ATI RN Predictor Study 2019 REVISED 2023/2024

ATI RN Predictor Study 2019 REVISED 2023/2024 Testing for TB - answer - A Mantoux skin test is the most accurate and valuable screening tool available for TB. A positive result means only that the client has been exposed to TB; it does not meant that the client has active TB. Testing for TB continue - answer - A sputum culture for acid fast bacillus (AFB) is used to confirm the diagnosis of pulmonary TB after a screening test and chest x-ray come back positive. Teaching instructions for the use of a cane: - answer (1) The cane is moved forward about 12 inches. (2) Then, the weak leg is moved even with the cane. (3) Finally, the strong leg is brought forward and ahead of the cane and weak leg. - Cane is held on stronger side. - The gripper of the cane should be level with the trochanter of the femur. Meningococcal vaccine - answer - Recommended that this vaccine be given to children who are 11 through 12 years of age and then given a booster dose at age 16. When should the single dose of Herpes zoster vaccine be given? - answer - To adults 60 years or older whether or not they report a previous episode of herpes zoster. Rotavirus should be given at what age? - answer - During the child's first year of life. Alendronate (Fosamax) - answer - This medication is used to prevent and treat postmenopausal osteoporosis and Paget's Disease. - Alendronate-taken in morning on an empty stomach. - The patient must be instructed to wait at least 30 minutes after taking Alendronate before eating, drinking, or taking other medications. What to expect with a patient having a chest tube? - answer - Continuous gentle bubbling in the suction control chamber. - Crepitus (with a pneumothorax, this will persist for several hours depending) - Oscillations-tidaling in the water seal chamber upon respiration are expected. What is a potential complication of a thyroidectomy? - answer - Hypocalcemia: numbness and tingling in the hands, soles of the feet and around the lips. What is Chvostek's sign? And how is it done? - answer Tap on the pt's face at a point just anterior to the ear and just below the zygomatic bone. A positive response would be twitching of the ipsilateral (same side only) facial muscles, suggestive of neuromuscular excitability caused by hypocalcemia. Brudzinski's sign - answer - Is an indication of meningeal irritation, which may be positive in patient's with meningitis. - To perform this, the client needs to be supine. The nurse: -places one hand behind patient's head. -places the other hand on the client's chest. Brudzinski's sign continue - answer -raises the clients head (with the hand behind the head) while the hand on the chest restrains the clients and prevents the client from rising. Flexion of the clients lower extremities constitutes a positive sign. Kernig's sign - answer - Is an indication of meningeal irritation. The maneuver is usually performed with the client supine with hips and knees in flexion. Extension of the knees is attempted and the inability to extend the clients knee beyond 135 degrees w/out causing pain constitutes a positive test. Babinski sign - answer - This is used to test for brain damage or upper motor neuron damage. It is considered positive if the toes flare up upon stroking the plantar aspect of the foot. Cataract surgery discharge instructions - answer - Do not lift anything heavier than 10lbs for at least one week - Sleep on your back or unaffected side to lessen the pressure. - Need to report any pain, decrease in vision or increase in discharge in the eye. Cataract continue - answer - It is normal to feel itching and mild discomfort after surgery, but the pt should be instructed not to rub or place pressure on the eye. Exposure or possible exposure to anthrax - answer - Administer an antibiotic prophylaxis to all pt's newly exposed **Those exposed to anthrax do not require decontamination and are not considered contagious** Botulism treatment - answer - Give an antitoxin Why would lidocaine (Xylocaine) be given to someone following cardiac arrest? - answer - Lidocaine is an antiarrhythmic med that is commonly used to restore a regular heartbeat in a client who has arrhythmia. This effect is produced by delaying abnormal nerve pulses to the heart and reducing irritability of the heart tissue. Factors that can trigger an exacerbation of SLE? - answer - Infection (especially a strep or viral infection. This can be a major stressor and can trigger an exacerbation) - Pregnancy (due to hormonal changes. The pt should be advised of the risks and must be monitored closely for effects on the renal and cardiovascular system if she decides to get pregnant) - Sunlight (Exposure to sunlight and artificial UV light is the leading cause of SLE exacerbation manifestations, especially the characteristic skin manifestations of lesions and butterfly rash) What diagnostic test would help the nurse monitor and evaluate the effectiveness of the aspirin medication for an Rhematoid arthritis patient? - answer - Erythrocyte sedimentation rate (ESR) ** RA is a chronic inflammatory disease. ESR is useful in detecting and monitoring tissue inflammation in clients with RA.** Antinuclear antibody (ANA) - answer - ANAs are frequently present in pts who have systemic lupus erythematosus and other autoimmune disorders such as RA and scleroderma. Rheumatoid factor (RF) diagnostic test - answer This is helpful in diagnosing RA, but the levels do not always correlate with the severity of the disease activity. Cheyne-Stokes Respirations - answer - Is characterized by a rhythmic increase (to the point of hyperventilation) and decrease (to the point of apnea) in the rate and depth of respirations. - It is commonly seen in pts who are unconscious, comatose or moribund (approaching death). Cryoprecipitate - answer - Clients with hemophilia (deficiency of clotting factor), are given cryoprecipitate to replace the deficient factor as a prophylactic measure before any invasive procedure, surgery or when actively bleeding. Cryoprecipitate continue - answer - Cryoprecipitate provides therapeutic amounts of Facto 8, Factor 13, von Willebrand factor and fibrinogen. These concentrates are made with recombinant DNA technology and are the treatment of choice with hemophilic A and von Willebrands disease. Cisplatin (Platinol) - answer - Treatment for cancer. - If a client has reported fatigue it is important to check the patients most recent CBC. The client I likely to be anemic as a result of myelosuppression (bone marrow suppression) from the chem