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ATI Comprehensive 2023
Predictor Study Notes (updated 2020) – Rasmussen
College
ATI – NCLEX Predictor Remediation Study Notes
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
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, 2
epidermis
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, 2
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
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
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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
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)
Downloaded by jane murage
()
ATI Comprehensive 2023
Predictor Study Notes (updated 2020) – Rasmussen
College
ATI – NCLEX Predictor Remediation Study Notes
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
Downloaded by jane murage
()
, 2
epidermis
Downloaded by jane murage
()
, 2
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
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
Downloaded by jane murage
()
, 3
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
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)
Downloaded by jane murage
()
