ATI Comprehensive 1 (Test 2019 A) UPDATED 2024 (questions and answers)

S/S of a hemolytic transfusion reaction - low back pain, tachycardia, hypotension What vaccine is safe to administer to a client who is pregnant? - Tdap (between 27-36 weeks) What is Sims' position? - Client is side-lying with flexion of hip and knee What are some potential causes of fixed, dilated pupils? - Brain aneurysm, brain tumor, cerebral edema head trauma, increased intracranial pressure, intracranial hemorrhage, stroke What is incidence proportion? - The proportion of an unaffected population that becomes affected in a specified time period What is prevalence proportion? - # of people affected by something in relation to # of people in population What action does meconium staining of amniotic fluid necessitate? - Prepare equipment needed for newborn resuscitation (in case of aspiration). Endotracheal suctioning is recommended if the newborn has poor respiratory effort, decreased muscle tone, and bradycardia after delivery. Photosensitivity vs photophobia? - Photosensitivity: Light irritates skin Photophobia: Light irritates eyes A nurse is developing an educational program about bioterrorism and smallpox. The nurse should include in the teaching that the smallpox rash is expected to first appear where? - On the face When should ACE inhibitors be taken in relation to meals? - 1 hour before or 2 hours after meals What is the moro reflex and when should it disappear? - Startle reflex-elicited by striking the surface next to newborn to startle him/her which causes abduction and extension of arms. Reflex dissipates after 4 mo (continued presence is associated with neurological disorder) At what age should an infant be allowed to try finger foods? - Self-feeding finger foods such as crackers at around 6 mo of age How long should an infant receive breast milk or iron-fortified formula? - Until 1 year of age What is open-angle glaucoma? - Damage to optic nerve from increased pressure from overproduction of fluid => painless ipsilateral dilated pupil, gradual tunnel vision, optic disc cupping *Open-angle: angel where iris meets cornea is as wide as it should be; it's normal What are the APGAR score ranges? - 0, 1, or 2 score in each of 5 categories. 1. skin color (pink all over) 2. heart rate (>100/min.) 3. respiratory effort (good, strong cry) 4. muscle tone (well-flexed extremities) 5. reflex irritability (responds to stimulation with cry, cough or sneeze) 0-3 severe distress 4-6 moderate distress 7-10 no distress What is closed-angle glaucoma? - Glaucoma in which the iris dilates and pushes against the lens of the eyes, disrupting flow of aqueous humor into the anterior chamber. This pressure in the posterior chamber then pushes the peripheral iris forward and blocks the angle causing intraocular eye pressure to damage optic nerve **ONLY KIND THAT CAUSES PAIN What is meperidine (Demerol)? - Opioid for moderate-to-severe pain. Which group is most at risk for developing Hep A? - Children and young adults b/c it is acquire through feces, bile, and blood of infected agents and they get it from school, poor hygiene, hand-to-mouth contact, or another form of close contact What is buprenorphine? - - Opioid "partial" agonist -Binds to opioid receptors, causing partial activation, but not enough to experience "high" or euphoria -Also acts indirectly as an opioid antagonist, blocking effects of other opioids Can estrogen-containing birth control pills be taken while breastfeeding? - No. Estrogen-containing birth control pills, implants, patches, and vaginal rings should not be taken d/t risk of inhibiting breast milk production What is the normal urine osmolality value? - 50-1200 mOsm/kg What happens to pupils during opioid toxicity? - Pinpoint What does the maternal serum alpha-fetoprotein screen for? - Open neural tube defects which takes place 16-18 weeks of gestation Vaso-occlusive crisis - Ischemia and pain caused by sickle-shaped red blood cells that obstruct blood flow to a portion of the body. A nurse is caring for a client who is 12 hours postop following a total hip arthroplasty. What med should the nurse administer? - Enoxaparin b/c it inhibits antithrombin and thrombin which prevents DVTs (it acts immediately whereas warfarin takes 1-7 days) A nurse is teachinga client who has osteoporosis and a new prescription for alendronate. What instruction should the nurse give? - Sit upright for 30 min. after taking the med. to prevent esophagitis How much weight should a woman gain during pregnancy? - 25-35 lbs. It is primarily maternal tissue growth during 1st and 2nd trimesters and fetal tissue growth during the 3rd trimester A nurse is caring for a newly admitted newborn who is large for gestational age. After 30 min, the newborn becomes jittery and lethargic with hypotonic muscles and a cry that is different from the time of admission. What should the nurse do? - Perform a heel stick to check the newborn's glucose level. A newborn who is large for gestational age is at risk for hypoglycemia. Jitteriness, lethargy, hypotonia, an unusual cry, respiratory distress, poor feeding, and an unstable body temp. indicate hypoglycemia How often and how long should contractions occur in early (latent) stage of labor? - 5-30 min. and 30-45 seconds A nurse is caring for an infant who has gastroenteritis and is dehydrated. What characteristic places the infant at a higher risk of electrolyte imbalance compared to an adult client? - Longer intestinal tract. Compared to adults or older children, infants have a longer intestinal tract. This results in greater fluid losses, especially through diarrhea. What is the healthy BMI range? - 18.5-24.9 kg/m^2 At what point in pregnancy should a GBS be obtained? - 35-37 weeks gestation Should be obtained vaginal/anal GBS=group B streptococcus B-hemolytic culture *Prophylactic antibiotics should be given during labor to clients that are positive At what age should a child be able to tie his/her shoes? - Age 5 At what age should a child be able to print the letters of his/her name? - Age 5 What is an autosomal recessive disease and what are some examples? - two copies of an abnormal gene must be present in order for the disease or trait to develop Ex: cystic fibrosis and sickle cell anemia What are the S/S of measles? - Koplik spots 2 days before maculopapular rash and accompanied by fevers, malaise, conjunctivitis, and other cold manifestations What disease causes swollen parotid glands in children? - Mumps What is magnesium sulfate and what is it used for? - Smooth muscle relaxant to prevent seizures in a client who has preeclampsia What is nalbuphine and what is it used for? - Opioid agonist-antagonist used for pain relief during labor What is terbutaline and what is it used for? - A smooth muscle relaxant used to decrease contractions during preterm labor What does a frontal headache indicate? - Fluid overload What are Heberden's nodes? - Hard, bony lumps or nodules in the joints of the fingers that result from osteoarthritis How can extreme edema be corrected in nephrotic syndrome? - Albumin administration. Causes serum albumin to rise and prompts fluid shift from the subcutaneous spaces into the bloodstream, decreasing edema What does pneumocystis jiroveci pneumonia (PCP) result from? - An impaired immune system. It exists as part of the normal flora of the lungs and develops into a fungus. It becomes aggressive when immune system is compromised What is thrombophlebitis? - inflammation (red and warm) of a vein with clot formation-often occurs during pregnancy What is fat embolism syndrome? - - Long bone fracture or multitrauma - Fat droplets from bone marrow or fat tissue make their way into torn or damaged veins and can travel to the lungs, heart, brain or reach other organs S/S neurological changes (encephalopathy, seizures, neurological deficits), petechial rash, and hypoxemia What are the common sites of breast cancer metastasis? - Bones, lungs, brain, and liver What happens to cholesterol in nephrotic syndrome? - Serum cholesterol increases because of the increase in plasma lipids What is primary intention of wound healing? - Healing of a clean wound without tissue loss. In this process, wound edges are brought together, so that they are adjacent to each other (re-approximated). Wound closure is performed with sutures (stitches), staples, or adhesive tape or glue. What is the allen's test? - Test for patency of ulnar artery prior to placing a radial arterial line or performing an ABG; examiner occludes both ulnar and radial arteries w/ fingers as patient makes fist; patient opens fist while examiner releases ulnar artery occlusion to assess blood flow to hand S/S of hypercalcemia? - Tachycardia, HTN, and muscle weakness What drug when taken with streptomycin will increase risk of developing nephrotoxicity? - Amphotericin B How long can an opened insulin vial be used for? - 28-30 days at room temp. or in fridge What TYPE of medication provides steady release over time? - Sustained-release Why are enteric-coated medications prescribed? - Reduce risk of gastric irritation because they do not dissolve until they reach the small intestine At what age should a child have language ability to identify time-related words like the days of the week? - Age 5 At what age should a child be able to identify left and right? - Age 6 How do you calculate a premature baby's adjusted (developmental) age? - Subtract # of weeks born premature from chronological age How often should air be cycled in TB client's room? - Well-ventilated room with 6-12 exchanges of fresh air per minute A nurse is admitting a client who has cirrhosis. What prescriptions should the nurse anticipate? - A. Obtain client's PT and INR (cirrhosis prevents liver from producing clotting factors, increasing hemorrhage risk) B. Administer lactulose 30 mL PO 4x daily (increase client's stool production to help eliminate ammonia excess since liver can't get rid of it) C. Obtain daily weight and abdominal girth measurements (to measure impact of ascites) D. Administer a daily multivitamin (cirrhosis leads to deficiency in many vitamins)