ATI RN MED SURG 2 PROCTORED EXAM ACTUAL EXAM ALL 70 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) ALREADY GRADED A+ when can you not preform head-tilt/chin-lift? - ANSWERc spine injury when to use modified jaw thrust

ATI RN MED SURG 2 PROCTORED EXAM ACTUAL EXAM ALL 70 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) ALREADY GRADED A+ when can you not preform head-tilt/chin-lift? - ANSWERc spine injury when to use modified jaw thrust maneuver? - ANSWERtrauma when is tetanus toxoid IM vaccine given? - ANSWERThis is given to patients with frostbite what degree of water to bath frostbite patient? - ANSWER104-108* F What temp is considered hypothermia? - ANSWERCore or 95F or below what temperature is considered heat stroke - ANSWERcore temp of 104 or above two vital signs of heat stroke? - ANSWERlow BP, high HR will a patient with heat stroke sweat? - ANSWERNo. when is it ok to apply ice packs to overheated patient? - ANSWERheat stroke. what IV fluids to give during heat stroke - ANSWER0.9% sodium chloride what age group are highest risk for snake bite? - ANSWERAges 1-9 list 4 things that are contraindicated after snake bite, and for how long? - ANSWERice, tourniquet, heparin, corticosteroids in the first 6-8 hours after being bit how often to assess tissue edema after being bit my spider or snake? - ANSWERevery 15-30 minutes is syrup of ipecac recommended after snake bit? - ANSWERNo, not anymore list 3 ways to remove snake venom? - ANSWERactivated charcoal gastric lavage aspiration how soon must gastric lavage be done after snake bite? - ANSWERone hour. what are the 5 H causes of PEA? - ANSWERhypovolemia, hypoxia, hydrogen ions (acidosis), hypo/hyperkalemia, hypothermia what are the 5 Ts that can cause PEA? - ANSWERtoxins, tamponade, tension pneumo, thrombosis(coronary or pulmonary) what med should you avoid taking with MAOIs? - ANSWERepi where to place extremities after snake bite? - ANSWERat heart level, not above or below. what pain meds to give after snake bite? - ANSWERopioids what is the goal of Erythropoietin? - ANSWERincrease hematocrit level in patients with anemia, which increases energy two foods high in tyramine? - ANSWERaged cheeses and smoked sausage should pt use heat therapy on radiation site? - ANSWERNo, this can further irritation. how long should it take to infused a unit of packed RBCs - ANSWER2-4hours what does a cerebral angiography do? - ANSWERprovides visualization of cerebral blood vessels what does an angiography detect? (3) - ANSWERnarrowing, obstruction or defects of vessels. does an angiography use iodine based contrast? - ANSWERyes what can be given through an angiography? - ANSWERchemo or meds that prevent/treat blood clots. how long should pt be NPO before angiography? - ANSWER4-6hours. can a pregnant woman get an angiography - ANSWERif benefits outweigh risks. should you void before or after angiography - ANSWERimmediately before how to position client for angiography? - ANSWERSupine with head/neck immobilized where is catheter usually placed for an angiography? - ANSWERfemoral artery. how is an angiography preformed? why is this done (2) - ANSWERA catheter is threaded through an artery up into the brain for detection or admin of drugs. how to position legs after amniography? - ANSWERkeep legs straight what does an EEG monitor - ANSWERelectrical activity/brain waves in the brain should you wash hair before EEG? - ANSWERyes what to avoid 12-24 hours before EEG (2) - ANSWERstimulants and sedatives when can a pt resume normal activity after EEG - ANSWERimmediately is NPO required for an EEG, - ANSWERno. What is ICP monitoring? - ANSWERdevice is inserted into cranial cavity to assess icp what GCS requires ICP monitoring - ANSWER8 or less. what is normal icp? - ANSWER10-15 how long should you limit ICP monitoring to? - ANSWER3-5 days. another name for lumbar puncture - ANSWERspinal tap Why is a lumbar puncture done? - ANSWERto examine csf or administer meds what can happen if you preform a lumbar puncture on someone with increased icp? - ANSWERbrain herniation what can happen if you preform a lumbar puncture on someone with a bleeding disorder - ANSWERblood can compress the spinal cord should pt void before or after lumbar puncture - ANSWERbefore why is an mri safer than a CT for a pregnant woman - ANSWERan mri uses magnets, a CT uses radiation who cannot get an mri - ANSWERpt with pacemaker what is a ventriculostomy - ANSWERintraventricular catheter for icp monitoring two examples of acute pain - ANSWERwound from injury surgery site healing two examples of chronic pain - ANSWERneuropathy and osteoarthritis What is nociceptive pain? - ANSWERdamage to body tissue two types of nociceptive pain - ANSWERsomatic and visceral where is somatic pain located - ANSWERskin, muscles, joints, bones where is visceral pain located - ANSWERinternal organs Where does neuropathic pain come from? - ANSWERfrom damaged nerves Examples of neuropathic pain (3) - ANSWER- Diabetic neuropathy - spinal cord injury - phantom limb what does neuropathic pain feel like? - ANSWERshooting, tingling, burning "pins & needles" What are meninges? - ANSWERmembranes that surround & protect the brain and spinal cord what are the two types of meningitis? - ANSWERbacterial and viral which meningitis's can resolve on its own without treatment? - ANSWERviral What does the Hib vaccine protect against? - ANSWERbacterial meningitis When is the Hib vaccine given? - ANSWER2,4,6, 12-15months (4 doses) What is nuchal rigidity? - ANSWERneck stiffness list 4 s/s of meningitis - ANSWERfever headache n/v photophobia list 2 positive signs a pt with meningitis will have - ANSWERpositive brudzinski's positive kernig's what indicates a positive brudzinksi's sign? - ANSWER what indicates a positive kernigs sign? - ANSWERflex in knees when head is pushed towards chest in a supine position what indicates a positive Kernigs sign - ANSWERstart with patients knees bent, patient is unable to straighten out leg. how to officially diagnose meningitis - ANSWERcsf sample through lumbar puncture what type of meningitis will have hypoglycemia - ANSWERbacterial which type of meningitis has clear csf? - ANSWERviral which type of meningitis has cloudy csf - ANSWERbacterial list 2 labs that will be elevated with meningitis - ANSWERWBC & protein what can be a secondary complication of meningitis - ANSWERpneumonia which meningitis may require continuous isolation? - ANSWERbacterial - droplet what position to have pt in with meningitis - ANSWERflat with HOB @ 30. should pt with meningitis be on bed rest? - ANSWERyes What can meningitis cause? - ANSWERseptic shock what to avoid administering in a pt with increased icp? - ANSWERopioids how often to do neuro checks on a pt with increased icp? - ANSWERevery 2 hours - at least what does the pneumococcal vaccine do? - ANSWERreduce risk of respiratory infection can meningitis cause bradycardia or tachycardia - ANSWERtachycardia which meningitis will you have a positive gram stain - ANSWERbacterial which meningitis will you have a negative gram stain - ANSWERviral what seizures are most common in infants & children under 2 years - ANSWERfebrile how many & what are the names of each category of seizures - ANSWERthere are 3 1. generalized 2. partial or focal/local 3. idiopathic/unclassified definition of a general seizure - ANSWERinvolves both hemispheres of brain how many types of generalized seizures are there? - ANSWERFIVE What is an atonic seizure? - ANSWERloss of muscle tone What is a myoclonic seizure? - ANSWERcontractions of single muscles or muscle groups - no loss of consciousness main way to diagnose a seizure ? - ANSWEREEG. what is a tonic clonic seizure - ANSWERloss of consciousness with stiffening and jerking what is a tonic seizure - ANSWERstiffening of muscle groups what is a clonic seizure - ANSWERRhythmic jerking of extremities list the 5 generalized seizures - ANSWER1 tonic clonic 2 tonic 3 clonic 4 myoclonic 5 atonic or akinetic what is the drug class of Phenytoin? - ANSWERHydantoin Anticonvulsant what can Phenytoin lower the effect of? - ANSWERoral contraceptive what does Phenytoin do to Warfarin? - ANSWERincrease metabolism of the drug - do not take together What is status epilepticus? - ANSWERSeizures that last longer than 5 minutes or 2 or more seizure in 30minutes. Is status epilepticus a medical emergency? - ANSWERYES! what IV push to give for status epilepticus? - ANSWERdiazepam or lorazepam when to use vagal nerve stimulation? - ANSWERtreatment of partial seizures when to avoid microwave oven? - ANSWERif pt has a vagal nerve stimulator where is the vagal nerve stimulator located? - ANSWERleft chest wall what can a patient do if they have a vagal nerve stimulator & have a seizure? - ANSWERhold magnet over site What is bradykinesia? - ANSWERslow movement list the four most common symptoms of Parkinson's - ANSWERtremor, muscle rigidity, bradykinesia, postural instability what does Parkinson's cause - ANSWERdecreased dopamine production what age group does Parkinson's typically begin? - ANSWERage 40-70 Is Parkinson's more common in men or women? - ANSWERmen what is the definite diagnosis of Parkinson's? - ANSWERThere isn't one how many types of anesthesia are there? - ANSWER3. list the types of anesthesia - ANSWERgeneral, regional and local example of regional anesthesia - ANSWERspinal block or epidural What is local anesthesia? - ANSWERtopical application of agent how long should pt be NPO post op? - ANSWERuntil gag telex returns how often to check vitals post op - ANSWERevery 5-15 minutes what is the PACU - ANSWERpost anesthesia care unit (recovery unit) two most common antidotes post op - ANSWERnaloxone & flumazenil most common two complications post op - ANSWERshock & hemorrhage normal range for WBC - ANSWER5,000-10,000 What is leukopenia? - ANSWERwbc count below 4k What is leukocytosis? - ANSWERwbc above 10k. what procedure can cause high wbc? - ANSWERsplenectomy what does a vaccine do? - ANSWERproduces antibodies against certain microbes what two things can vaccines be made from? - ANSWERkilled or live (weakened) viruses. what are the two types of immunity - ANSWERactive & passive. What is active immunity? - ANSWERbody makes antibodies in response to entry of antigens What is passive immunity? - ANSWERantibodies are transferred from another source which cells do HIV target - ANSWERHelper T cells what infection do all pregnant woman get tested for - ANSWERHIV how soon do you start to see symptoms of HIV after infection? - ANSWER2-4 weeks what can HIV infection mimic - ANSWERflu - also cause a rash how long can pt with HIV remain asymptomatic after initial infection? - ANSWERup to 10 years how long can the AIDS stage last before death - ANSWER5 years what is the 3rd stage of HIV also known as? - ANSWERAIDS what foods should a pt with HIV avoid? - ANSWERraw foods - fruits & veggies uncooked eggs what household chore should pt with HIV avoid? - ANSWERchanging litter box what does SLE stand for - ANSWERsystemic lupus erythematosus what is SLE - ANSWERchronic inflammatory disorder of the connective tissue of organ systems How to diagnose DLE - ANSWERskin biopsy How to diagnose SLE? - ANSWERimmunological tests what can SLE lead to - ANSWERorgan failure What does DLE stand for? - ANSWERdiscoid lupus erythematosus what does DLE effects - ANSWERonly the skin which type of lupus is temporary - ANSWERmedication induced lupus Are men or woman more like to get lupus - ANSWERwoman what age group is most likely to get lupus - ANSWER20-40 list 3 nationalities that have increased risk of lupus - ANSWERnative American, hispanic & asian. What are antinuclear antibodies? (ANA) - ANSWERantibodies produced against one's own DNA patients with what disease have ANA - ANSWERlupus list 2 s/s of renal compromise in pt with lupus - ANSWER1. hypertension 2. edema what diet considerations for pt with lupus - ANSWERsmall, frequent meals. offer meal supplements between eating why should a patient with lupus limit salt intake - ANSWERthey're prescribed steroids, so this can cause fluid retention When are NSAIDs contraindicated? - ANSWERimpaired kidney function list 2 things a patient with lupus should avoid - ANSWERUV exposure & large crowds Example of dry heat injury? - ANSWERthese result from open flames (fire, explosions) most common heat injury seen in children & geri - ANSWERdry heat (steam) example of contact burns - ANSWERhot metal, tar, grease makes contact with skin how often to clean chimney & fireplace - ANSWERyearly what is an autograft - ANSWERskin from another part of patients body rule of 9 - legs - ANSWER9% on each side of each leg what percent is burned if both legs, front & back are burned, - ANSWER36% rule of 9's - face - ANSWER4.5% rule of 9's - back of head - ANSWER4.5% what is the percentage burnt if front & back of head is burned? - ANSWER9% rule of 9's - genitalia - ANSWER1% rule of 9's - arms - ANSWER4.5 for both front & back, each arm what percentage is burned if both arms are burned on both sides? - ANSWER18% rule of 9's - back - ANSWER18% , upper half is 9 & lower half is 9 rule of 9's - chest/torso - ANSWER18% , upper half is 9 & lower half is 9 how many phases of burn care are there? list them - ANSWER3 : emergent, acute, rehab when does emergent phase of burn begin & end - ANSWERbegins with injury, lasts 24-48 hours when does the acute burn phase start & end - ANSWER36-48 hours, when fluid shift resolves. ends with closure of wound does glucose decrease or increase with burns - ANSWERincrease as a stress response what med to not take with sildenafil - ANSWERnitro what can a night cough indicate, - ANSWERheart failure how often to preform self exam of testes - ANSWERonce a month what herb effects atrovastatin - ANSWERst. john's wart