ATI RN
ATI Capstone Medical Surgical Assessment 1 Quizlet
1. Which lab value is a priority for a patient with HIV?
- A. CD4 T-cell count 180 cells/mm3
- B. Albumin levels below 3.5 g/dL
- C. Potassium levels below 3.5 mEq/L
- D. White blood cell count below 5000/mm3
Correct answer: A
Rationale: A CD4 T-cell count of less than 180 cells/mm3 is a priority for a patient with HIV because it indicates severe immunocompromise and an increased risk for opportunistic infections. Monitoring CD4 levels helps in assessing the immune status and guiding treatment decisions in patients with HIV. Albumin levels (choice B) are important for assessing nutritional status but are not a direct indicator of immune function in HIV patients. Potassium levels (choice C) and white blood cell count (choice D) are also important, but the CD4 T-cell count is specifically crucial for evaluating the immune function in individuals with HIV.
2. What is the priority action if a patient experiences hypoglycemia after an insulin dose?
- A. Check the patient's blood glucose level
- B. Administer IV dextrose
- C. Document the incident
- D. Continue monitoring the patient
Correct answer: A
Rationale: The priority action when a patient experiences hypoglycemia after an insulin dose is to check the patient's blood glucose level. This is crucial to confirm hypoglycemia before initiating any treatment. While administering IV dextrose may be necessary if the patient's blood glucose level is critically low, confirming hypoglycemia is essential to guide appropriate interventions. Documenting the incident is important for documentation purposes but is not the immediate priority when the patient's safety is at risk. Continuing to monitor the patient is essential, but it should follow the confirmation and initial management of hypoglycemia.
3. What precaution should be advised to a patient following a cataract surgery?
- A. Wear dark glasses while outdoors
- B. Avoid NSAIDs
- C. Use warm compresses
- D. Apply cold packs
Correct answer: A
Rationale: Following cataract surgery, patients are advised to wear dark glasses while outdoors. This is crucial to protect the eyes from bright light and prevent complications such as excessive glare or discomfort. Choice B, avoiding NSAIDs, is not directly related to post-cataract surgery care. Choices C and D, using warm compresses and applying cold packs, are not typically part of the standard post-operative care for cataract surgery.
4. A nurse is assessing a client who has a heart rate of 40/min. The client is diaphoretic and has chest pain. Which of the following medications should the nurse plan to administer?
- A. Lidocaine
- B. Adenosine
- C. Atropine
- D. Verapamil
Correct answer: C
Rationale: The correct answer is C: Atropine. The client's presentation of bradycardia, diaphoresis, and chest pain indicates reduced cardiac output, requiring intervention to increase the heart rate. Atropine is used to treat bradycardia by blocking cardiac muscarinic receptors, thus inhibiting the parasympathetic nervous system. Lidocaine (Choice A) is used for ventricular arrhythmias, not bradycardia. Adenosine (Choice B) is used for supraventricular tachycardia, not bradycardia. Verapamil (Choice D) is a calcium channel blocker used for certain arrhythmias and hypertension, but not for increasing heart rate in bradycardia.
5. What intervention should the nurse take for a patient experiencing delayed wound healing?
- A. Monitor serum albumin levels
- B. Apply a dry dressing
- C. Administer antibiotics
- D. Change the wound dressing every 8 hours
Correct answer: A
Rationale: Monitoring serum albumin levels is crucial for patients with delayed wound healing. Low albumin levels indicate a lack of protein, which can impair the healing process and increase the risk of infection. By monitoring serum albumin levels, the nurse can assess the patient's nutritional status and make necessary interventions to promote wound healing. Applying a dry dressing (Choice B) may be appropriate depending on the wound characteristics, but it does not address the underlying cause of delayed healing. Administering antibiotics (Choice C) is not the first-line intervention for delayed wound healing unless there is an active infection present. Changing the wound dressing every 8 hours (Choice D) may lead to excessive disruption of the wound bed and hinder the healing process.
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