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Exam (elaborations)

Ati Rn Medical Protocored Exam 2023/2024

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A nurse has prepared a sterile field for assisting a provider with a chest tube insertion. Which of the following events should the nurse recognize as contaminating the field (Select all that apply) A. provider drops a sterile instrument onto the near side of the sterile field B. nurse moistens a cotton ball with sterile normal saline and places it on sterile field C. procedure is delayed 1hr because the provider receives an emergency call D. nurse turns to speak to someone who enters through the door behind the nurse E. clients hand brushes against the outer edge of the sterile field - CORRECT ANSWERS-B, C, D A nurse has removed a sterile pack from its outside cover and place it on a clean work surface in preparation for an invasive procedure. Which of the following flaps should the nurse unfold first: A. closest to body B. right side C. left side D. farthest from body - CORRECT ANSWERS-D A nurse is wearing sterile gloves in prep for performing a sterile procedure. Which of the following objects can the nurse touch without breaking sterile technique (Select all that apply) A. bottle containing sterile solution B. edge of sterile drape at the base of the field C. inner wrapping of an item on the sterile field D. irrigation syringe on the sterile field E. one gloved hand with the other gloved hand - CORRECT ANSWERS-C, D, E A pt has a positive TB skin test what would your first action be? - CORRECT ANSWERS-put a mask on either the pt or yourself Appropriate oropharyngeal suctioning; select all: - CORRECT ANSWERS--encourage pt to deep breath & cough prior -monitor O2 sats -store catheter in clean dry place for use -perform care 3 times a day (Q 8hrs) AV block - CORRECT ANSWERS-AV block Before an Endoscopy (EGD): - CORRECT ANSWERS--NPO 6-8 hr -remove dentures brady - CORRECT ANSWERS-brady Caring for a client following a stroke of the right side with left-sided hemipalegia: - CORRECT ANSWERS--thicken liquids/foods -high fowlers - speech therapist for helping w/eating & speech -monitor gag reflex/swallowing abilities -have suction equipment available -occupational therapy -support left arm with pillows, slings, etc Caring for a client who has pancreatitis: - CORRECT ANSWERS--keep NPO -NG tube to suction gastric contents -low fat, high protein, high carb diet Risk factors: -high fat diet -excessive alcohol consumption -age Client teaching for anticoagulant therapy: - CORRECT ANSWERS-- bleeding precautions -no added meds that increase bleeding -on it for 6-8 weeks prior to hematologic dx procedure -must have blood levels checked often -monitor vitamin K in their diet Client teaching for genital herpes: - CORRECT ANSWERS--can be transmitted with or w/out blisters -sexual partners should be informed & screened -no cure, just meds to help w/symptoms -abstain from intercourse until lesions are completely healed -gently clean areas w/mild soap & water Client teaching for Nitroglycerin: - CORRECT ANSWERS-1. stop activity & rest 2. place nitro tab under tongue 3. if pain is Aunrelieved in 5 min, call 911 or go to ED 4. take 2 or more doses at 5 min intervals -headache is a common side effect of nitro Contraindications for Nadolol: - CORRECT ANSWERS--asthma -sinus bradycardia -cardiogenic shock -cardiac failure -diabetes -pregnancy -right side HF -emphysema -severe COPD Endoscopy (


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