1
ATI – NCLEX PREDICTOR REMEDIATION STUDY NOTES
2026 LATEST RELEASED VERSION
Renal Calculi - Pain: Flank pain → Kidney or Ureter (if pain radiates → stones in ureter or bladder)
Performing Ear Irrigation: Sterile technique, warm meds, pull up & back, tilt toward affected ear
Thrombolytic Therapy (Stroke): Reteplase recombinant (rTPA – clot buster) w/ in 4.5 hours of initial
symptoms
Trach care: Dressing ∆, inner cannula ½ hydrogen peroxide, & stoma □ knot
Head injury (changes in LOC): Length of time unconscious & GCS
General anesthesia (post-op): ABC’s – full body assessment, Vitals every 15 minutes, Lateral position
(if unresponsive or unconscious
- monitor LOC), Fluids/Electrolytes
Superficial Burns: Painful, pink, red, mild edema (3-6 day healing), damage to epidermis
Dialysis (reporting unexpected findings): Temp of 100 degrees, ↓ BP, bleeding, 1 L of fluid =
1Kg, clotting, H/A, Nausea, Disequilibrium syndrome (rapid ↓ BUN & Fluid volume), anemia,
peritonitis, ↑ BG, ↑ cholesterol
Pacemaker (complications): Infection, hematoma, pneumothorax, hemo-thorax,
arrhythmias, pacer spikes before P or QRS, hiccups / muscle twitching
Magnesium (Mg) Sulfate → Increase Mg+ >
1.3 Mg/dL
↑ Mg foods = (Dairy, dark leafy greens
veges)
↓ Mg causes → Hyperactive deep tendon reflexes
* Paresthesia’s, muscle tetany, positive chvostek’s & Trousseau’s sign,
hypoactive bowels, constipation, abdominal distention, paralytic Ileus.
TPN Admin: (Total parenteral nutrition) -feeding that bypasses the GI tract. Fluids are given
into a vein to provide most of the nutrients the body needs. Given when person cannot/
should not receive feedings or fluids by mouth.
Hypertonic (20-50% dextrose), Used in chronic pain,
peritonitis, burns, Infection, etc No more than 10% hourly, ↑
in rate for body adjustment, check BG
,2
Hyperglycemia, hypoglycemia, vitamin deficiencies, air embolism (clamp,
place in Trendelenburg pos., O2) Fluid imbalance → Fluid volume excess
Wound Culture specimen: Sterile field, press / rotate over wound surface inside the wound (center)
in drainage
Diabetes Mellitus (Nephropathy): Kidney damage d/t prolonged ↑ BG & dehydration
Monitor I & O, Creatinine, BP
Avoid Soda, alcohol, acetaminophen/NSAIDS / 2 – 3 L fluid from food / beverages
Kidney Biopsy (Post op):
Monitor VS → Client receives sedation
Assess dressings & urinary output (hematuria-blood in urine)
Labs: HgB & Hct values, Admin PRN pain meds, Complications hemorrhage / infection
Thyroidectomy (Post Op): Needs Thyroid hormone replacement
Client in high fowler’s position, Respiratory (trach supplies) present,
Check for laryngeal nerve damage Pain management, Hypocalcemia /
Tetany can occur
Prioritization: Apply knowledge to Standards to
determine priority action Systemic before
Local – “Life before Limb”
Acute before Chronic
Actual Problems before
Potential Future Listen
carefully to clients & Don’t
Assume
Recognize & Respond - Trends vs. Transient findings
,3
Recognize indications - Emergencies vs. Expected
Delegate to LPN: Monitoring Findings, Reinforcing teaching, performing trach care,
suctioning, checking NG tube patency, administer tube feedings, inserting urinary
catheter, administering meds (No IV)
Delegate to AP: ADLs, Bathing, Grooming, Dressing, toileting, Ambulating, feeding w/out
swallowing precautions, positioning, routine tasks, bed making, specimen collection, I &
O, VS for stable clients, monitoring clinical manifestations after initial RN assess/eval.
Paracentesis (prep) - take out fluid from belly (peritoneal fluid) Have client VOID
Bariatric Surgery:
(weight loss surgery) – Semi fowlers, 6 small meals/day, liquid/pureed food for
first 6 weeks (not to exceed 1cup), Vitamin / mineral supplements, & 2 servings of protein
daily.
Ostomy (in small intestine) Avoid odorous & gas foods (dark green veges, dairy, fish,
eggs, beans, corn), yogurt ↓ gas Avoid ↑ fiber foods for first 2 months, ↑
fluid intake
Dumping Syndrome: Happens within 15mins of eating.
Sx: cramps, diarrhea, tachycardia, dizziness, fatigue, hypoglycemia
Interventions: small frequent meals, drink liquids 1hr b4/after
Parkinson’s disease: Tremor, muscle rigidity, bradykinesia (slowness in movement), postural instability
Stages:
1. Unilateral shaking / tremor of one limb
2. Bilateral limb involvement, difficulty walking/balance
3. Slowed physical movements
4. Akinesia & Rigidity make ADL’s difficult
5. Unable to stand/walk, dependent of cares, dementia
Assault: threat Battery: touching
Hypoglycemia Sx: Shakiness, confusion, sweating, tachycardia, diaphoresis, palpitations, H/A,
lack of coordination, blurred vision, seizures, coma
Oral Hypoglycemic Agents : promote insulin release from pancreas (Type2 DM)
Glipizide (Glucotrol), Chlorpropamide (Diabines), Glyburide (Diabinese), Metformin
(Glucophage).
* Med for insulin overdose = Glucagon
Radiation Adverse Effects: Skin changes, hair loss, debilitating fatigue, 30 minute visits / stays 6ft
away / private room
Infection control in clients home: good hygiene, avoid crowded areas, avoid raw foods
(veges/meats), avoid cleaning litter boxes, clean home and avoid sick family.
,4
Client evacuation in response to fire: greatest good for the greatest amount of people
Client in seclusion: 18 yo+ → 4 hours, 9 – 17 yo →2 hours, 8 yo & younger →1 hour
Conduct Disorders: lack of remorse, bullies, threatens, low self-esteem, tempers, physical
cruelty, destroys property, truant, and shoplifts
Manic Phase: ↑ mood, irritable, lasts at least a week, euphoria, agitation, restless, ↑ in
talking, flight of ideas, grandiose view of self, impulsive, manipulative, poor judgement,
attention seeking.
Paranoid: distrust / suspiciousness
Schizoid: emotional detachment, disinterest in relationships, indifferent to praise/criticism,
uncooperative
Schizotypal: odd beliefs, eccentric appearance, magical thinking, perceptual distortions
ATI – NCLEX PREDICTOR REMEDIATION STUDY NOTES
2026 LATEST RELEASED VERSION
Renal Calculi - Pain: Flank pain → Kidney or Ureter (if pain radiates → stones in ureter or bladder)
Performing Ear Irrigation: Sterile technique, warm meds, pull up & back, tilt toward affected ear
Thrombolytic Therapy (Stroke): Reteplase recombinant (rTPA – clot buster) w/ in 4.5 hours of initial
symptoms
Trach care: Dressing ∆, inner cannula ½ hydrogen peroxide, & stoma □ knot
Head injury (changes in LOC): Length of time unconscious & GCS
General anesthesia (post-op): ABC’s – full body assessment, Vitals every 15 minutes, Lateral position
(if unresponsive or unconscious
- monitor LOC), Fluids/Electrolytes
Superficial Burns: Painful, pink, red, mild edema (3-6 day healing), damage to epidermis
Dialysis (reporting unexpected findings): Temp of 100 degrees, ↓ BP, bleeding, 1 L of fluid =
1Kg, clotting, H/A, Nausea, Disequilibrium syndrome (rapid ↓ BUN & Fluid volume), anemia,
peritonitis, ↑ BG, ↑ cholesterol
Pacemaker (complications): Infection, hematoma, pneumothorax, hemo-thorax,
arrhythmias, pacer spikes before P or QRS, hiccups / muscle twitching
Magnesium (Mg) Sulfate → Increase Mg+ >
1.3 Mg/dL
↑ Mg foods = (Dairy, dark leafy greens
veges)
↓ Mg causes → Hyperactive deep tendon reflexes
* Paresthesia’s, muscle tetany, positive chvostek’s & Trousseau’s sign,
hypoactive bowels, constipation, abdominal distention, paralytic Ileus.
TPN Admin: (Total parenteral nutrition) -feeding that bypasses the GI tract. Fluids are given
into a vein to provide most of the nutrients the body needs. Given when person cannot/
should not receive feedings or fluids by mouth.
Hypertonic (20-50% dextrose), Used in chronic pain,
peritonitis, burns, Infection, etc No more than 10% hourly, ↑
in rate for body adjustment, check BG
,2
Hyperglycemia, hypoglycemia, vitamin deficiencies, air embolism (clamp,
place in Trendelenburg pos., O2) Fluid imbalance → Fluid volume excess
Wound Culture specimen: Sterile field, press / rotate over wound surface inside the wound (center)
in drainage
Diabetes Mellitus (Nephropathy): Kidney damage d/t prolonged ↑ BG & dehydration
Monitor I & O, Creatinine, BP
Avoid Soda, alcohol, acetaminophen/NSAIDS / 2 – 3 L fluid from food / beverages
Kidney Biopsy (Post op):
Monitor VS → Client receives sedation
Assess dressings & urinary output (hematuria-blood in urine)
Labs: HgB & Hct values, Admin PRN pain meds, Complications hemorrhage / infection
Thyroidectomy (Post Op): Needs Thyroid hormone replacement
Client in high fowler’s position, Respiratory (trach supplies) present,
Check for laryngeal nerve damage Pain management, Hypocalcemia /
Tetany can occur
Prioritization: Apply knowledge to Standards to
determine priority action Systemic before
Local – “Life before Limb”
Acute before Chronic
Actual Problems before
Potential Future Listen
carefully to clients & Don’t
Assume
Recognize & Respond - Trends vs. Transient findings
,3
Recognize indications - Emergencies vs. Expected
Delegate to LPN: Monitoring Findings, Reinforcing teaching, performing trach care,
suctioning, checking NG tube patency, administer tube feedings, inserting urinary
catheter, administering meds (No IV)
Delegate to AP: ADLs, Bathing, Grooming, Dressing, toileting, Ambulating, feeding w/out
swallowing precautions, positioning, routine tasks, bed making, specimen collection, I &
O, VS for stable clients, monitoring clinical manifestations after initial RN assess/eval.
Paracentesis (prep) - take out fluid from belly (peritoneal fluid) Have client VOID
Bariatric Surgery:
(weight loss surgery) – Semi fowlers, 6 small meals/day, liquid/pureed food for
first 6 weeks (not to exceed 1cup), Vitamin / mineral supplements, & 2 servings of protein
daily.
Ostomy (in small intestine) Avoid odorous & gas foods (dark green veges, dairy, fish,
eggs, beans, corn), yogurt ↓ gas Avoid ↑ fiber foods for first 2 months, ↑
fluid intake
Dumping Syndrome: Happens within 15mins of eating.
Sx: cramps, diarrhea, tachycardia, dizziness, fatigue, hypoglycemia
Interventions: small frequent meals, drink liquids 1hr b4/after
Parkinson’s disease: Tremor, muscle rigidity, bradykinesia (slowness in movement), postural instability
Stages:
1. Unilateral shaking / tremor of one limb
2. Bilateral limb involvement, difficulty walking/balance
3. Slowed physical movements
4. Akinesia & Rigidity make ADL’s difficult
5. Unable to stand/walk, dependent of cares, dementia
Assault: threat Battery: touching
Hypoglycemia Sx: Shakiness, confusion, sweating, tachycardia, diaphoresis, palpitations, H/A,
lack of coordination, blurred vision, seizures, coma
Oral Hypoglycemic Agents : promote insulin release from pancreas (Type2 DM)
Glipizide (Glucotrol), Chlorpropamide (Diabines), Glyburide (Diabinese), Metformin
(Glucophage).
* Med for insulin overdose = Glucagon
Radiation Adverse Effects: Skin changes, hair loss, debilitating fatigue, 30 minute visits / stays 6ft
away / private room
Infection control in clients home: good hygiene, avoid crowded areas, avoid raw foods
(veges/meats), avoid cleaning litter boxes, clean home and avoid sick family.
,4
Client evacuation in response to fire: greatest good for the greatest amount of people
Client in seclusion: 18 yo+ → 4 hours, 9 – 17 yo →2 hours, 8 yo & younger →1 hour
Conduct Disorders: lack of remorse, bullies, threatens, low self-esteem, tempers, physical
cruelty, destroys property, truant, and shoplifts
Manic Phase: ↑ mood, irritable, lasts at least a week, euphoria, agitation, restless, ↑ in
talking, flight of ideas, grandiose view of self, impulsive, manipulative, poor judgement,
attention seeking.
Paranoid: distrust / suspiciousness
Schizoid: emotional detachment, disinterest in relationships, indifferent to praise/criticism,
uncooperative
Schizotypal: odd beliefs, eccentric appearance, magical thinking, perceptual distortions
