ATI RN ADV MEDSURG PROCTORED EXAM CLASSROOM//// ATI RN ADV MEDSURG PROCTORED EXAM CLASSROOM//// ATI RN ADV MEDSURG PROCTORED EXAM CLASSROOM

1/6/24, 1:10 PM ATI RN ADV MEDSURG PROCTORED EXAM
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Med-Surg ATI Practice Exam Concepts

o Crutches
 Place body weight on crutches
 Advance unaffected leg onto the stair
 Shift weight from crutches to unaffected leg
 Bring crutches and affected leg up to the stair
o Closed-suction drain nursing interventions
 Negative-pressure device
 Doesn’t require wall suction
 *Compress the drain reservoir after emptying (creates negative pressure)
 Do not need to put below bed (doesn’t use gravity)
o External fixation device
 Surgeon applies the external fixation device directly to the client’s bone to form a
rigid structure around the affected extremity
 Casts, boots, or splints are applied directly to the leg for internal fixation
 Client should wear external fixation device continuously for a period of 4-6 weeks
 Nurse should teach the client to perform care of the wound and pin sites at
home
 Use crutches with rubber tips
 Prevents the client from slipping and decreases fall risks
 Only the provider should adjust the client’s external fixation device in order to
maintain bone alignment
o Long-term mechanical ventilation complications
 Decreased cardiac output and hypotension, related to positive pressure from
mechanical ventilation inhibiting blood return to the heart
 Fluid retention related to decreased cardiac output
 Stress ulcers, related to elevated levels of HCl in the stomach
 Increase risk for systemic infection and require pharmacological treatment
 Hyponatremia, secondary to fluid retention
o Postoperative nursing interventions following mastectomy
 Instruct client that the drain will remain in place for 1-3 weeks after surgery and will
be removed when there is 25 mL of output or less in a 24-hour period
 Instruct client to start exercising the arm on side of surgery 24 hours after surgery
 Elevate arm on surgical side on a pillow to promote lymphatic fluid return
 Nurse should elevate the head of the client’s bed to at least 30 degrees to promote
drainage from the surgical site and facilitate breathing
o Patient teaching for active tuberculosis
 Sputum specimens are necessary every 2-4 weeks until there are three negative
cultures
 After 3 negative cultures, the client is no longer considered infectious
 Client’s infection is usually no longer contagious after taking TB medications for 2-3
weeks
 Family members do not need to follow airborne precautions because they have
already been exposed to TB




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,1/6/24, 1:10 PM ATI RN ADV MEDSURG PROCTORED EXAM
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 A follow-up evaluation of the client’s TB should be performed using a chest x-ray
because the TB skin test is no longer considered accurate after a person has tested
positive
o Nursing interventions following total hip arthroplasty
 Assist client to maintain legs in abduction
 Client should not flex hip greater than 90 degrees to prevent hip dislocation
 Nurse should place a pillow between client’s legs to prevent hip dislocation
 Nurse should not keep client’s hip internally rotated, as this can lead to hip
dislocation
o Patient teaching on kidney organ donation
 Client who is recipient of organ donation will require lifelong immunosuppressive
therapy to protect against transplant rejection
 A healthy donor who has one kidney can manage the body’s urinary excretion
requirements
 Client’s nonfunctioning kidney remains in the body until transplant surgery, unless
the client has chronic kidney infection or pain
 A client who receives a kidney from live donor has a lower rate of transplant rejection
 Client who receives a kidney from a live donor has a lower rate of transplant
rejection because the donor is often more medically compatible than a donor
who is deceased
o Patient teaching about prevention of atherosclerosis
 Smoking cessation
 Maintain an appropriate weight
 Eat a low-fat diet
o MRSA precautions for health care professionals
 Client should wear an isolation gown and wash hands before being transported from
the room to prevent spread of micro-organisms
 Nurse should bathe client using warm water and a chlorhexidine solution to prevent
the spread of micro-organisms
 Use dedicated assessment equipment when assessing the client and leave in room to
prevent cross-contamination with other clients
 Mode of transmission = contact
o Nephrostomy expected findings
 Red-tinged urine during the first 12-24 hours
 Normal BUN
 Increased urine output (notify provider for decreased UO)
 NOTIFY PROVIDER FOR BACK PAIN
 Can indicate the tube is dislodged or clogged
o Nursing interventions for dysrhythmias
 Defibrillation for ventricular tachycardia or ventricular fibrillation
 Cardioversion for all other dysrhythmias
 CPR for a client who is pulseless or not breathing
 Lidocaine IV bolus for a client who has ventricular dysrhythmia
o Seizure precautions
 Client should limit intake of alcohol or caffeine, minimize stress, fever, and fatigue to
prevent triggering a seizure




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