ATI RN
ATI Capstone Adult Medical Surgical Assessment 2
1. What ECG changes are seen with hyperkalemia?
- 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 ECG sign of hyperkalemia. Hyperkalemia affects the repolarization phase of the cardiac action potential, leading to changes such as peaked T waves, prolonged PR interval, widened QRS complex, and ultimately sine wave pattern. Elevated ST segments, prominent U waves, and widened QRS complex are not typically associated with hyperkalemia, making choices B, C, and D incorrect.
2. A nurse is planning care for a patient diagnosed with diabetes insipidus. What should be included in the care plan?
- A. Monitor serum albumin levels
- B. Restrict protein intake to 0.55-0.60 g/kg/day
- C. Encourage the patient to increase fluid intake
- D. Teach the patient to avoid alcohol
Correct answer: A
Rationale: The correct answer is to monitor serum albumin levels. In patients with diabetes insipidus, monitoring serum albumin levels is essential to assess for dehydration and nutritional deficits. Choices B, C, and D are not directly related to managing diabetes insipidus. Restricting protein intake, encouraging fluid intake, and teaching the patient to avoid alcohol are interventions that may be relevant for other medical conditions but are not specific to addressing the needs of a patient with diabetes insipidus.
3. What does continuous bubbling in the water seal chamber of a chest tube indicate?
- A. An air leak
- B. Normal chest tube function
- C. A blockage in the chest tube
- D. A malfunction in the drainage system
Correct answer: A
Rationale: Continuous bubbling in the water seal chamber of a chest tube indicates an air leak. This bubbling occurs when air leaks from the patient's pleural space into the chest tube system. It is essential to address this issue promptly to prevent complications like a pneumothorax. Choices B, C, and D are incorrect because continuous bubbling in the water seal chamber is not indicative of normal chest tube function, a blockage in the chest tube, or a malfunction in the drainage system.
4. A patient is receiving discharge instructions for GERD. Which of the following statements by the patient demonstrates an understanding of the teaching?
- A. I should take my medication with orange juice.
- B. Having a bedtime snack will prevent heartburn.
- C. I will lie down after meals.
- D. I will limit activities that require bending at the waist.
Correct answer: D
Rationale: The correct answer is D. Patients with GERD should avoid activities that increase intra-abdominal pressure, such as bending at the waist, as this can lead to reflux. Choice A is incorrect because medications for GERD are usually taken with water, not citrus juices. Choice B is incorrect as having a bedtime snack can worsen GERD symptoms. Choice C is incorrect because lying down after meals can also exacerbate reflux due to the effects of gravity.
5. What is an escharotomy and why is it performed?
- A. A surgical incision made to improve circulation in burn injuries
- B. A procedure to remove dead tissue from a wound
- C. A procedure to remove excess fluid from the lungs
- D. A procedure to relieve pain from burns
Correct answer: A
Rationale: An escharotomy is a surgical procedure involving an incision through the eschar (dead tissue) to relieve pressure in burn injuries. It is performed to improve circulation to the affected area, prevent further damage, and restore blood flow. Choice B is incorrect because an escharotomy is not primarily focused on removing dead tissue but rather on relieving pressure. Choice C is incorrect as it describes a procedure related to pulmonary issues, not burn injuries. Choice D is incorrect because while pain relief may be a result of an escharotomy, it is not the primary purpose of the procedure.
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