ATI RN Medical-Surgical Proctored Focus questions and answers 2023

EGD positioning left side lying Before an EGD: -NPO 6-8 hr -remove dentures 00:35 01:20 ( infectious diarrhea) -restrict dairy, caffeine -eat foods high in potassium -increase fluid intake -contact precautions Gastroenteritis care plan: In what order do you open the sterile package? flap furthest from body, side flaps, then closest A nurse has removed a sterile pack from its outside cover and place it on a clean work surface in preparation for an invasive procedure. Which of the following flaps should the nurse unfold first: A. closest to body B. right side C. left side D. farthest from body D A nurse is wearing sterile gloves in prep for performing a sterile procedure. Which of the following objects can the nurse tough without breaking sterile technique (Select all that apply) A. bottle containing sterile solution B. edge of sterile drape at the base of the field C. inner wrapping of an item on the sterile field D. irrigation syringe on the sterile field E. one gloved hand with the other gloved hand C, D, E A nurse has prepared a sterile field for assisting a provider with a chest tube insertion. Which of the following events should the nurse recognize as contaminating the field (Select all that apply) A. provider drops a sterile instrument onto the near side of the sterile field B. nurse moistens a cotton ball with sterile normal saline and places it on sterile field C. procedure is delayed 1hr because the provider receives an emergency call D. nurse turns to speak to someone who enters through the door behind the nurse E. clients hand brushes against the outer edge of the sterile field B, C, D TB is suspected, what to do? -negative airflow room, airborne precautions -nurses wear N95 mask, client wears if going out of the room -admin heat & humidified O2 therapy as prescribed TB interventions: -family members should be screened -4 meds taken for 6-12 months -not contagious when they have 3 negative sputum cultures Rifampin Isoniazid adverse effects tingling in hand and feet What to watch for when on Rifampin: -orange secretions normal -watch for jaundice -interferes with birth control What to watch for when on Ethambutol: vision changes 00:08 01:20 Client teaching for genital herpes: -can be transmitted with or w/out blisters -sexual partners should be informed & screened -no cure, just meds to help w/symptoms -abstain from intercourse until lesions are completely healed -gently clean areas w/mild soap & water Caring for a client following a stroke of the right side with left-sided hemipalegia: -thicken liquids/foods -high fowlers -speech therapist for helping w/eating & speech -monitor gag reflex/swallowing abilities -have suction equipment available -occupational therapy -support left arm with pillows, slings, etc What high sodium foods clients with HF & Pulmonary edema should avoid: -cheese -soups -bread -cold cuts/cured meats -pizza -eggs & omelets -hot dogs -baked ham Which non-opioid drug decreases the effect of aspirin? ibuprofen Ketorolac should not be used concurrently with... other NSAIDS Glucocorticoids increase the risk of gastric bleeding when taken with... non-opioid analgesics To access an implanted port, you must use a... noncoring (Huber) needle When done accessing an implanted port... flush with 10 mL 0.9% sodium chloride Therapeutic effects of Furosemide Decrease in: preload of the heart potassium levels BP edema -increases urine output Valsartan for HF expected outcomes/findings: -vasodilation -excretion of sodium & water -reduces BP -reduces risk of mortality in post-MI pts left w/vent dysfunction Expected findings of meds that affect urinary output (diuretics): -decreased potassium -weight loss -decrease in edema -decreased calcium -increased urine output -decreased BP -decrease in ICP & IOP Client teaching for Nitroglycerin: 1. stop activity & rest 2. place nitro tab under tongue 3. if pain is unrelieved in 5 min, call 911 or go to ED 4. take 2 or more doses at 5 min intervals -headache is a common side effect of nitro Which foods should the client on Warfarin avoid? dark leafy green veggies Client teaching for anticoagulant therapy: -bleeding precautions -no added meds that increase bleeding -on it for 6-8 weeks prior to hematologic dx procedure -must have blood levels checked often -monitor vitamin K in their diet Expected prescriptions for Hypertension: -furosemide -aldactone -hydrochlorothiazide -verapamil -dilitiazem -captopril, lisinopril -losartan, telmisartan -eplerenone -atenolol -metoprolol -clonidine -prazosin (minipress) Contraindications for Nadolol: -asthma -sinus bradycardia -cardiogenic shock -cardiac failure -diabetes -pregnancy -right side HF -emphysema -severe COPD Treatment for diabetes insipidus: -daily weights -no caffeine or alcohol -desmopressin acetate/DDVAP -aqueous vasopressin/Pitressin -carbamazepine (tegretol) -high fiber diet Meds for DI, what to look out for/do: -adjust based on urine output -daily weights -inform of weight gain of 2 lb in 24 hr -notify if headaches or confusion occur -monitor for infection -monitor for dizziness/drowsiness Protein requirement of an adult: _____g of protein per kg 0.8 g Caring for a client who has pancreatitis: -keep NPO -NG tube to suction gastric contents -low fat, high protein, high carb diet Risk factors: -high fat diet -excessive alcohol consumption -age Expected lab findings for a client with pancreatitis: -increased amylase & lipase -increased WBC -decreased platelets -increased glucose -increased liver enzymes & bilirubin -elevated ESR -decreased calcium & magnesium What med do you give for symptomatic bradycardia? What electrical management? med=atropine elec= pacemaker insertion What med/meds do you give for AFib? What electrical management? meds= amiodarone, adenosine, verapamil elec= synchronized cardioversion What med/meds do you give for SVT? What electrical management? meds= amiodarone, adenosine, verapamil elec= synchronized cardioversion What med/meds do you give for V-tach w/a pulse? What electrical management? meds= amiodarone, adenosine, verapamil elec= synchronized cardioversion What med/meds do you give for V-tach w/out a pulse or V-fib? What electrical management? meds= amiodarone, lidocaine, & epi elec= defibrillation V-tach V-tach V-fib V-fib SVT SVT brady brady AV block AV block If a pt with a catheter is complaining of pain and there is no irrigation fluid coming out of the catheter what will the priority nursing action be? irrigate catheter with saline solution If the pt has had their prostate removed and the irrigating 3 way catheter shows bright red clotted blood being released from the end what should you do? increase the flow rate What assessment finding would be a cause for concern in an immobile pt? diminished pedal pulses redness/edema in legs How would you care for a pt with a stage III pressure ulcer? Apply proteolytic enzymes What would be an appropriate nursing intervention for a stage II pressure ulcer in the heel? increase IV fluids pillow/sheet under ankle What foods would you teach a pt suffering from cholescystitis to eliminate from their diet at home? fried eggs (inflammation of the gallbladder) What assessment finding would lead you to believe a pt suffers from Hypovolemia? increased blood osmolarity What lab finding would you expect in a pt receiving chemotherapy? decreased WBC