ATI Capstone Proctored Comprehensive Assessment Form A – Practice Questions, Test Bank & Study Guide

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Assessment Form A

Electrolyte Imbalances: Identifying Manifestations of a Calcium Imbalance

Hypocalcemia:

- Level: <9 mg/dL

- Risk factors: Calcium deficit, diarrhea, end-stage kidney disease, wound drainage;
alkalosis, acute pancreatitis, immobility, parathyroid removal/damage

- S&S: Tetany (most common manifestation), paresthesia of the fingers and lips, muscle
twitches,

seizure, muscle spasms, hyperactive DTRs, positive Chvostek's sign (facial twitching),
positive Trousseau's sign (hand/finger spasms with BP cuff inflation), cardiovascular
irregularities, diarrhea, abdominal cramps

- Tx: Vitamin D supplements

- Complications: Cardiac arrest




Associated manifestation of Hypocalcemia

Positive Trousseau's sign




Associated manifestation of Hyperkalemia




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ECG with tall, peaked t-waves




Associated manifestation of Hyponatremia

Bounding pulse




Associated manifestation of Hypokalemia

Hypoactive bowel sounds




The nurse is assessing the client for Chvostek's sign. Which of the following actions
should the nurse take?

a. Apply a BP cuff to the client's arm

b. Place a stethoscope bell over the client's carotid artery

c. Ask the client to lower their chin to their chest

d. Tap lightly on the client's cheek

d. Tap lightly on the client's cheek




Tap over the facial nerve just below and anterior to the ear to elicit Chvostek's sign.

A positive sign = Facial twitching on the side of the face




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The nurse is assessing the client who reports nausea, vomiting, and weakness. Which
of the following findings are manifestations of hypocalcemia? SATA

a. Tingling in fingers

b. Poor skin turgor

c. Abdominal pain

d. Elevated temperature

e. Muscle twitching

a, c, e




Numbness and tingling in fingers and toes, abdominal cramps and diarrhea, and muscle
twitching are manifestations of hypocalcemia.




Respiratory Diagnostic Procedures: Planning Care for a Client Who Is Scheduled for a
Thoracentesis

Preprocedure:

- Percussion, auscultation, radiography, or sonography is used to locate the effusion
and needle insertion site.

- Assist the older client to maintain still for the procedure




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