what should the nurse do when a patient is admitted with chest pain from acute coronary syndrome
Logo

Nursing Elites

ATI RN

ATI Capstone Medical Surgical Assessment 2 Quizlet

1. What should be the priority action when a patient is admitted with chest pain from acute coronary syndrome?

Correct answer: A

Rationale: The correct answer is to administer sublingual nitroglycerin. This is the priority action in treating chest pain associated with acute coronary syndrome as it helps to dilate blood vessels, improve blood flow to the heart, and reduce cardiac tissue damage. Administering nitroglycerin is crucial in managing the symptoms and potential complications of acute coronary syndrome. Obtaining IV access (Choice B) is important for administering medications and fluids but does not address the immediate symptom of chest pain. Checking cardiac enzymes (Choice C) and administering aspirin (Choice D) are essential steps in the management of acute coronary syndrome, but they should follow the administration of nitroglycerin to address the immediate symptom and improve blood flow to the heart.

2. A nurse is planning care for a patient diagnosed with diabetes insipidus. What should be included in the care plan?

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 dietary recommendations should a patient with GERD follow?

Correct answer: A

Rationale: Patients with GERD should follow dietary recommendations to manage their symptoms effectively. Choice A, 'Avoid mint and spicy foods,' is the correct answer. Mint and spicy foods can trigger acid reflux and worsen GERD symptoms. Choice B, 'Consume liquids between meals,' is not the best recommendation as consuming liquids during meals can worsen GERD symptoms by increasing stomach pressure. Choice C, 'Eat three large meals per day,' is incorrect as large meals can exacerbate GERD symptoms; instead, smaller, more frequent meals are recommended. Choice D, 'Drink milk as a snack,' is not ideal as full-fat dairy products like milk can trigger acid reflux in some individuals. Therefore, the best recommendation for a patient with GERD is to avoid mint and spicy foods.

4. A nurse is assessing a client who has a sodium level of 122 mEq/L. Which of the following findings should the nurse expect?

Correct answer: A

Rationale: Corrected deep tendon reflexes occur with hyponatremia. Other manifestations of hyponatremia include headache, confusion, lethargy, fatigue, seizures, and muscle weakness. Positive Chvostek's sign is associated with hypocalcemia, hyperactive bowel sounds are not typically related to hyponatremia, and dry mucous membranes are more commonly seen with dehydration.

5. A patient reports abdominal cramping after enema administration. What action should the nurse take to relieve the discomfort?

Correct answer: A

Rationale: The correct action to relieve abdominal cramping after enema administration is to lower the height of the solution container. This adjustment slows down the flow rate of the enema solution, which can help reduce discomfort by decreasing the pressure on the patient's abdomen. Increasing the flow of the enema solution (Choice B) would exacerbate the cramping by introducing more solution quickly. Removing the enema tubing (Choice C) is not necessary to address the cramping, and stopping the procedure (Choice D) may not be needed if adjusting the height of the solution container can resolve the issue.

Similar Questions

What should be taught to a patient following cataract surgery?
What should a healthcare professional do if a patient experiences abdominal cramping during enema administration?
A patient with a chest tube has continuous bubbling in the water seal chamber. What does this indicate?
What is the first nursing action for a patient with chest pain and possible acute coronary syndrome?
What are the common manifestations of a thrombotic stroke?

Access More Features

ATI RN Basic
$69.99/ 30 days

  • 5,000 Questions with answers
  • All ATI courses Coverage
  • 30 days access

ATI RN Premium
$149.99/ 90 days

  • 5,000 Questions with answers
  • All ATI courses Coverage
  • 30 days access

Other Courses