ATI Comprehensive Predictor 2024 new version, Exams of Nursing

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ATI Comprehensive Predictor 2024 new

version

Fontanel closing on newborns - Answer :: anterior 12-18 months posterior 1-2 months Best time to perform bladder scan - Answer :: immediately after void Cholecystitis Diet - Answer :: no cheese! low fat, no fatty/greasy food, low cholesterol, Increase fruit and veggies, Whole grain (Melon) Moro reflex - Answer :: startled; hit surface next to the newborn Position for suppository or enema administration - Answer :: - Sim's/left lateral/Rt. knee to chest Varicella contraindication - Answer :: corticosteroids Dtap contraindication - Answer :: Hx of inconsolable crying Newborn car seat safety - Answer :: Snug harness across axillary. Not across abdomen or neck. Ileostomy what pt expect on appearance - Answer :: - Initial drainage: dark green, odorless.

• Some initial bleeding normal
• Pink or red stoma color normal
• Initial swelling; decreases 2-3 weeks later delirium - Answer :: simple orientation and low stimuli Hep b contraindication - Answer :: Baker's yeast MMR contraindications - Answer :: pregnancy, recent blood transfusion

Anorexia nervosa - Answer :: increase in sodium, potassium, chloride, BUN, liver function, cholesterol Bulimia therapeutic nursing care - Answer :: offer small and frequent meals 89% postoperative - Answer :: change to another finger Non rebreather mask - Answer :: Ensure two "flaps" open during exhalation/close during inhalation. Venture mask - Answer :: ensure reservoir bag 2/3 full during inspiration and expiration Thoracentesis position - Answer :: sitting position, arms raised and resting overbed table Chlorpromazine (psychoses) - Answer :: adverse effect (SPASMS/TREMORS) treat benzo (COGENTIN) BENADRYL Variable deceleration - Answer :: cord compression Early decelerations - Answer :: safe Begin prior to peak of the contraction and end by the end of it. they are caused by head compression. no need for intervention if variability is within normal range (6-10) and the FHR is within normal range. Cystic fibrosis - Answer :: DNA mutant gene, sprinkle capsule on food Levothyroxine - Answer :: thyroid, caution with cardiac pts (TACHY ANXIETY) take in morning Levothyroxine toxicity - Answer :: anxiety, chest pain, tachy, hypertension Bucks traction - Answer :: immobilization, reposition q 2hrs, provide pin care, neuro checks Amputation - Answer :: apply prosthetic before ambulating

Ferrous sulfate - Answer :: treats iron deficiency, REPORT nausea, constipation, heartburn, take on an empty stomach through a straw and rinse, increase H/H Orientation phase - Answer :: Introduce, Discuss confidentiality, Set goals Working phase - Answer :: to problem-solve Terminal phase - Answer :: Evaluation (evaluate goals, experience, feelings) Chadwick's sign - Answer :: Bluish-purple coloration of the vaginal mucosa and cervix Hysterectomy states (I CAN POSSIBLY PLAN A PREGNANCY) - Answer :: outcome Vaginal flush complications - Answer :: Preterm Labor: Ruptured membranes, signs of infection Sucralfate for PUD - Answer :: coats stomach to prevent formation of ulcer and aids with healing existing ulcers 17 y/o having emergency surgery intervene when - Answer :: verbal consent Insulins not to mix - Answer :: garglarine and determis malfunctioning iv machine - Answer :: tag and get new one best recommendation for newly diabetes 2 independently - Answer :: refer to support group Circumcision post op - Answer :: change diaper q 4hr, clean penis every change, petroleum jelly for 24 hr, fan fold diaper, avoid wrapping penis, trickle warm water over penis to wash, do not remove yellowish mucus do not use moist towelettes, heals in a couple weeks TB precautions - Answer :: private negative pressure room, N95 mask, wear mask when transported, 4 meds at a time, for up to 6-12 months, test exposed family members, sputum culture q2-3 weeks, 3 negative= noninfectious

leukorrhea - Answer :: white discharge from the vagina during early pregnancy MRSA Contact Precautions - Answer :: - keep distance within 3 ft of client

• Private room or share with someone with similar infection (wound infection, herpes simplex)
• double bag dressing gauze.
• PPE: Gloves and Gowns. Metformin common side effect - Answer :: renal kidney failure drawing up insulin - Answer :: NR-RN regular NPH (Clear then cloudy) Interaction between SSRI and st johns warts - Answer :: hypertensions and increased heart rate that can become life threatening. diabetic foot care - Answer :: - Nailcare: Podiatrist, cut nail straight across.
• Wear Clean Cotton Socks/Closed Shoes
• Do not soak feet or wear ointments Used Opioid overdose - Answer :: Naloxone (Narcan) Contraindication during alcohol withdrawals - Answer :: Delirium, accompanied by hallucinations Pt education for amniocentesis - Answer :: supine or rolled towel under right hip, continue breathing normally as needle is inserted, rest 30 min after, increase fluids for 24 hrs after Indications for fluid depletion - Answer :: thread pulse, hypotensive, tachy, increased resp, cool, clammy, diaphoretic, decreased UOP, thirst

Type of stomas - Answer :: single one stoma, loop proximal active distal inactive, divided proximal digestive distal mucus, double barrel sutured together Documentation for ostomy care - Answer :: amount, color, consistency Priority for panic disorder - Answer :: Breathing Technique Education on meds - Answer :: digoxin- 2hrs of meals monitor pulse for 1 min, toxicity, sodium polystyrene- hypokalemia, restrict sodium, epogen- blood twice a week, monitor hypertension, ferrous sulfate-administer following dialysis with stool softner take with food, aluminum hydroxide gel- avoid pts with gi disorders, 2 hrs before/ after dig, Lasix- monitor i&o, bp, weight, report thirst cough Newborn water temp and room temp - Answer :: 120F 97.9-99F Bathing newborn technique - Answer :: Bathe from cleanest to dirtiest

• Eyes
• Face
• Head
• Chest
• Arms
• Legs
• Groin (last) Newborn reflex shown on day 1 - Answer :: hear voice Immunization recommended for postexposure protection - Answer :: Hep A

Arthroplasty pt education - Answer :: do not bend at waist, abductor pillow between legs, CPM, ice packs COPD - Answer :: high fowlers, increase fluids, albuterol Dementia Living coordination - Answer :: Home health Agency>Assisted Living>Nursing Home Need for Sterile Gloves - Answer :: Inserting Catheter Discomforts During Pregnancy - Answer :: - Nausea

• Fatigue
• Backache
• Constipation
• Varicose Veins
• Hemoroids
• Heartburn
• Nasal stuffiness
• Dyspnea
• Leg Cramps
• Edema lower extremities Acute Mania Interventions - Answer :: - Decrease stimuli and one to one observation if necessary. Bulimia Plan of Care when meal planning - Answer :: closely monitor the client during and after meals to prevent purging Reinforcing Teaching About Oppositional Defiant Disorder - Answer :: clear limits unacceptable behaviors, reward acceptable behavior

Osteoarthritis - Answer :: Alternate: Heat Therapy for Pain and Cold Therapy for Inflammation

• Use assistive devices (raised toilet to help not straining) Before bolus feedings - Answer :: check residual Pt complaints of cramping - Answer :: decrease infusion rate Location for drainage bag of catheters - Answer :: bed frame below level of bladder ventilator alarms - Answer :: low: disconnection high: kink, suction Glascow Coma Scale - Answer :: 15: Good 3: severe Pressure ulcer strategies - Answer :: reposition bed q 2hr, chair q 1hr, apply barrier cream and moisture absorbing pads Immunization: booster every 10 years - Answer :: DTP HPV vaccine - Answer :: 3 doses given starting at age 11- 12 How to measure Fundal Height - Answer :: top of symphysis pubis to top of fundus Calcular due date - Answer :: Day of LMP - 3 months + 1 yr & 7 days Contraindicated immunizations during pregnancy - Answer :: - Varicella
• Zoster
• MMR True labor vs False labor - Answer :: true- pain in lower back; regular rhythmic contractions; increased intensity with ambulation false-discomfort at abdomen; no lower back pain; contraction stop with ambulation or position change

Deceleration - Answer :: early head compression late uteroplacental insufficiency variable cord compression interventions in late variable deceleration - Answer :: left lateral side laying oxygen C-section Normal FHR - Answer :: 120- 160 Nursing car boggy uterus - Answer :: void, massage top of fundus with fingers reassess q 15 min Nursing care engorgement - Answer :: moist heat for 5 in before breastfeeding, ice compresses after feeding to reduce swelling and discomfort Nursing care mastitis - Answer :: continue breastfeeding and take antibiotics as prescribes Narcotic antidote - Answer :: Naloxone (Narcan) Anemia Lab - Answer :: RBC 4.20-4. BUN and creatinine - Answer :: 10-20, 0.9-10. sodium - Answer :: 136- 145 Potassium - Answer :: 3.5-5. Chloride - Answer :: 96- 106 Magnesium Sulfate Toxicity - Answer :: calcium gluconate Magnesium toxicity - Answer :: Absent or decreased deep tendon reflexes Respiratory depression Cardiac arrest

Decreased urine output Mom Rh-, baby Rh+ - Answer :: Give Rhogam Stroke eating precautions - Answer :: - check gag reflex

• thickened fluids/puree
• Sit upright/flexed neck forward Dehydration s/s - Answer :: weak thread pulse, hypotension, confused, decrease UOP, dry skin mucous membranes, urine specific gravity increased Urine Specific Gravity - Answer :: 1.00-1. JVD - Answer :: right sided heart failure Adverse of ACE inhibitors - Answer :: increase potassium Kosher Diet - Answer :: no shellfish, no meat and milk together, only fish with fins and scales, no pork Post Pelvic Surgery with Catheter - Answer :: avoid stress on incision site and bladder Crutches should be on what side when rising - Answer :: unaffected aide walking affected side arms should be at what degree when gripping crutches - Answer :: 30 degree walking gate for stairs - Answer :: 3 point Normal Stoma Finding - Answer :: moist shiny pink, mild soap and water, then dry gently and completely, apply paste if used, apply barrier paste to creases Latent Phase of Labor - Answer :: 0-3 cm, contractions mild to moderate, 5-30 apart 30 - 45 seconds Active Phase of Labor - Answer :: contractions 3 min apart

Variable decelerations - Answer :: cord compression, prep for c section, change position, d/c oxytocin Follow initial nursing action for late decelerations - Answer :: left lateral position Demerol - Answer :: best pain management post op cholecystectomy Do you report chlamydia - Answer :: mandated reporting to CDC w/out consent JP Drain - Answer :: empty 1/2 full Q 8 hrs clean with soap and water JP Drainage doubles in two hours - Answer :: think hemorrhage assess start cbc Notify MD Foods high in potassium - Answer :: • Avocado

• Bananas
• Cantaloupe
• Carrots
• Fish
• Mushrooms
• Oranges
• Potatoes
• Pork, Beef, Veal
• Raisins
• Spinach
• Strawberries

• Tomatoes MAOI Nardil - Answer :: avoid cheese food for hyponatremia - Answer :: cheese high in sodium and protein Drainage pin sites - Answer :: document COCA, leave crust pin care TID Phytoin SMZ-TMP - Answer :: command hallucination- phytoin toxicity Command hallucinations - Answer :: An individual hearing voices that direct the person to take action. without meds Methergine risk - Answer :: treats postpartum hemorrhage, risk for: hypertension, check bp, watch n/v headache 2 years of age presentation - Answer :: round soft abdomen 3 years immunizations - Answer :: dtap, ipv, mmr, varicells, influenza 3 year normal - Answer :: 2-3kg y, 2.5-3 in y, picky eaters, initiative vs guilt, imaginary friends, ride tricycle, jump off bottom step, stand on one foot for a few seconds First thing to do with newborn - Answer :: ABC, Dry off Terminally ill patient - Answer :: anticipatory Client involved in MVA severe internal bleeding - Answer :: 5% dextrose in LR Hypovolemic shock - Answer :: 5% Dextrose in LR Family asks to pray with you - Answer :: refer to spiritual services

Blood transfusion - Answer :: look at HGB increase 1-2 per unit of blood Antibiotic in TPN line - Answer :: NOTHING GOES IN TPN TPN infusion line - Answer :: change q 24 hr Family change dressing q 8hr - Answer :: square knot ties with 1-2 finger width TPN slow down infusion d/c until new bag - Answer :: do not d/c Hip arthroplasty - Answer :: watch peripheral pulses cool weak 1+ call provider Rifampin, isoniazid, phenytoin - Answer :: decrease phenytoin dosage Palpate fontanels by 2-3 yr - Answer :: DO NOT PALPATE buldgin could mean increased ICP/ meningitis First priority for DKA pts - Answer :: venous access DKA BG drops 450- 250 - Answer :: measure glucose, k+ hourly IV glucose at 250 Pt paralysis 2nd floor home - Answer :: PT respite care- SOCIAL SERVICES #1, OT, PT Highest risk to patient - Answer :: restraint tied to bed rails Scaly spots erythemic papillae - Answer :: report lips Woman contraception wants to get pregnant - Answer :: IUD ectopic pregnany (CONDOM USE) Infant substernal heaves - Answer :: O2, suction, survanta for surfactant, vent support Ptt normal level - Answer :: 25- 35 Platelets - Answer :: 150,000-400, Ptt 30 platelets 200 - Answer :: nothing wrong Delagete LPN to check - Answer :: NG tube placement (NOT FIRST FEEDING ventricular tachycardia - Answer :: widened QRS

3 month old - Answer :: graham crackers, flex and tuck Febrile cooling blanket - Answer :: shivering is adverse reaction Dig toxicity - Answer :: - 3.2 is possible Report in preterm labor - Answer :: severe headache; hypertensive crisis tuna - Answer :: high in protein and potassium anemic - Answer :: decrease milk increase iron craniotomy things to report - Answer :: aphasia, HOB increase 30 Prednisone - Answer :: not long term, risk for infection Losing 1lb in a week - Answer :: - 500 calories a day Bad sign with newborn - Answer :: disapproval diet glomerulonephritis - Answer :: low sodium, water restriction dehydrated peds - Answer :: do not give gingerale, fruit juice, or water postop colon resection - Answer :: monitor treat pain&evaluate pain relief, provide wound care using surgical aseptic technique, advise the client to use stool softners to prevent straining priority infection for amniotomy - Answer :: fever/infection stroke pt priority therapy - Answer :: speech/ABC's best to orient - Answer :: - follow nurse informed consent - Answer :: - parent of minor, spouse relative, court ordeed rep, legal guardian impaired nurse - Answer :: report to charge nurse

veracity - Answer :: med error

• PCA pump, PRN morphine - Answer :: walking talking pain management Singulair - Answer :: - once daily at bed time Peak gentamicin - Answer :: - 30 min after giving IM or after IV finished, trough before next dose Lithium level - Answer :: 0.4-1. Lithium toxicity - Answer :: slurs speech, NVD, thirst, polyuria, muscle weakness Central line push resistance - Answer :: do not push Pt with anthrax - Answer :: strip down Beta Blockers - Answer :: **** DO NOT give with ASTHMA, BRONCHIAL CONSTRICTIVE DISEASE!!!**** "LOL" Antenolol, metoprolol. labetolol Antihypertensive. Blocks beta-adrenergic receptors in heart, decreases excitability of the heart, reduces caridac workload and O2 consumption. Lowers BP. Check BP before giving (hypotension) *Orthostatic Hypotension

• Do not D/C abruptly (2wks)

*Blocks normal signs of Hypoglycemia (sweating, tachycardia). Monitor Blood glucose!! ACE inhibitors - Answer :: dry cough Dopamine - Answer :: increases cardiac output Thorazine - Answer :: hold if shuffling Fentanyl patch - Answer :: change Q 72-48 hr if intolerant Long term steroid - Answer :: loss of hair chronic emphysema ABG - Answer :: RESP, acid (low ph, low co2) Increased PAWP - Answer :: LSHF Pt umbilical prolapse - Answer :: hold in vagina GERD s/s - Answer :: atypical chest pain, SOB Reglan - Answer :: EPS (twitching, facial spasms, antihistamine) iron deficiency - Answer :: H < H < Oxygen Toxicity - Answer :: bradypnea explain irrigating with solution - Answer :: hold 1 inch above Dehisced wound - Answer :: saline soak guaze histrionic personality - Answer :: flirty and seductive Shizo findings - Answer :: - memory deficit, difficulty concentrating, disordered thinking, poor problem solving and decision making CA-125 for ovarian cancer - Answer :: hard 2 beat after biopsy Post op care for diabetes - Answer :: vitamin C Flush central line - Answer :: 10 CC Abnormal Pap smear - Answer :: cervical cancer

trying to get pregnant - Answer :: after stops may take a while Chlamydia mom and baby - Answer :: Zithromax, amoxicillin and erythromycin Decontamination radiaton - Answer :: soap and water disposable towels insulin, rotate sites or no? - Answer :: do not rotate site Valproic acid - Answer :: Liver failure/ jaundice Implementing staff changes - Answer :: - investigate issue with task force Consent from ED to do surgery - Answer :: - get official interpreter Heavy lochia boggy fundus - Answer :: - give oxytocin Autism ati - Answer :: Lack of responsiveness Frequent variable decels - Answer :: turn on left side first Post EGD - Answer :: cool, clammy skin= perforation Cytoxan for neuroblastomas in toddlers - Answer :: hydrate liberally Risk for diabetes insipidus - Answer :: - monitor for polyuria Postpartum, immediate action - Answer :: boggy uterus, massage fundus Cushings Disease - Answer :: moon face, increased cortisol Memory Loss - Answer :: ICP Equation for calculating pulse pressure - Answer :: SBD-DBP = PP Trough - Answer :: 1 hour prior to next dose Overhydration - Answer :: tachycardia, bounding pulses, hypertension, tachypnea, increased CVP, confusion, muscle weakness, wt gain, ascites, dyspnea, crackles Hyponatremia - Answer :: hypothermia, tachycardia, rapid thread pulse, hypotension, ortho hypotension, headache, condusion, decreased DTR, hyperactive bowel sounds

Hypernatremia - Answer :: hyperthermia, tachycardia, rapid thread pulse ortho hypotension, restlessness, irritability, muscle twitching, reduced to absent DTR, hyperactive bowel sounds Hyperkalemia - Answer :: slow/irregular pulse, hypotension, restlessness, irritability, flaccid paralysis, N/V/D, hyperactive bowel sounds Hypokalemia - Answer :: hyperthermia, weak irregular pulse, hypotension, resp distress, muscle cramping, pvc's, bradycardia, decreased mobility Complications hypophysectomy - Answer :: bleeding and nasal drainage csf leak, assess nuero condition q hr for 24 hr and q 4hr after Nursing intervention for preventing delays in healing - Answer :: encourage fluid intake 2 - 3L increase protein, keep serum albumin level above 3. Meds for sinus tach - Answer :: amiodarone, adenosine, verapamil, cardioversion Hyperglycemia - Answer :: bg>250, thirst, polyuria, hunger, warm dry flushed skin, weakness, malaise, rapid weak pulse, hypotension deep rapid respirations Complications of pericarditis - Answer :: cardiac tamponade, hypotension, muffled heart sounds, JVD, paradoxical pulse Pericarditis - Answer :: follows a resp infection s/s pericarditis - Answer :: - chest pressure/pain

• friction rub
• SOB
• pain relieved when sitting and leaning forward fasting blood glucose - Answer :: post pone diabetic med after levels are drawn fasted for 8hr prior to blood drawn

oral glucose tolerance test - Answer :: fasting BG, eat 30 min-2hr, bg, instruct client consume balanced diet for 3d prior then fast 10-12 hr glycosylate hemoglobin - Answer :: 120 days normal range is 4-6 diabetic range 6.5- 8 evaluating proper tube placement of NG tube - Answer :: aspirate to collect gastric contents and test ph, xray IV urography - Answer :: detect obstruction, assess parenchymal mass, size of kidney Before IV urography check - Answer :: - allergy to iodine, creatinine, Complications of chest tube insertion - Answer :: - air leaks

• monitor water seal chamber for cont bubbling,
• tension pneumothorax, - sucking chest wound,
• prolonged clamping of the tubing
• kinks in the tubing or obstructing After a rhinoplasty - Answer :: frequent swallowing is a sign of hemorrhage (TWICE PICTURE QUESTION - Answer :: stage 1 lyme disease 200lb person wants to lose 15lb what percent body weight is that?? - Answer :: Preventing phlebitis - Answer :: rotate site Q 72 hours or by policy avoid lower extremities hand hygiene surgical asepsis Care for frostbite - Answer :: - never rub!
• remove person from cold
• skin to skin contact for minor frostbite

• water bath(98.6-106F)
• tetanus What does glaucoma look like through patients eyes - Answer :: Google picture of tree Scoliosis Assessment - Answer :: - instruct pt to bed at the waist w arms reaching toward toes
• inspect and palpate down the spine using thumb and forefinger
• inspect the spine again with client standing
• Expected findings: no tenderness with spinal vertebrae that are midline To avoid contractures - Answer :: frequent position changes things to report during first trimester - Answer :: bleeding leakage of fluid contractions Preventing infection in immunocompromised pt - Answer :: - dont place stuff on floor
• dont shake linens
• clean least soiled area first
• use plastic bag for moist contaminated items
• empty all liquids used into drain Contraindication of acupuncture - Answer :: herpes zoster Primary Prevention - Answer ::