ATI Comprehensive Predictor Exam Questions and Answers (Verified by Expert)

Fontanel closing on newborns - anterior 12-18 months posterior 1-2 months Best time to perform bladder scan - immediately after void Cholecystitis Diet - no cheese! low fat, no fatty/greasy food, low cholesterol, Increase fruit and veggies, Whole grain (Melon) Moro reflex - startled; hit surface next to the newborn Position for suppository or enema administration - -Sim's/left lateral/Rt. knee to chest Varicella contraindication - corticosteroids Dtap contraindication - Hx of inconsolable crying Newborn car seat safety - Snug harness across axillary. Not across abdomen or neck. Ileostomy what pt expect on appearance - -Initial drainage: dark green, odorless. -Some initial bleeding normal -Pink or red stoma color normal -Initial swelling; decreases 2-3 weeks later delirium - simple orientation and low stimuli Hep b contraindication - Baker's yeast MMR contraindications - pregnancy, recent blood transfusion Anorexia nervosa - increase in sodium, potassium, chloride, BUN, liver function, cholesterol Bulimia therapeutic nursing care - offer small and frequent meals 89% postoperative - change to another finger Non rebreather mask - Ensure two "flaps" open during exhalation/close during inhalation. Venture mask - ensure reservoir bag 2/3 full during inspiration and expiration Thoracentesis position - sitting position, arms raised and resting overbed table Chlorpromazine (psychoses) - adverse effect (SPASMS/TREMORS) treat benzo (COGENTIN) BENADRYL Variable deceleration - cord compression Early decelerations - *safe* Begin prior to peak of the contraction and end by the end of it. they are caused by head compression. no need for intervention if variability is within normal range (6-10) and the FHR is within normal range. Cystic fibrosis - DNA mutant gene, sprinkle capsule on food Levothyroxine - thyroid, caution with cardiac pts (TACHY ANXIETY) take in morning Levothyroxine toxicity - anxiety, chest pain, tachy, hypertension Bucks traction - immobilization, reposition q 2hrs, provide pin care, neuro checks Amputation - apply prosthetic before ambulating Ferrous sulfate - treats iron deficiency, REPORT nausea, constipation, heartburn, take on an empty stomach through a straw and rinse, increase H/H Orientation phase - Introduce, Discuss confidentiality, Set goals Working phase - to problem-solve Terminal phase - Evaluation (evaluate goals, experience, feelings) Chadwick's sign - Bluish-purple coloration of the vaginal mucosa and cervix Hysterectomy states (I CAN POSSIBLY PLAN A PREGNANCY) - outcome Vaginal flush complications - Preterm Labor: Ruptured membranes, signs of infection Sucralfate for PUD - coats stomach to prevent formation of ulcer and aids with healing existing ulcers 17 y/o having emergency surgery intervene when - verbal consent Insulins not to mix - garglarine and determis malfunctioning iv machine - tag and get new one best recommendation for newly diabetes 2 independently - refer to support group Circumcision post op - change diaper q 4hr, clean penis every change, petroleum jelly for 24 hr, fan fold diaper, avoid wrapping penis, trickle warm water over penis to wash, do not remove yellowish mucus do not use moist towelettes, heals in a couple weeks TB precautions - private negative pressure room, N95 mask, wear mask when transported, 4 meds at a time, for up to 6-12 months, test exposed family members, sputum culture q2-3 weeks, 3 negative= noninfectious leukorrhea - white discharge from the vagina during early pregnancy MRSA Contact Precautions - -keep distance within 3 ft of client -Private room or share with someone with similar infection (wound infection, herpes simplex) -double bag dressing gauze. -PPE: Gloves and Gowns. Metformin common side effect - renal kidney failure drawing up insulin - NR-RN regular NPH (Clear then cloudy) Interaction between SSRI and st johns warts - hypertensions and increased heart rate that can become life threatening. diabetic foot care - -Nailcare: Podiatrist, cut nail straight across. -Wear Clean Cotton Socks/Closed Shoes -Do not soak feet or wear ointments Used Opioid overdose - Naloxone (Narcan) Contraindication during alcohol withdrawals - Delirium, accompanied by hallucinations Pt education for amniocentesis - supine or rolled towel under right hip, continue breathing normally as needle is inserted, rest 30 min after, increase fluids for 24 hrs after Indications for fluid depletion - thread pulse, hypotensive, tachy, increased resp, cool, clammy, diaphoretic, decreased UOP, thirst Type of stomas - single one stoma, loop proximal active distal inactive, divided proximal digestive distal mucus, double barrel sutured together Documentation for ostomy care - amount, color, consistency Priority for panic disorder - Breathing Technique Education on meds - digoxin- 2hrs of meals monitor pulse for 1 min, toxicity, sodium polystyrene- hypokalemia, restrict sodium, epogen- blood twice a week, monitor hypertension, ferrous sulfate-administer following dialysis with stool softner take with food, aluminum hydroxide gel- avoid pts with gi disorders, 2 hrs before/ after dig, Lasix- monitor i&o, bp, weight, report thirst cough Newborn water temp and room temp - 120F 97.9-99F Bathing newborn technique - Bathe from cleanest to dirtiest -Eyes -Face -Head -Chest -Arms -Legs -Groin (last) Newborn reflex shown on day 1 - hear voice Immunization recommended for postexposure protection - Hep A Arthroplasty pt education - do not bend at waist, abductor pillow between legs, CPM, ice packs COPD - high fowlers, increase fluids, albuterol Dementia Living coordination - Home health Agency>Assisted Living>Nursing Home Need for Sterile Gloves - Inserting Catheter Discomforts During Pregnancy - -Nausea -Fatigue -Backache -Constipation -Varicose Veins -Hemoroids -Heartburn -Nasal stuffiness -Dyspnea -Leg Cramps -Edema lower extremities Acute Mania Interventions - -Decrease stimuli and one to one observation if necessary. Bulimia Plan of Care when meal planning - closely monitor the client during and after meals to prevent purging Reinforcing Teaching About Oppositional Defiant Disorder - clear limits unacceptable behaviors, reward acceptable behavior Osteoarthritis - Alternate: Heat Therapy for Pain and Cold Therapy for Inflammation -Use assistive devices (raised toilet to help not straining) Before bolus feedings - check residual Pt complaints of cramping - decrease infusion rate Location for drainage bag of catheters - bed frame below level of bladder ventilator alarms - low: disconnection high: kink, suction Glascow Coma Scale - 15: Good 3: severe Pressure ulcer strategies - reposition bed q 2hr, chair q 1hr, apply barrier cream and moisture absorbing pads Immunization: booster every 10 years - DTP HPV vaccine - 3 doses given starting at age 11-12 How to measure Fundal Height - top of symphysis pubis to top of fundus Calcular due date - Day of LMP -3 months + 1 yr & 7 days Contraindicated immunizations during pregnancy - -Varicella -Zoster -MMR True labor vs False labor - true- pain in lower back; regular rhythmic contractions; increased intensity with ambulation false-discomfort at abdomen; no lower back pain; contraction stop with ambulation or position change Deceleration - early head compression late uteroplacental insufficiency variable cord compression interventions in late variable deceleration - left lateral side laying oxygen C-section Normal FHR - 120-160 Nursing car boggy uterus - void, massage top of fundus with fingers reassess q 15 min Nursing care engorgement - moist heat for 5 in before breastfeeding, ice compresses after feeding to reduce swelling and discomfort Nursing care mastitis - continue breastfeeding and take antibiotics as prescribes Narcotic antidote - Naloxone (Narcan) Anemia Lab - RBC 4.20-4.87 BUN and creatinine - 10-20, 0.9-10.5 sodium - 136-145 Potassium - 3.5-5.0 Chloride - 96-106 Magnesium Sulfate Toxicity - calcium gluconate Magnesium toxicity - Absent or decreased deep tendon reflexes Respiratory depression Cardiac arrest Decreased urine output Mom Rh-, baby Rh+ - Give Rhogam Stroke eating precautions - -check gag reflex -thickened fluids/puree -Sit upright/flexed neck forward Dehydration s/s - weak thread pulse, hypotension, confused, decrease UOP, dry skin mucous membranes, urine specific gravity increased Urine Specific Gravity - 1.00-1.029 JVD - right sided heart failure Adverse of ACE inhibitors - increase potassium Kosher Diet - no shellfish, no meat and milk together, only fish with fins and scales, no pork Post Pelvic Surgery with Catheter - avoid stress on incision site and bladder Crutches should be on what side when rising - unaffected aide walking affected side arms should be at what degree when gripping crutches - 30 degree walking gate for stairs - 3 point Normal Stoma Finding - moist shiny pink, mild soap and water, then dry gently and completely, apply paste if used, apply barrier paste to creases Latent Phase of Labor - 0-3 cm, contractions mild to moderate, 5-30 apart 30-45 seconds Active Phase of Labor - contractions 3 min apart Variable decelerations - cord compression, prep for c section, change position, d/c oxytocin Follow initial nursing action for late decelerations - left lateral position Demerol - best pain management post op cholecystectomy Do you report chlamydia - mandated reporting to CDC w/out consent JP Drain - empty 1/2 full Q 8 hrs clean with soap and water JP Drainage doubles in two hours - think hemorrhage assess start cbc Notify MD Foods high in potassium - • Avocado • Bananas • Cantaloupe • Carrots • Fish • Mushrooms • Oranges • Potatoes • Pork, Beef, Veal • Raisins • Spinach • Strawberries • Tomatoes MAOI Nardil - avoid cheese food for hyponatremia - cheese high in sodium and protein Drainage pin sites - document COCA, leave crust pin care TID Phytoin SMZ-TMP - command hallucination- phytoin toxicity Command hallucinations - An individual hearing voices that direct the person to take action. without meds Methergine risk - treats postpartum hemorrhage, risk for: hypertension, check bp, watch n/v headache 2 years of age presentation - round soft abdomen 3 years immunizations - dtap, ipv, mmr, varicells, influenza 3 year normal - 2-3kg y, 2.5-3 in y, picky eaters, initiative vs guilt, imaginary friends, ride tricycle, jump off bottom step, stand on one foot for a few seconds First thing to do with newborn - ABC, Dry off Terminally ill patient - anticipatory Client involved in MVA severe internal bleeding - 5% dextrose in LR Hypovolemic shock - 5% Dextrose in LR Family asks to pray with you - refer to spiritual services Blood transfusion - look at HGB increase 1-2 per unit of blood Antibiotic in TPN line - NOTHING GOES IN TPN TPN infusion line - change q 24 hr Family change dressing q 8hr - square knot ties with 1-2 finger width TPN slow down infusion d/c until new bag - do not d/c Hip arthroplasty - watch peripheral pulses cool weak 1+ call provider Rifampin, isoniazid, phenytoin - decrease phenytoin dosage Palpate fontanels by 2-3 yr - DO NOT PALPATE buldgin could mean increased ICP/ meningitis First priority for DKA pts - venous access DKA BG drops 450-250 - measure glucose, k+ hourly IV glucose at 250 Pt paralysis 2nd floor home - PT respite care- SOCIAL SERVICES #1, OT, PT Highest risk to patient - restraint tied to bed rails Scaly spots erythemic papillae - report lips