RN ATI Capstone Adult Medical Surgical Focused Review exam with verified detailed solutions

RN ATI Capstone Adult Medical Surgical
Focused Review exam with verified
detailed solutions

Hematologic Diagnostic Procedures: Bone Marrow Biopsy (RM AMS RN 10.0
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Chp 39, Active Learning Template - Diagnostic Procedure) - correct answer
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✔Bone biopsy takes a small sample of bone marrow removed by needle
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aspiration for cytological (histological) examination
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Performed with local anesthesia or conscious sedation.
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Used to diagnose blood disorders (anemia, thrombocytopenia) or diseases of
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bone marrow (leukemia, infection) or stage lymphoma or other forms of
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cancer.
Teaching: teach client to report excessive bleeding and evidence of infection
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to provider
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Teach client to check the biopsy site daily, keep the dressing clean, dry, and
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intact
If sutures in place, have client return in 7 days to have them removed
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Esophageal Disorders: Dietary Selections for a Client Who Has a Hiatal Hernia
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(Active Learning Template - System Disorder, RN QSEN - Patient-centered
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Care, RM AMS RN 10.0 Chp 48) - correct answer ✔Avoid eating immediately
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prior to going to bed
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Avoid foods and beverages that decrease LES pressure (fatty and fried foods,
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chocolate, coffee, peppermint, spicy foods, tomatoes, citrus fruits, and
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alcohol)

,Musculoskeletal Trauma: Teaching Strategies to Prevent Carpal Tunnel x x x x x x x x


Syndrome (RN QSEN - Safety , RM AMS RN 10.0 Chp 71, Active Learning
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Template - Basic Concept) - correct answer ✔Avoid repetitive flexion of wrist
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Perform ROM x




Have item under wrists while using computer to prevent prolonged flexion
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Elevate hand above level of heart
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Renal Calculi: Priority Intervention for a Client Who Has Renal Calculi (Active
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Learning Template - System Disorder, RM AMS RN 10.0 Chp 61) - correct
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answer ✔Report laboratory and diagnostic findings to the provider
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Strain all urine to check for passage of the calculus and save the calculus for
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laboratory analysis x




Encourage client to increase oral intake to 3L/day unless contraindicated
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Encourage ambulation to promote passage of the calculus
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Administer IV fluids as prescribed x x x x




Asthma: Monitoring peak expiratory flow rates (AMS Ch. 21) - correct answer
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✔fastest airflow rate reached during exhalation.
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Urinary Elimination: Identifying Type of Urinary Incontinence (Active Learning
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Template - System Disorder, RM FUND 9.0 Ch 44) - correct answer ✔Stress:
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loss of small amounts of urine from increased abdominal pressure without
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bladder muscle contraction with laughing, sneezing or lifting
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Urge: inability to stop urine flow long enough to reach the bathroom due to
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an overactive detrusor muscle with increased bladder pressure
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, Overflow: urinary retention from bladder overdistention and frequent loss of
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small amounts of urine due to obstruction of the urinary outlet or an
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impaired detrusor muscle x x




Reflex: involuntary loss of a moderate amount of urine usually without
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warning due to hyperreflexia of the detrusor muscle, usually from spinal cord
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dysfunction
x




Functional: loss of urine due to factors that interfere with responding to the
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need to urinate, such as cognitive, mobility and environmental barriers
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Total: unpredictable involuntary loss of urine that generally does not respond
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xto treatment
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Rheumatoid Arthritis: Adverse Effects of NSAIDs (Active Learning Template -
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Medication, RM AMS RN 10.0 Chp 88) - correct answer ✔NSAIDS -> provide
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analgesic, antipyretic and anti-inflammatory effects.
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*NSAIDs can cause considerable gastrointestinal (GI) distress*
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Nursing considerations:
x




Monitor for fluid retention, hypertension and renal dysfunction
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Education:
Have client take with food or full glass of water or milk, if taken routinely an
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H2 receptor antagonist can also be prescribed
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