Advanced Med-Surg Proctored ATI EXAM VERIFIED SOLUTIONS, SCORED A+.

Advanced Med-Surg Proctored ATI EXAM
VERIFIED SOLUTIONS, SCORED A+



Arterial .Blood .Gas .- .CORRECT .ANSWER-ABG's .via .arterial .puncture .or .arterial
.line: .allows .the .most .accurate .method .of .assessing .respiratory .function.


Steps .for .collecting .ABG's .- .CORRECT .ANSWER-a. .Perform .Allen .test .if .no
.arterial .line
b. .sample .is .drawn .into .heparinized .syringe
c. .keep .on .ice .and .transport .to .laboratory .immediately
d. .document .amount .and .method .of .oxygen .delivered .for .accurate .results
e. .apply .direct .pressure .to .puncture .site .at .least .5 .min .(longer .for .clients .at .risk
.for .bleeding)


Bronchoscopy .- .CORRECT .ANSWER-visualizes .the .larynx, .trachea, .bronchi;
.obtains .tissue .biopsy; .and .removes .foreign .bodies.


Steps .for .a .bronchoscopy .procedure .- .CORRECT .ANSWER-a. .obtain .informed
.consent
b. .maintain .NPO .8 .to .12 .hr.
c. .Provide .local .anesthetic .throat .spray
d. .position .upright
e. .administer .medications .as .prescribed, .such .as .atropine .(to .reduce .oral
.secretions), .sedation, .and/or .anti-anxiety.
f. .label .specimen
g. .observe .postprocedure
-gag .reflex
-bleeding
-respiratory .status, .vital .signs, .and .level .of .consciousness

Mantoux .test .- .CORRECT .ANSWER-Positive .test .indicates .exposure .to
.tuberculosis. .Diagnosis .must .be .confirmed .with .sputum .culture .for .presence .of
.acid-fast .bacillus .(AFB).


Mantoux .test .steps .- .CORRECT .ANSWER-a. .administer .0.1 .mL .of .purified
.protein .derivation .intradermal .to .upper .half .inner .surface .of .forearm .(insert
.needle .bevel .up)
b. .Assess .for .reaction .in .48 .to .72 .hr .following .injection; .induration .(hardening)
.of .10 .mm .or .greater .is .considered .a .positive .test; .5 .mm .may .be .considered
.significant .if .immunocompromised.

,QuantiFERON-TB .Gold .test .(QFT-GT) .and .T-SPOT.TB .- .CORRECT .ANSWER-
Identify .the .presence .of .Mycobacterium .tuberculosis .infection .by .measuring .the
.immune .response .to .the .TB .bacteria .in .whole .blood.


Thoracentesis .- .CORRECT .ANSWER-Surgical .perforation .of .the .pleural .space .to
.obtain .specimen, .to .remove .fluid .or .air, .or .to .instill .medication.


Steps .for .Thoracentesis .- .CORRECT .ANSWER-a. .informed .consent
b. .educate .client: .remain .still, .feeling .of .pressure, .positioning
c. .position .upright
d. .monitor .respiratory .status .and .vital .signs
e. .label .specimens
f. .Document .client .response, .amount, .color .and .viscosity .of .fluid .(maximum
.amount .of .fluid .to .be .removed .at .a .time .is .1L).
g. .Chest .tube .at .bedside
h. .Obtain .CXR .before .and .after .procedure

Asthma .- .CORRECT .ANSWER-Chronic .inflammatory .disorder .of .the .airways
.resulting .in .intermittent .and .reversible .airflow .obstruction .of .the .bronchioles.


Contributing .factors .of .asthma .- .CORRECT .ANSWER--Extrinsic: .antigen-
antibody .reaction .triggered .by .food, .medications, .or .inhaled .substances
-Intrinsic: .pathophysiological .abnormalities .within .the .respiratory .tract
-Older .clients: .beta .receptors .are .less .responsive .to .agonist .and .trigger
.bronchospasms.


Manifestations .of .asthma .- .CORRECT .ANSWER--Sudden, .severe .dyspnea .with
.use .of .accessory .muscles
-sitting .up, .leaning .forward
-diaphoresis .and .anxiety
-wheezing, .gasping
-coughing
-cyanosis .(late .sign)
-barrel .chest

Diagnostic .procedures .for .asthma .- .CORRECT .ANSWER--ABGs
-sputum .cultures
-pulmonary .function .tests

Nursing .interventions .for .asthma .- .CORRECT .ANSWER--remain .with .the .client
.during .the .attack
-position .in .high-fowler's .
-assess .lung .sounds .and .pulse .oximetry
-administer .oxygen .therapy
-maintain .oxygen .access

Medications .for .athma .- .CORRECT .ANSWER-Administer .bronchodilators .before
.anti-inflammatory
1. .Bronchodilators

, -short-acting .inhaled: .albuterol; .for .rapid .relief
-Methylxanthines: .theophylline; .monitor .therapeutic .range .for .toxicity.
2. .Anti-inflammatory
-corticosteriods: .fluticasone .and .prednisone
-Leukotriene .antagonist: .montelukast
3. .Combination .agents
-Ipratropium .and .albuterol .(Combivent)
-Fluticasone .and .salmeterol .(Advair)

Therapeutic .measures .for .asthma .- .CORRECT .ANSWER--respiratory .treatments
-oxygen .administration

Client .Education .for .asthma .- .CORRECT .ANSWER--avoidance .of .allergens .and
.triggers
-proper .use .of .inhaler .and .peak .flow .monitoring

Status .asthmaticus .- .CORRECT .ANSWER-life-threatening .episode .of .airway
.obstruction .this .is .often .unresponsive .to .treatment


Manifestations .of .status .asthmaticus .- .CORRECT .ANSWER--extreme .wheezing
-labored .breathing
-use .of .accessory .muscles
-distended .neck .veins
-high .risk .for .cardiac .and/or .respiratory .arrest

Nursing .interventions .for .status .asthmaticus .- .CORRECT .ANSWER--place .in
.high-fowler's .
-prepare .for .emergency .intubation
-administer .oxygen, .epinephrine, .and .systemic .steroid .as .prescribed
-provide .emotional .support

Chronic .Obstructive .Pulmonary .Disease .- .CORRECT .ANSWER-encompasses
.pulmonary .emphysema .and .chronic .bronchitis. .COPD .is .not .reversible.


Pulmonary .emphysema .- .CORRECT .ANSWER--destruction .of .alveoli, .narrowing
.of .bronchioles, .and .trapping .of .air .resulting .in .loss .of .lung .elasticity


Contributing .factors .of .pulmonary .emphysema .- .CORRECT .ANSWER--cigarette
.smoking .(main .causative .factor); .passive .smoke .inhalation
-advanced .age
-exposure .to .air .pollution
-Alpha-antitrypsin .deficiency .(inability .to .break .down .pollutants)
-Occupational .dust .and .chemical .exposure

Manifestations .of .emphysema .- .CORRECT .ANSWER--dyspnea .with .productive
.cough
-difficult .exhalation, .use .of .pursed-lip .breathing
-wheezing, .crackles
-barrel .chest