what dietary recommendations should be given to a patient with pre dialysis end stage kidney disease
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Nursing Elites

ATI RN

ATI Capstone Adult Medical Surgical Assessment 2

1. What dietary recommendations should be given to a patient with pre-dialysis end-stage kidney disease?

Correct answer: A

Rationale: The correct recommendation for a patient with pre-dialysis end-stage kidney disease is to reduce phosphorus intake to 700 mg/day. High phosphorus levels can lead to complications in such patients. Increasing sodium intake (Choice B) is generally not recommended due to its association with hypertension and fluid retention. While protein is essential, increasing protein intake (Choice C) in kidney disease can be harmful as it can lead to increased waste products that the kidneys may struggle to excrete. Increasing potassium intake (Choice D) is not advisable as well, as patients with kidney disease may already have difficulty excreting potassium, leading to hyperkalemia.

2. What does continuous bubbling in the water seal chamber of a chest tube indicate?

Correct answer: A

Rationale: Continuous bubbling in the water seal chamber of a chest tube indicates an air leak. This signifies that air is escaping from the patient's pleural space into the chest tube system rather than being evacuated properly. An air leak can lead to lung collapse or pneumothorax and requires immediate attention. Therefore, choice A is the correct answer. Choices B, C, and D are incorrect because continuous bubbling does not indicate normal chest tube function, drainage in the chest tube, or a blocked chest tube.

3. What is the preferred electrical intervention for a patient with ventricular tachycardia with a pulse?

Correct answer: A

Rationale: The correct answer is A: Synchronized cardioversion. In ventricular tachycardia with a pulse, synchronized cardioversion is the preferred electrical intervention. Synchronized cardioversion is used to treat tachyarrhythmias where there is a pulse present. Defibrillation (choice B) is used in emergencies for pulseless ventricular tachycardia or ventricular fibrillation. Pacing (choice C) is more suitable for bradycardias or certain conduction abnormalities. Medication administration (choice D) may be used in stable cases or as an adjunct to other treatments, but synchronized cardioversion is the primary intervention for ventricular tachycardia with a pulse.

4. What are the characteristics of a thrombotic stroke?

Correct answer: A

Rationale: The correct answer is A. Thrombotic strokes typically have a gradual onset over minutes to hours as they result from a clot obstructing blood flow. Choice B, numbness on one side of the body, is more commonly associated with an ischemic stroke rather than specifically a thrombotic stroke. Choice C, loss of consciousness, is not a defining characteristic of a thrombotic stroke. Choice D, seizures and convulsions, are more commonly seen in hemorrhagic strokes rather than thrombotic strokes.

5. A nurse is admitting a client who has suspected appendicitis. Which of the following findings should the nurse report to the provider immediately?

Correct answer: A

Rationale: A distended, board-like abdomen should be reported to the provider immediately because it indicates peritonitis, a serious complication of appendicitis resulting from a ruptured appendix. Option B, an elevated WBC count, may indicate infection but is not as urgent as a board-like abdomen. Option C, rebound tenderness over McBurney's point, is a classic sign of appendicitis but does not indicate immediate life-threatening complications. Option D, a slightly elevated temperature, is not as concerning as a distended, board-like abdomen.

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