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?
- A. Reduce phosphorus intake to 700 mg/day
- B. Increase sodium intake
- C. Increase protein intake
- D. Increase potassium intake
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 ECG changes should be monitored in a patient with hypokalemia?
- A. Flattened T waves and prominent U waves
- B. Elevated ST segments and wide QRS complexes
- C. Tall T waves and flattened QRS complexes
- D. Widened QRS complexes and decreased P wave amplitude
Correct answer: A
Rationale: The correct answer is A: Flattened T waves and prominent U waves. In hypokalemia, there is a decrease in potassium levels, which can lead to ECG changes such as flattened T waves and prominent U waves. These changes are classic findings associated with hypokalemia. Choices B (Elevated ST segments and wide QRS complexes), C (Tall T waves and flattened QRS complexes), and D (Widened QRS complexes and decreased P wave amplitude) are all incorrect. Elevated ST segments and wide QRS complexes are not typically seen in hypokalemia. Tall T waves and flattened QRS complexes, as well as widened QRS complexes and decreased P wave amplitude, do not represent the typical ECG changes seen in hypokalemia.
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. What precaution should be advised to patients following cataract surgery?
- A. Wear dark glasses while outdoors
- B. Use warm compresses
- C. Avoid NSAIDs
- D. Avoid bright lights
Correct answer: A
Rationale: Patients who have undergone cataract surgery should wear dark glasses when outdoors to shield their eyes from light exposure, which can be uncomfortable or harmful during the recovery period. Using warm compresses (choice B) is not typically recommended after cataract surgery as it's more relevant for certain eye conditions. Avoiding NSAIDs (choice C) is advised to prevent bleeding complications, but it is not directly related to eye protection post-surgery. While avoiding bright lights (choice D) is crucial, wearing dark glasses provides a practical solution to achieve this, making choice A the most appropriate precaution.
5. What teaching should be provided to a patient following cataract surgery?
- A. Avoid NSAIDs
- B. Wear dark glasses outdoors
- C. Creamy white drainage is normal
- D. Avoid alcohol
Correct answer: A
Rationale: The correct teaching to provide to a patient following cataract surgery is to avoid NSAIDs. NSAIDs should be avoided post-cataract surgery to reduce the risk of bleeding. Choice B, wearing dark glasses outdoors, is important to protect the eyes from bright light but is not directly related to medication use. Choice C, stating that creamy white drainage is normal, is incorrect as drainage should be monitored for excessive redness, swelling, or pain. Choice D, avoiding alcohol, is not a direct post-cataract surgery teaching point related to medication use.
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