what ecg changes are expected in a patient with hypokalemia

ATI RN

ATI Capstone Adult Medical Surgical Assessment 2

1. What ECG changes are expected in a patient with hypokalemia?

A. Flattened T waves
B. Prominent U waves
C. Widened QRS complexes
D. Tall T waves

Correct answer: A

Rationale: Flattened T waves are an early indicator of hypokalemia on an ECG. Hypokalemia primarily presents with flattened T waves, not prominent U waves, widened QRS complexes, or tall T waves. Prominent U waves are associated with hypokalemia only in severe cases. Widened QRS complexes are more indicative of hyperkalemia, while tall T waves are seen in hyperkalemia as well.

2. A nurse in a rural community center is providing education to a group of clients about first aid interventions for snake bites. Which of the following instructions should the nurse include in the teaching?

A. Apply an ice pack directly to the affected area
B. Immobilize the affected extremity with a splint
C. Place a tourniquet above and below the affected area
D. Elevate the affected extremity

Correct answer: B

Rationale: The correct answer is to immobilize the affected extremity with a splint. This helps to slow the spread of venom by limiting movement. Applying an ice pack directly to the affected area (Choice A) is not recommended for snake bites as it could exacerbate tissue damage. Placing a tourniquet above and below the affected area (Choice C) is also not advised as it can lead to further complications. Elevating the affected extremity (Choice D) is not recommended for snake bites; keeping it below the level of the heart is more appropriate to reduce venom spread.

3. What are the dietary recommendations for a patient with GERD?

A. Avoid mint and spicy foods
B. Eat large meals before bedtime
C. Consume liquids with meals
D. Avoid NSAIDs

Correct answer: A

Rationale: The correct answer is to avoid mint and spicy foods for a patient with GERD. These foods can increase gastric acid secretion and worsen symptoms of GERD. Choice B is incorrect because eating large meals before bedtime can exacerbate GERD symptoms due to increased gastric pressure when lying down. Choice C is also incorrect as consuming liquids with meals can lead to increased gastric distention, potentially triggering GERD symptoms. Choice D, avoiding NSAIDs, though important for some patients with GERD due to their potential to irritate the stomach lining, is not a general dietary recommendation for all GERD patients.

4. A nurse is assessing a client who has a permanent spinal cord injury and is scheduled for discharge. Which of the following client statements indicates that the client is coping effectively?

A. I would like to play wheelchair basketball. When I get stronger, I think I'll look for a league.
B. I'm glad I'll only be in this wheelchair temporarily. I can't wait to get back to running.
C. I'm so upset that this happened to me. What did I do to deserve this?
D. I feel like I'll never be able to do anything that I want to again. All I am is a burden to my family.

Correct answer: A

Rationale: Choice A is the correct answer because it shows that the client has accepted their disability and is looking towards the future with realistic goals. This positive attitude and focus on engaging in activities that are achievable despite the disability indicate effective coping mechanisms. Choice B is incorrect as it reflects denial of the permanent nature of the disability. Choice C is incorrect as it shows feelings of anger and possible self-blame, which are not indicative of effective coping. Choice D is incorrect as it demonstrates a sense of hopelessness and self-perceived burden, which are signs of maladaptive coping.

5. What dietary recommendation should be given to a patient with GERD?

A. Avoid mint and spicy foods
B. Eat large meals before bedtime
C. Consume liquids with meals
D. Eat three large meals per day

Correct answer: A

Rationale: The correct recommendation for a patient with GERD is to avoid mint and spicy foods. Mint and spicy foods can aggravate GERD symptoms by relaxing the lower esophageal sphincter and increasing stomach acid production, leading to acid reflux. Choices B, C, and D are incorrect. Eating large meals before bedtime can worsen GERD symptoms as lying down can promote acid reflux. Consuming liquids with meals can also exacerbate GERD by increasing stomach distension and pressure on the lower esophageal sphincter. Eating three large meals per day can overload the stomach and trigger acid reflux episodes in patients with GERD.