ATI Capstone Adult Medical Surgical Assessment 1

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Sample questions from ATI Capstone Adult Medical Surgical Assessment 1

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A nurse receives handoff on four clients. Which client should the nurse assess first?

   • A.A client with COPD whose oxygen saturation is 90% on the prescribed 2 L/min by nasal cannula
   • B.A client 1 day after thyroidectomy who reports tingling around the mouth
   • C.A client with heart failure who has bilateral ankle edema and requests assistance to the bathroom
   • D.A client with diabetes mellitus whose premeal glucose is 198 mg/dL

   Rationale: Perioral tingling after thyroidectomy can indicate hypocalcemia from parathyroid injury, which may progress to laryngospasm and airway obstruction. The COPD client's saturation is within a common individualized target range, while the edema and glucose require follow-up but are not immediate threats. The exam takeaway is to prioritize a new finding that may signal rapid airway compromise.

2. 2.A client with heart failure is receiving IV furosemide. Which finding requires the nurse's immediate follow-up?

   • A.Urine output of 900 mL over 4 hours
   • B.Potassium level of 2.8 mEq/L
   • C.Blood pressure decrease from 148/86 to 136/80 mm Hg
   • D.Weight decrease of 0.7 kg in 24 hours

   Rationale: A potassium level of 2.8 mEq/L is significant hypokalemia and increases the risk of dangerous dysrhythmias, especially in a client with heart disease. Diuresis, a modest blood pressure decrease, and weight loss can be expected therapeutic effects, though they should be monitored. The exam takeaway is to recognize electrolyte complications of loop diuretics as a priority.

3. 3.A client arrives with sudden chest pressure, diaphoresis, and nausea. Which action should the nurse take first?

   • A.Obtain a 12-lead electrocardiogram
   • B.Administer an oral antacid
   • C.Ask the client to walk to determine whether the pain worsens
   • D.Schedule a fasting lipid panel

   Rationale: A 12-lead ECG should be obtained promptly to identify ischemia or infarction and guide time-sensitive treatment. An antacid does not rule out acute coronary syndrome, and ambulation could worsen myocardial oxygen demand. A lipid panel is useful for risk assessment but is not an immediate priority.

4. 4.A client with a suspected stroke has facial droop and slurred speech. Which action is appropriate before giving oral medication?

   • A.Offer water to assess whether the client can swallow
   • B.Perform a prescribed or facility-approved swallow screen
   • C.Place the medication in applesauce
   • D.Ask the family whether the client has swallowing problems

   Answer and rationale are in the full material.

5. 5.A client with diabetes is awake, diaphoretic, and shaky; the blood glucose is 54 mg/dL. What should the nurse do?

   • A.Give 15 g of a rapid-acting carbohydrate and recheck glucose in 15 minutes
   • B.Administer the scheduled rapid-acting insulin
   • C.Give a high-protein meal and recheck glucose in 1 hour
   • D.Withhold all food and repeat the glucose in 30 minutes

   Answer and rationale are in the full material.