring blood glucose levels is crucial. This helps in preventing and identifying hypoglycemia promptly. Choice B, monitoring for respiratory distress, is not directly related to hypoglycemia caused by insulin. Choice C, monitoring for hypertension, is not typically associated with hypoglycemia. Choice D, monitoring for hyperkalemia, is not a common concern in patients receiving insulin who are at risk for hypoglycemia.
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