(Summary) Fundamentals ATI RN 2019 Exam Questions And Correct Answers| Question Bank| Updated 2023 Over300 Questions And Correct Answers

(Summary) Fundamentals ATI RN 2019 Exam Questions And Correct Answers| Question Bank| Updated 2023 Over300 Questions And Correct Answers Telephone orders: best practice -have a second RN listen in -repeat the prescription back -make sure the provider signs the prescription within 24 hr Information Security -HIPPA: ensures confidentiality of health info -Only those responsible for patient's care may access the medical record. -Do not use patient names on display boards -communication about the pt should happen in a private place or at the nurse's station -password protect electronic records. Do not share passwords. -Do not share pt information with unauthorized people. code system can be used. living will communicates patient's wishes regarding medical treatment if patient becomes incapacitated. DPOA durable power of attorney patient designates health care proxy to make medical decisions for them if they become incapacitated. Provider's orders Prescription for DNR and/or AND Mandatory reporting for RN -suspicion of abuse (child, elderly, domestic violence) -communicable diseases to local/state health department (mandated by state) informed consent: Provider responsibility -communicate purpose of procedure, and complete description of procedure in the patient's primary language (use medical interpreter if needed) -explain risks vs. benefits -describe other options to treat the condition informed consent: RN responsibility -ensure the provider gave the pt the above information -ensure pt is competent to give informed consent (adult, emancipated minor, not impaired) -have patient sign consent document -notify provider if pt has more questions or doesn't understand any information provided. nonspecific immunity defense mechanisms (barriers) in the body that respond immediately to all antigens. Barriers include: skin, stomach acid, mucus, inflammatory response, phagocytic cells. specific adaptive immunity body produces antibodies in response to a specific antigen through action of B and T lymphocytes. Requires more time, but the immune response against that antigen in the future is more efficient. incubation time from when the pathogen enters the body until the first symptom appears. prodromal stage time from the onset of general symptoms (malaise, fatigue) to specific symptoms. illness stage time when specific symptoms occur convalescence time from when symptoms disappear to complete recovery (can take months) primary prevention prevents initial occurrence of disease ex: education, immunizations, prenatal classes secondary prevention focuses on early detection of disease, limiting severity of disease. ex: screenings, control of outbreaks tertiary prevention maximize recovery after injury /illness ex: rehab, PT/OT, support groups active natural immunity body produces antibodies in response to exposure to live pathogen active artificial immunity body produces antibodies in response to vaccine passive natural immunity antibodies are passed from the mom to her baby through the placenta or breast milk passive artificial immunity immunoglobulins are administered to an individual after they have been exposed to a pathogen ABCDE Principle A (airway): ensure pt airway. Stabilize cervical spine if neck/head trauma is suspected B (breathing): assess for respirations C (circulation): check heart rate, blood pressure, and capillary refill D (disability): assess the patient's level of consciousness E (exposure): assess the patient's body for trauma, exposure to heat/cold Using an interpreter -DO NOT use patient's family or friends -use certified medical interpreter -explain purpose of meeting to interpreter prior to approaching the patient -direct questions at family, not interpreter -use layman's terms (NOT medical jargon) -DO NOT supplement words with gestures or nonverbal reinforcement nursing care: Hearing loss -face the pt and avoid covering your mouth -speak slowly and clearly; use brief sentences -try lowering vocal pitch -do not shout -use sign-language interpreter, or write down communication nursing care: aphasia -speak clearly and slowly, using short sentences -make sure only one person speaks at a time -give patient plenty of time to respond -tell patients if you do not understand them preventing pressure injuries and skin damage -turn patient Q2 -limit chair/wheelchair sitting to one hour, advise pt to shift weight every 15 minutes, use pressure-relieving device -ensure proper hydration and nutrition (especially protein) -keep HOB <=30 degrees. rise heels off of bed. -lift (vs pull) patients up in bed -DO NOT massage bony prominences DO NOT use powder or cornstarch Components of pain assessment -location of pain -quality (how it feels: burning) -intensity (pain scale from 0-10) -timing (onset, duration, frequency) -setting ( how it affects patient's ADLs) -associated symptoms (nausea, fatigue) -aggravating/ relieving factors (what makes it better or worse) Wound Healing: Primary Intention wound edges approximated (sutures/staples). Heals quickly, minimal scarring Wound Healing: Secondary Intention wound edges widely separated. Longer healing time, scarring, increased infection risk. Wound Healing: Tertiary Intention wound left open to address infection and then close at a later time Factors that delay wound healing old age, decreased immune function, impaired nutrition (especially protein!), decreased perfusion, smoking Denture Care -remove upper dentures by pulling down and out -remove lower dentures by pulling up and out -brush w/ toothbrush and denture cleaner - store in cup (labeled) with water to keep moist oral hygiene for unconscious patients -have suction available -do not put fingers in patients mouth -position patient on side, with head turned towards you. allows oral secretions to drain out, and prevents aspiration nursing care for a patient with dysphagia -place patient in Fowler's or high-fowlers position -give one med at a time -lightly stroke chin/throat to promote swallowing -thicken thin liquids -check for food pockets in mouth before feeding -encourage pt to tuck their chin when swallowing -monitor pt during meals, have suction set up -avoid straws key conversions for dosage calculations 1mg = 1,000 mcg 1 g = 1,000 mg 1 oz = 30 ml 1 tsp = 5 ml 1 tbsp= 15 ml 1 tbsp = 3 tsp 1 kg = 2.2 kg 1 gr = 60 mg Tracheostomy care -give oral care every 2 hours, tracheostomy care every every 8 hours -suction tracheostomy PRN (not routinely) -apply oxygen loosely if patient's spo2 decreases during procedure -use split gauze dressing under tracheostomy plate ( do not cut gauze) -replace trach ties as needed. secure new ties before removing soiled ones home care: cleanse w/ NS using medical asepsis, cover tract when outside pulses normal range for adults: 60-100 (120-160 bpm for infants) rhythm: regular/irregular equality: right vs. left side pulses strength: 0 (absent) 1 + (diminishes) 2 + (normal) 3 + (strong) 4 + (bounding) Tachycardia heart rate greater than 100 bpm causes: fever, exercise, meds, pain, stress, hypovolemia, hyperthyroidism Bradycardia heart rate less than 60 bpm causes: meds, athletes, hypothyroidism, hypothermia changes in older adults eyes: decreased vision, yellowing of lens, issues w/ glare and darkness ears: hearing loss, thickening of tympanic membrane mouth: decreased sense of taste, gum disease, tooth loss, decreased salivation, pale gums voice: increased vocal pitch nose: decreased sense of smell delegation to LPN med administration, enteral feedings, urinary Cath insertion, suctioning, tracheostomy care, reinforcement of pt education delegation to CNA bathing, dressing, ambulating, toileting, feeding pt without swallowing precautions, positioning, vital signs, bed making, specimen collection, I + O RN shouldn't delegate: patient education, any task that requires nursing judgement, nursing assessment, blood transfusions 5 rights of delegation right task: repetitive, non-invasive, doesn't require much supervision right circumstance: DO NOT assign a pt who is unstable right person: make sure delegate is competent and operating within their scope of practice, check facilities job description. right direction/communication: communicate timeline, expected results, and follow-up communication expectations right supervision/evaluation: intervene if needed, provided feedback Unintential Tort negligence: (forgetting to set bed alarm for a patient who is at risk for falls) malpractice: (med error that harms the pt) intentional tort: assault: nurse threatens pt battery: nurse hits pt, or gives med against pt's will false imprisonment: nurse inappropriately restrains a pt or administers a chemical restraint such as a sedative setting up a sterile field -position package with top flap facing away from you -open top flap away from you -open right side flap with right hang, then do the left with your left hand -open last flap towards you sterile solutions place bottle cap face up on sterile surface hold bottle so the label is against your palm pour a small amount (1-2 ml) away when pouring solution, do not touch bottle to site sterile field do not cough, sneeze, or talk over field 1 in edge of field is NOT sterile; discard any item that comes in contact with this area below waist, and above chest is contaminated add objects to sterile field at least 6 " above the field never turn your back, or reach across the field any sterile item that comes in contact with moisture, is considered non sterile cognitive learning focusing on thinking, knowledge, and comprehension affective learning focuses on feelings, ideas, beliefs, and values Psychomotor learning focuses on physical skills (coordination, movement, manipulation) nasopharyngeal and nasotracheal suctioning -place pt in Fowler's or high-fowlers -lube distal 6-8 cm of catheter with water-soluble lubricant -insert catheter during inhalation. insert distance from tip of nose to base of earlobe -apply suction intermittently while withdrawing the catheter, and rotating it for 10-15 seconds -perform up to 2 passes, waiting 1 minute in between what is a normal magnesium level? 1.3-2.1 mEq/L Magnesium's Function in the body nerve and muscle function, bone formation. Critical for many biochemical reactions in the body. Hypomagnesemia causes: GI loss, diuretics, malnutrition, alcohol abuse symptoms: dysrhythmias, tachycardia, hypertension, tremors, seizures, increased DTRs Hypermagnesemia causes: kidney disease, laxatives containing mag. symptoms: hypotension, muscle weakness, lethargy, respiratory and cardiac arrest Urinary tract infections: risk factors female (close proximity of urethral meatus to anus) foley (indwelling) catheters uncircumcised penis menopause frequent sexual intercourse prevention of UTIs include? females: wipe front to back Cath care uncircumcised male: clean under foreskin drink 2-3 L of fluid daily cranberry juice decreases risk of UTIs minimum urinary output per hour urine output < 30 ml/hr needs to be reported to provider! expected intake vs. output fluid intake should approx. equal urine output 24 hr urine collection -discard first void, collect all urine for 24 hrs -do not allow contamination of stool -keep urine on ice Foley Catheter Care