what are the expected changes on an ecg for a patient with hypokalemia

ATI RN

ATI Capstone Adult Medical Surgical Assessment 2

1. What are the expected changes on an ECG for a patient with hypokalemia?

A. Flattened T waves
B. Prominent U waves
C. ST elevation
D. Wide QRS complexes

Correct answer: A

Rationale: Flattened T waves are an early sign of hypokalemia on an ECG. Hypokalemia primarily manifests as flattened T waves on an ECG. While prominent U waves can be seen in hypokalemia, they are not as specific as flattened T waves. ST elevation is more commonly associated with conditions like myocardial infarction rather than hypokalemia. Wide QRS complexes are typically not a feature of hypokalemia on an ECG.

2. A nurse is providing discharge teaching for a client who has COPD about nutrition. Which of the following instructions should the nurse include?

A. Eat three large meals daily
B. Consume high-calorie foods
C. Limit caffeinated drinks to two per day
D. Drink fluids during meal time

Correct answer: B

Rationale: The correct answer is B: 'Consume high-calorie foods.' Clients with COPD often have increased energy needs due to the work of breathing. Consuming high-calorie, high-protein foods can help provide the necessary energy and prevent weight loss. Choice A is incorrect because eating three large meals daily may lead to increased shortness of breath due to a full stomach putting pressure on the diaphragm. Choice C is incorrect because caffeinated drinks can contribute to dehydration, which is not ideal for clients with COPD. Choice D is incorrect because drinking fluids during mealtime can cause bloating and early satiety, making it difficult for clients to consume enough calories.

3. A nurse is caring for a client who has a peripherally inserted central catheter (PICC). For which of the following findings should the nurse notify the provider?

A. The dressing was changed 7 days ago
B. The circumference of the client's upper arm has increased by 10%
C. The catheter has not been used in 8 hours
D. The catheter has been flushed with 10 mL of sterile saline after medication use

Correct answer: B

Rationale: An increase in the circumference of the client's upper arm by 10% could indicate deep vein thrombosis, which is a serious condition. Deep vein thrombosis can impede blood flow and potentially lead to life-threatening complications. Therefore, the nurse should notify the provider immediately about this finding. Choice A is not an immediate concern as PICC dressing changes are usually done every 7 days. Choice C is a normal finding as catheters may not be used for certain periods. Choice D is a correct procedure for maintaining catheter patency after medication use.

4. What are the signs of compartment syndrome?

A. Unrelieved pain, pallor, pulselessness
B. Muscle weakness, hyporeflexia
C. Pins-and-needles sensation, swelling
D. Severe swelling and tightness in the affected extremity

Correct answer: A

Rationale: The correct signs of compartment syndrome include unrelieved pain, pallor, and pulselessness due to increased pressure within a muscle compartment. Choice B, muscle weakness, and hyporeflexia are not typical signs of compartment syndrome. Choice C, pins-and-needles sensation and swelling, are not specific signs of compartment syndrome. Choice D, severe swelling and tightness in the affected extremity, could be seen in compartment syndrome but are not the primary signs.

5. A patient with a new diagnosis of diabetes insipidus is planning care. What should be included in the plan of care?

A. Avoid alcohol
B. Increase exercise to reduce stress
C. Increase fluid intake
D. Restrict sodium intake

Correct answer: A

Rationale: The correct answer is to avoid alcohol. In diabetes insipidus, excessive urination leads to fluid loss, so it is essential to avoid alcohol which can exacerbate dehydration. Choice B is incorrect as increasing exercise may not directly impact diabetes insipidus. Choice C is also incorrect because although increasing fluid intake may seem intuitive, it is not the primary concern in managing diabetes insipidus. Choice D is not directly related to managing diabetes insipidus; sodium restriction is more relevant in conditions like hypertension or heart failure.