ATI RN MEDICAL-SURGICAL PROCTORED PRACTICE EXAM LATEST EDITION

ATI RN MEDICAL-SURGICAL PROCTORED PRACTICE EXAM LATEST EDITION Endoscopy (EGD) positioning - CORRECT ANSWER-left side lying Before an Endoscopy (EGD): - CORRECT ANSWER--NPO 6-8 hr -remove dentures Gastroenteritis care plan: - CORRECT ANSWER--restrict dairy, caffeine, milk -eat foods high in potassium -increase fluid intake -contact precautions In what order do you open the sterile package? - CORRECT ANSWER-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 - CORRECT ANSWER-D A nurse is wearing sterile gloves in prep for performing a sterile procedure. Which of the following objects can the nurse touch 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 - CORRECT ANSWER-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 - CORRECT ANSWER-B, C, D TB is suspected, what precautionary actions to do? - CORRECT ANSWER--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: - CORRECT ANSWER--family members should be screened -4 meds taken for 6-12 months -not contagious when they have 3 negative sputum cultures What to watch for when on Isoniazid: - CORRECT ANSWER-numb/tingling in the hands & feet What to watch for when on Rifampin: - CORRECT ANSWER--orange secretions normal -watch for jaundice -interferes with birth control What to watch for when on Ethambutol: - CORRECT ANSWER-vision changes Client teaching for genital herpes: - CORRECT ANSWER--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: - CORRECT ANSWER--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 High sodium foods clients with HF & Pulmonary edema should avoid: - CORRECT ANSWER--cheese -soups -bread -cold cuts/cured meats -pizza -eggs & omelets -hot dogs -baked ham Which non-opioid drug decreases the effect of aspirin? - CORRECT ANSWERibuprofen Ketorolac should not be used concurrently with... - CORRECT ANSWER-other NSAIDS Glucocorticoids increase the risk of gastric bleeding when taken with... - CORRECT ANSWER-non-opioid analgesics To access an implanted port, you must use a... - CORRECT ANSWER-noncoring (Huber) needle When done accessing an implanted port... - CORRECT ANSWER-flush with 10 mL 0.9% sodium chloride Therapeutic effects of furosemide (Lasix) - CORRECT ANSWER--decreases preload of the heart -decreases potassium levels -increases urine output -decrease BP -decrease edema Valsartan for HF expected outcomes/findings: - CORRECT ANSWER--vasodilation -excretion of sodium & water -reduces BP -reduces risk of mortality in post-MI pts left w/vent dysfunction Expected findings of meds that increase urinary output (diuretics): - CORRECT ANSWER--decreased potassium -weight loss -decrease in edema -decreased calcium -increased urine output -decreased BP -decrease in ICP & IOP Client teaching for Nitroglycerin: - CORRECT ANSWER-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? - CORRECT ANSWER-dark leafy green veggies Client teaching for anticoagulant therapy: - CORRECT ANSWER--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: - CORRECT ANSWER--furosemide (Lasix) -aldactone (potassium sparing diuretic) -hydrochlorothiazide (diuretic) -verapamil, dilitiazem (CCB) -captopril, lisinopril (ACE inhibitors) -losartan, telmisartan (ARBs) -eplerenone -atenolol, metoprolol (Beta blockers) -clonidine -prazosin (minipress) Contraindications for Nadolol: - CORRECT ANSWER--asthma -sinus bradycardia -cardiogenic shock -cardiac failure -diabetes -pregnancy -right side HF -emphysema -severe COPD Treatment for diabetes insipidus: - CORRECT ANSWER--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: - CORRECT ANSWER--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 - CORRECT ANSWER-0.8 g Caring for a client who has pancreatitis: - CORRECT ANSWER--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: - CORRECT ANSWER--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? - CORRECT ANSWER-med=atropine elec= pacemaker insertion What med/meds do you give for AFib? What electrical management? - CORRECT ANSWER-meds= amiodarone, adenosine, verapamil elec= synchronized cardioversion What med/meds do you give for SVT? What electrical management? - CORRECT ANSWER-meds= amiodarone, adenosine, verapamil elec= synchronized cardioversion What med/meds do you give for V-tach w/a pulse? What electrical management? - CORRECT ANSWER-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? - CORRECT ANSWER-meds= amiodarone, lidocaine, & ep