VATI RN COMPREHENSIVE PREDICTOR REMEDIATION
QUESTIONS & ANSWERS
/. Private rooms - Answer-are required for clients who have an infectious disease that
requires airborne precautions, or clients who require a protective environment._______
_____ are preferred for clients who are on droplet and contact precautions. These
clients can cohort if no _______ ______ are available and if all of the following are true.
●The clients have the same active infection with the same micro-organisms. ●The
clients remain at least 3 feet away from each other. ●The clients have no other existing
infection. ______ _______ is also preferred for the following clients. ●Client who are
agitated ●Client who have dementia and a history of wandering ●Clients who require a
quiet environment (those at risk for increased intracranial pressure [stroke, traumatic
brain injury]) ●Clients who are at risk for sensory overload (those who are having pain,
are acutely ill, have invasive tubes [nasogastric, IVs, endotracheal], or have reduced
cognitive function [head injury]) ●Clients who require privacy (those who are near death)
/.Prior to delegating client care, consider the following. - Answer-Predictability of
outcome ●Will the completion of the task have a predictable outcome? ●Is it a routine
treatment? ●Is it a new treatment? Potential for harm ●Is there a chance that something
negative can happen to the client (risk for bleeding, risk for aspiration)? ●Is the client
unstable? Complexity of care ●Are complex tasks required as a part of the client's care?
●Is the delegatee legally able to perform the task and do they have the skills
necessary? Need for problem solving and innovation ●Is nursing judgment required
while performing the task? ●Does it require nursing assessment skills? Level of
interaction with the client ●Is there a need to provide psychosocial support or education
during the performance of the task?
/.Examples of tasks nurses can delegate to practical nurses and assistive personnel -
Answer-TO PN Monitoring findings (as input to the RN's ongoing
assessment)Reinforcing client teaching from a standard care planPerforming
tracheostomy careSuctioningChecking NG tube patencyAdministering enteral
feedingsInserting a urinary catheterAdministering medication (excluding IV medication
in some states). TO AP Activities of daily living (ADLs) Bathing Grooming Dressing
Toileting Ambulating Feeding (without swallowing precautions). Positioning Routine
tasks. Bed making. Specimen collection Intake and output Vital signs (for stable clients).
/.Right direction/communication (five rights of delegations) - Answer-Data that needs to
be collected ●Method and timeline for reporting, including when to report
concerns/findings ●Specific task(s) to be performed; client-specific instructions
●Expected results, timelines, and expectations for follow-up communication
RIGHT DIRECTION AND COMMUNICATION: Delegate an AP to assist the client in
room 312 with a shower before 0900 and to notify the nurse when complete.
, WRONG DIRECTION AND COMMUNICATION: Delegate an AP to assist the client in
room 312 with morning hygiene.
/.Steps in providing educational programs - Answer-1. Identify and respond: Determine
the need for knowledge or skill proficiency 2. Analyze: Look for deficiencies, and
develop learning objectives to meet the need 3. Research: Resources available to
address learning objectives based on evidence-based practice 4. Plan: Program to
address objectives using available resources 5. Implement: Program(s) at a time
conducive to staff availability; consider online learning modules 6. Evaluate: Use
materials and observations to measure behavior changes secondary to learning
objectives
/.Tetralogy of Fallot. - Answer-Four defects that result in mixed blood flow: Pulmonary
stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy.
Cyanosis at birth: progressive cyanosis over the first year of life. Systolic murmur.
Episodes of acute cyanosis and hypoxia (blue or "Tet" spells knee chest position or
squating). SURGICAL PROCEDURES Shunt placement until able to undergo primary
repair. Complete repair within the first year of life.
/.Defects that increase pulmonary blood flow - Answer-Ventricular septal defect (VSD)
(20.1) Atrial septal defect (ASD), Patent ductus arteriosus (PDA),
/.Defects that increase pulmonary blood flow Ventricular septal defect (VSD) - Answer-
_______ A hole in the septum between the right and left ventricle that results in
increased pulmonary blood flow (left-to-right shunt) ●Loud, harsh murmur auscultated at
the left sternal border ●Heart failure ●Many VSDs close spontaneously early in life.
/.Defects that increase pulmonary blood flow Atrial septal defect (ASD) - Answer-A hole
in the septum between the right and left atria that results in increased pulmonary blood
flow (left-to-right shunt) ●Loud, harsh murmur with a fixed split second heart sound
●Heart failure ●Asymptomatic (possibly)
/.Defects that increase pulmonary blood flow Patent ductus arteriosus (PDA) - Answer-A
condition in which the normal fetal circulation conduit between the pulmonary artery and
the aorta fails to close and results in increased pulmonary blood flow (left-to-right shunt)
●Systolic murmur (machine hum) ●Wide pulse pressure ●Bounding pulses
●Asymptomatic (possibly) ●Heart failure ●Rales
/.Obstructive defects - Answer-include those where blood flow exiting the heart meets
an area of narrowing (stenosis), which causes obstruction of blood flow. ●The pressure
that occurs before the defect is increased (ventricle) and the pressure that occurs after
the defect is decreased. This results in a decrease in cardiac output. ●These children
can present with manifestations of heart failure. Pulmonary stenosis (20.2), Aortic
stenosis, Coarctation of the aorta (20.3)
QUESTIONS & ANSWERS
/. Private rooms - Answer-are required for clients who have an infectious disease that
requires airborne precautions, or clients who require a protective environment._______
_____ are preferred for clients who are on droplet and contact precautions. These
clients can cohort if no _______ ______ are available and if all of the following are true.
●The clients have the same active infection with the same micro-organisms. ●The
clients remain at least 3 feet away from each other. ●The clients have no other existing
infection. ______ _______ is also preferred for the following clients. ●Client who are
agitated ●Client who have dementia and a history of wandering ●Clients who require a
quiet environment (those at risk for increased intracranial pressure [stroke, traumatic
brain injury]) ●Clients who are at risk for sensory overload (those who are having pain,
are acutely ill, have invasive tubes [nasogastric, IVs, endotracheal], or have reduced
cognitive function [head injury]) ●Clients who require privacy (those who are near death)
/.Prior to delegating client care, consider the following. - Answer-Predictability of
outcome ●Will the completion of the task have a predictable outcome? ●Is it a routine
treatment? ●Is it a new treatment? Potential for harm ●Is there a chance that something
negative can happen to the client (risk for bleeding, risk for aspiration)? ●Is the client
unstable? Complexity of care ●Are complex tasks required as a part of the client's care?
●Is the delegatee legally able to perform the task and do they have the skills
necessary? Need for problem solving and innovation ●Is nursing judgment required
while performing the task? ●Does it require nursing assessment skills? Level of
interaction with the client ●Is there a need to provide psychosocial support or education
during the performance of the task?
/.Examples of tasks nurses can delegate to practical nurses and assistive personnel -
Answer-TO PN Monitoring findings (as input to the RN's ongoing
assessment)Reinforcing client teaching from a standard care planPerforming
tracheostomy careSuctioningChecking NG tube patencyAdministering enteral
feedingsInserting a urinary catheterAdministering medication (excluding IV medication
in some states). TO AP Activities of daily living (ADLs) Bathing Grooming Dressing
Toileting Ambulating Feeding (without swallowing precautions). Positioning Routine
tasks. Bed making. Specimen collection Intake and output Vital signs (for stable clients).
/.Right direction/communication (five rights of delegations) - Answer-Data that needs to
be collected ●Method and timeline for reporting, including when to report
concerns/findings ●Specific task(s) to be performed; client-specific instructions
●Expected results, timelines, and expectations for follow-up communication
RIGHT DIRECTION AND COMMUNICATION: Delegate an AP to assist the client in
room 312 with a shower before 0900 and to notify the nurse when complete.
, WRONG DIRECTION AND COMMUNICATION: Delegate an AP to assist the client in
room 312 with morning hygiene.
/.Steps in providing educational programs - Answer-1. Identify and respond: Determine
the need for knowledge or skill proficiency 2. Analyze: Look for deficiencies, and
develop learning objectives to meet the need 3. Research: Resources available to
address learning objectives based on evidence-based practice 4. Plan: Program to
address objectives using available resources 5. Implement: Program(s) at a time
conducive to staff availability; consider online learning modules 6. Evaluate: Use
materials and observations to measure behavior changes secondary to learning
objectives
/.Tetralogy of Fallot. - Answer-Four defects that result in mixed blood flow: Pulmonary
stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy.
Cyanosis at birth: progressive cyanosis over the first year of life. Systolic murmur.
Episodes of acute cyanosis and hypoxia (blue or "Tet" spells knee chest position or
squating). SURGICAL PROCEDURES Shunt placement until able to undergo primary
repair. Complete repair within the first year of life.
/.Defects that increase pulmonary blood flow - Answer-Ventricular septal defect (VSD)
(20.1) Atrial septal defect (ASD), Patent ductus arteriosus (PDA),
/.Defects that increase pulmonary blood flow Ventricular septal defect (VSD) - Answer-
_______ A hole in the septum between the right and left ventricle that results in
increased pulmonary blood flow (left-to-right shunt) ●Loud, harsh murmur auscultated at
the left sternal border ●Heart failure ●Many VSDs close spontaneously early in life.
/.Defects that increase pulmonary blood flow Atrial septal defect (ASD) - Answer-A hole
in the septum between the right and left atria that results in increased pulmonary blood
flow (left-to-right shunt) ●Loud, harsh murmur with a fixed split second heart sound
●Heart failure ●Asymptomatic (possibly)
/.Defects that increase pulmonary blood flow Patent ductus arteriosus (PDA) - Answer-A
condition in which the normal fetal circulation conduit between the pulmonary artery and
the aorta fails to close and results in increased pulmonary blood flow (left-to-right shunt)
●Systolic murmur (machine hum) ●Wide pulse pressure ●Bounding pulses
●Asymptomatic (possibly) ●Heart failure ●Rales
/.Obstructive defects - Answer-include those where blood flow exiting the heart meets
an area of narrowing (stenosis), which causes obstruction of blood flow. ●The pressure
that occurs before the defect is increased (ventricle) and the pressure that occurs after
the defect is decreased. This results in a decrease in cardiac output. ●These children
can present with manifestations of heart failure. Pulmonary stenosis (20.2), Aortic
stenosis, Coarctation of the aorta (20.3)
