Nursing Care, Medication Administration, and Patient Education Practices, Exams of Nursing

Download Nursing Care, Medication Administration, and Patient Education Practices and more Exams Nursing in PDF only on Docsity! ATI Comprehensive Predictor 2020 Questions and Answers 2024 Signs/Symptoms of Hypothyroidism Correct Answer is Intolerance to cold, constipation, weight gain, thick-brittle fingernails, bradycardia, hypotension Nursing care for hypothyroidism Correct Answer is Monitor for low BP, bradycardia, edema and monitor weight. A task an AP can do Correct Answer is Specimen collection A task an AP can do Correct Answer is Obtain clean urine specimen samples What is something you would report if a patient has hypothyrodism Correct Answer is Chest pain Drug of choice for hypothyroidism Correct Answer is levothyroxine Levothyroxine can increase the effects of? Correct Answer is Warfarin What is the antidote for warfarin? Correct Answer is Vitamin K How many mg of minerals are required through dietary sources each day? Correct Answer is 100mg Nursing actions when a patient is taking phosphorus? Correct Answer is Evaluate the use of antacids and use of alcohol because alcohol impairs absorption Colostomies end in the Correct Answer is Colon Ileostomies end in the Correct Answer is Ileum Stool samples should come from where? Correct Answer is Fresh stools, avoid contaminating with water or urine. How far do you insert a rectal tube during an enema for an adult? Correct Answer is 7.5 to 10 cm (3 to 4 inches) How far do you insert a rectal tube during an enema for a child? Correct Answer is 5 to 7.5 cm (2 to 3 inches) Ostomy care includes Correct Answer is Wash hands. Don gloves. Remove pouch from stoma. Stoma should be moist, shiny and pink. Use mild soap and water to cleanse it. Cut about 1/8 inch larger to fit over. Arthroplasty refers to the surgical removal of what? Correct Answer is A diseased joint due to osteoarthritis, osteonecrosis, rheumatoid arthritis, trauma or congenital anomalies, and replaced with prosthetics or artificial components made of metal or plastic. Post-op care of a patient recovering from a knee arthroplasty? Correct Answer is Avoid knee gatches and pillows, place one pillow under the lower calf and foot to cause a slight extension of the knee joint, and to prevent flexion contracturas. The knee can rest flat on the bed. Place a small pillow/blanket above the ankle area to keep heals off the bed. Post-op care of a patient recovering from a hip arthroplasty? Correct Answer is Monitor HgB and HCT levels. They can continue to drop for 48 hours after and neuromuscular status every 2-4 hours. Apply ice following ambulation to decrease pain. How would you position a patient recovering from a hip arthroplasty? Correct Answer is Place head slightly elevated with the affected leg in neutral position. Place a pillow or abduction device between the legs when turning to the unaffected side. DO NOT TURN TO THE OPERATIVE SIDE. How do you store nitroglycerin tablets? Correct Answer is Store tablets in original bottles and in a cool, dark place. Post-op care instructions for a patient who has a thyroidectomy? Correct Answer is Keep client in a semi-Fowler's position. Support head and neck with pillows, AVOID NECK EXTENSION. How long do you monitor VS after a patient has a thyroidectomy? Correct Answer is Every 15 minutes until stable then every 30. How often should deep-breathing exercises be performed after a thyroidectomy? Correct Answer is Every 30 to 60 minutes. Most important assessment after a thyroidectomy is what? Correct Answer is This is when recovery starts with delivery of the placenta and includes at least 2 hours after birth. What is the immediate goal for the 4th stage of labor? Correct Answer is Monitor for PP hemorrhage. How long can HCG be detected for after birth? Correct Answer is Up tp 4 weeks after In lactating clients - what is some education you would teach the patient regarding ovulation? Correct Answer is Blood prolactin levels remain increased and suppress ovulation. Typically it is 6 months before the first ovulation. In a non-lactating client - what is some education you would teach the patient regarding ovulation? Correct Answer is Ovulation occurs 7 to 9 weeks after birth. Period resumes by 12 weeks PP. Where should the fundus be in the 4th stage of labor? Correct Answer is Palpable firm at the midline and 2 cm below the umbilicus. One hour after delivery, where should the fundus be? Correct Answer is It will rise to the umbilicus. At 12 hours post-Parton, where should the fundus be? Correct Answer is The fundus will be 1 cm above the umbilicus. What do you do if a patient has a boggy uterus? Correct Answer is Massage in a circular motion. Lochia rubra is what? Correct Answer is Dark-red blood, lasts 1-3 days Lochia serosa is what? Correct Answer is Pinkish-brown color, lasts 4-10 days. Lochia alba is what? Correct Answer is Yellowish, white and creamy in color. Lasts day 10 to about 8 weeks postpartum. How long after ovulation can the human ovum be fertilized for? Correct Answer is 24 hours. How long does the ability for sperm to fertilize the ovum last for? Correct Answer is 48 to 72 hours Fertile period is approximately which days on the calendar? Correct Answer is Day 8 through 19. Basal body temperature does what? Correct Answer is Drops slightly and rises during ovulation. How would you take your basal body temperature? Correct Answer is Take temperature after waking up and getting out of bed. Following ovulation, mucus becomes what? Correct Answer is Thin and flexible. Diaphragm - birth control - teaching points for a patient? Correct Answer is Use spermicidal gel/cream. It has to be properly fitted. Replaced every 2 years. It can be inserted up to 6 hours before intercourse and must stay in place 6 hours after intercourse but no more than 24 hours. Empty bladder prior to insertion. Contraindications for taking oral contraceptives? Correct Answer is Clients who have a history of thromboembolic disorders, stroke, heart attack, coronary artery disease, gallbladder, cirrhosis, breast cancer, liver tumor, less than 6 weeks pp, hypertension Oral contraceptives effectiveness decrease when a patient is also taking which meds (classification of meds only) Correct Answer is Anticonvulsants, Antifungals, and some antibiotics. Use 2 methods of birth control to decrease getting pregnant. Who is at greatest risk for suicide? Correct Answer is Females are more likely to commit, but males are more successful. Older adults. Veterans. People with mental health disorders, white people, and people who have access to lethal methods (firearms) Nursing care for a patient at risk for suicide? Correct Answer is Always follow-up with a question if the first answer is negative. Nursing care after discharge for a patient at risk for suicide? Correct Answer is Have the patient agree to a no-suicide contract, a verbal or written agreement to not harm themselves. Identifying risk factors for child maltreatment - which are? Correct Answer is Younger parents, low-income, lack of education, substance use disorder, history of abuse, children younger than 1 years old, kids who are hyperactive, or have physical/mental disabilities, premature infants, unemployment/crowded living conditions, substitute caregivers Interventions to prevent self-harm? Correct Answer is Monitor the clients suicide plan. What is considered primary intervention in suicide patients? Correct Answer is Focusing on the use of community education and screenings to identify individuals at risk What is considered secondary intervention? Correct Answer is Focuses on a client having an acute suicidal crisis. Precautions are included in this stage. Tertiary prevention is considered what? Correct Answer is Focusing on providing support and assistance to survivors of a client who died by suicide. Nursing care for a patient at risk for suicide? Correct Answer is Provide one-on-one supervision. Remove all harmful objects. Allow client to have plastic eating utensils and count them. NEVER LEAVE A SUICIDAL PATIENT ALONE What is the best way to respond to escalating aggression? Correct Answer is FIRST PRIORITY - Provide a safe environment. Respond quickly and remain calm and in control. Encourage the patient to express their feelings verbally. Seclusion and restraints are a LAST RESORT. Allow as much personal space as possible. Maintain eye contact and sitting/standing at the same level. Avoid accusing or threatening statements. Describe options clearly and offer choices. Set limits for the client. Therapeutic communication for a patient being aggressive? Correct Answer is "I need you to stop yelling, and walk with me to the day room where we can talk" What can you encourage the patient who is being aggressive? Correct Answer is Encourage physical activity, such as walking to de-escalate anger and behaviors. Inform the client of the consequences of their behavior, such as loss of privileges. Cultural awareness refers to Correct Answer is Self-awareness for the nurse, examining personal attitude to identify possible bias Best way to communicate with a client who speaks a different language? Correct Answer is Use gestures to increase understanding, speak slowly at a normal volume avoiding abbreviations or slang. Determine understanding throughout the conversation. Use printed materials suited to the clients level of understanding. Alcohol delirium is what? Correct Answer is 2 to 3 days after cessation of alcohol. This is considered a medical emergency. Manifestations of alcohol delirium include? Correct Answer is Severe disorientation, psychotic effects (hallucinations), severe hypertension, cardiac dysrythmias which can lead to death. What is some client teaching you would provide for Phenytoin? Correct Answer is It's an anti epileptic drug. Take the med at the same time every day to be effective. Go to all routine dental visits and have good oral hygiene. Avoid oral contraceptives, and avoid warfarin. What are adverse effects of Ciprofloxacin? Correct Answer is GI discomfort ( N/V, Diarrhea), take with food. Achilles' tendon rupture, suprainfection such thrust or yeast infections, and photo toxicity (severe sunburn) You cannot give Ciprofloxacin to which age group? Correct Answer is Kids under 18 years old. Things to know about advance directives includes Correct Answer is Advance directives don't expire, however they might not be accepted into another state. Non-maleficence Correct Answer is do no harm Prioritization order? Correct Answer is Basic life support, ABC, Maslow's hierarchy of needs, steps of the nursing process, acute vs. chronic, and new onset vs. unexpected For a client taking Digoxin, you should do what before administering the medication? Correct Answer is Take the apical heart rate for 1 minute. Hold the medication if the apical pulse is less than 60/min, and notify the provider. What should you observe the client for after administering digoxin that can indicate toxicity? Correct Answer is Fatigue, muscle weakness, confusion and loss of appetite. Also monitor for nausea and vomiting. Education for a patient taking digoxin? Correct Answer is Count pulse for 1 full minute. Take the dose at the same time each day. Do not take digoxin at the same time as antacids - separate the two meds by at least 2 hours. Have blood digoxin and potassium levels checked regularly. How far do you insert a vaginal suppository along the posterior wall? Correct Answer is 7.5 to 10 cm (3 to 4 inches) How far do you insert creams, jellies or foams along the posterior wall of the vaginal wall? Correct Answer is 5 to 7.5 cm (2 to 3 inches) How long should a female patient remain supine after insertion of a suppository? Correct Answer is 10 minutes after insertion. The vastus lateralis is best for who? Correct Answer is Infants 1 year and younger. The ventrogluteal site is preferable for what? Correct Answer is IM injections and for injecting volumes exceeding 2 mL What size gauge needle would you use for older adults? Correct Answer is 22 to 24-gauge Older adults require smaller does of medications due to what? Correct Answer is The possibility of accumulation in the body. Morphine is contraindicated after which surgery? Correct Answer is Biliary tract surgery Before administering a pain medication, you should measure the patients respiratory rate and withhold if it is less than? Correct Answer is 12/min Nursing care for opioid medications Correct Answer is Double check opioid doses with another nurse prior to administration. Ensure that IV opioids are given slowly over 4 to 5 minutes. Have naloxone and resuscitation equipment available. Agonist-Antagonist opioids are which meds? Correct Answer is Butorphanol, Nalbuphine, Buprenorphine, Pentazocine. Common complications of agonist-antagonist opioids like butophanol and buprenorphine are what? Correct Answer is Abstinence syndrome, sedation and respiratory depression, dizziness, headache Contraindications for agonist-antagonist opioids? Correct Answer is Use cautiously in clients who have a history of MI, kidney or liver disease, respiratory depression, or head injury, and clients who are physically dependent on opioids. Nursing care for a patient taking agonist-antagonist opioids? Correct Answer is Measure baseline vital signs, if the respiratory rate is less than 12/min, withhold the medication and notify the charge nurse and provider. Have naloxone ready. Use caution when getting out of bed or standing, and do not operate heavy machinery or drive until CNS effects are known. What is electrocompulsive therapy used for? Correct Answer is It uses electrical current to induce a brief seizure activity while the client is anesthetized. What are the contraindications for ECT? Correct Answer is There are no absolute contraindications. However conditions such as cardiovascular disorders such as a recent MI, hypertension, heart failure, cardiac arrhythmias. Cerebrovascular disorders such as a history of stroke, brain tumor, subdural hematoma. ECT increases intracranial pressure and blood flow through the brain during treatment. Mental health conditions for which ECT has not been found useful include the following. Correct Answer is Substance use disorders, personality disorders, dysphoric disorder. Before doing ECT, what should you do as a nurse? Correct Answer is Thirty minutes prior to the beginning of the procedure, an IM injection of atropine sulfate or glycopyrrolate is administered to decrease secretions that could cause aspiration as to counteract bradycardia. Complications of ECT? Correct Answer is Memory loss and confusion that can last for up to several weeks. Reactions to anesthesia, cardiovascular changes, relapse of depression What do you assess for after a thyroidectomy? Correct Answer is Watch for laryngeal edema damage by assessing for hoarseness or inability to speak clearly. What equipment and meds should a nurse have available after a thyroidectomy? Correct Answer is A tracheostomy set, along with oxygen and suction machine. Also have calcium gluconate easily accessible in the even the parathyroid glands were removed. Who governs the PNs responsibility in assigning, supervising and accepting assignments and making assignments Correct Answer is Nurse Practice Act When should you check the patients blood pressure after initiation of treatment? Correct Answer is 2 hours after Client education for a patient taking an ACE inhibitor? Correct Answer is Advise the patient to change positions slowly and lie down if feeling dizzy, lightheaded or faint. What symptom should a patient report to the HCP immediately while taking an ACE inhibitor? Correct Answer is Dry cough Diet recommendations for a patient taking an Ace inhibitor? Correct Answer is Advise patients to avoid the use of salt substitutes containing potassium. Monitor for hyperkalemia when taking an ACE inhibitor? Correct Answer is These symptoms include numbness and tingling and paresthesia in hands and feet. What other medication should a patient avoid using concurrently with an ACE inhibitor? Correct Answer is NSAIDS You administered ACE inhibitors orally except which drug that can be administered IV use? Correct Answer is Enalaprilat Where do you store nitroglycerin tablets? Correct Answer is In original bottles and in a cool, dark place How do you validate a patient has learned discharge instructions taught? Correct Answer is By the patient providing a return demonstration? When can you break confidentiality? Correct Answer is When you need to warn and protect third parties, and the reporting of child and vulnerable adult abuse. If you as a nurse overhear two people discussing/breaching a clients confidentiality while on an elevator, what should you do? Correct Answer is Immediately take action to stop the violation. Nursing care for obtaining a telephone prescription from a provider? Correct Answer is Have a second nurse listen to a telephone prescription, repeat it back and be sure ton include the medications name, dosage, time and route. Make sure the provider signs the prescription in person within the time frame according to the facility, typically this is 24 hours. What are acceptable identifiers before medication administration? Correct Answer is Clients name, an assigned identification number, telephone number, birthday, photo id card. Each facility must have an emergency operating plan. How often is the EOP mandated to be tested for? Correct Answer is At least twice a year External emergencies include what? Correct Answer is These affect a facility indirectly and include weather (tornado, and hurricane, pandemic fly, chemical plant explosions) In a nursing facility, what document will offer clear instructions for disaster management at your facility level? Correct Answer is The Hospital Incident Command System (HICS) What strain of staphylococcus bacteria is resistant to vancomycin Correct Answer is VRSA What precautions should a patient be on who has a multi-drug resistant organisms? Correct Answer is Contact precautions Nursing care for a patient on contact precautions? Correct Answer is Required if anyone is within 3 feet of the client. Requires a private room or a room with other clients who have the same infection. Gloves and gown worn by the caregivers and visits. Disposal of infectious dressing material into a single, nonporous bag without touching the outside of the bag. When should a TB skin test be read? Correct Answer is in 48 to 72 hours An induration (palpable, raised, and hardened area) of 10 mm or greater in diameter indicates what? Correct Answer is a positive skin tb test What nursing care should you take for a patient with TB? Correct Answer is Administer humidified oxygen therapy. Wear a N95 HEPA filter or powered air purifying respirator when caring for clients who are hospitalized. Place pt in a negative airflow room and implement airborne precautions. Have the client wear a surgical mask if transportation to another department is necessary. Test exposed family members for TB What order do you suction a newborn? Correct Answer is Suction the side of the mouth then the nasal passages - one at a time. When bathing, what is important that you do as a nurse to keep the babys temperature stable? Correct Answer is Expose only one body part at a time, washing and drying thoroughly. When can bathing begin for a newborn? Correct Answer is Once the newborns temperature has stabilized to at least 97.7 degrees. Bathing infant by submerging in water should not occur until when? Correct Answer is The cord has fallen off. Most cords fall off within the first 10 to 14 days although it can take up to 3 weeks. What medication is given to newborns as a prophylactic eye care to prevent ophthalmia neonatorum? Correct Answer is Erythromycin. Ophthalmia neonatorum is caused by gonorrhoeae or chlamydia and can cause blindness. How often is complete bathing performed in a newborn? Correct Answer is Two to three times per week using mild soap. What order do you clean a baby? Correct Answer is Move from the cleanest to the dirtiest part of the newborns body - beginning with the eyes, face, and head. Proceed to the chest, arms and legs and wash the groin area last. When should bathing take place? Correct Answer is At the convenience of the parents, but not immediately after feeding to prevent spitting up and vomitting. What temperature is the hot water seat at when bathing a newborn? Correct Answer is Set at 120.2 degrees or less. The room should be warm and the bath water should be 98 to 99 degrees. How do you test bath water? Correct Answer is Test comfort with your elbow prior to bathing a newborn. If a patient has an MI and needs to decrease their caffeine intake - what can happen if they dont? Correct Answer is The caffeine will stimulate the heart and increase the heart rate. What are some good practices to prevent self-harm? Correct Answer is Initiate one-on-one constant supervision around the clock. Document every 15 minutes. Search the clients belongings with the client present.