MEDSURG RN ATI PROCTORED EXAM GUIDE 2025 ALL QUESTIONS AND CORRECT ANSWERS

Manifestations of fecal impaction - -constipation, gas, flatulence, urge to void but no output, fecal smears, no bowel movement When doing digital rectal maneuvers WOF - -vasovagal symptoms like bradycardia, dizziness, and syncope Nutrition for immunocompromised pt. - --increase vitamin c -no raw fruits, or veggies, or uncooked food -take antacids 2 hours prior or after medications Nutrition for chemotherapy pt. - --increase protein -small frequent meals -anti nausea meds ATC -serve food cold to reduce nausea Nutrition for pt. with cardiovascular disease - --DASH diet (for weight loss and prevention of cardiovascular disease) -increase calcium, potassium -limit sodium to 2,000 mg/day, low salt diet -Limit fluid intake Nutrition for COPD - --small frequent meals -mechanical soft diet, if SOB -increase calories -manuever the nasal cannula to allow the pt. to eat Sources of fiber - -plant based, green leafy veggies **avoid fiber such as potatoes, cereals, and starches Teaching about managing constipation - --increase fiber, fluid and activity -take antihypothyroid medications Nutrition for crowns disease - --high protein, high calorie, low fiber -avoid alcohol, coffee -increase vitamin and iron supplementation ***help identify foods that trigger symptoms MEDSURG MEDSURG TPN for crohns disease - -is done to replace nutrition loss ***pt. will be NPO if the bowel is inflamed What is Crohn's disease? - -inflammatory bowel disorder characterized by abdominal pain/cramping often in right lower quadrant s/s of crohns disease - -fever, anorexia, weight loss, diarrhea, high pitched bowel sounds, steatorrhea What is skeletal traction? - -traction that uses pulling force to promote/maintain alignment of the injured area What should be included in the traction prescription? - -type of traction, amount of weight, and whether the traction can be removed for nursing care How often do you check for neuromuscular status for pt. with a traction? - -every hour for 24 hours and every 4 hours after Nursing care for skeletal traction - -avoid lifting or removing weights, ensure weights hang freely, notify DR if weights are displaced, ensure no knots, fraying, loosening and improper positioning every 8-12 hours Interventions for skeletal traction - --may use heat or massage as prescribed to treat muscle spasms -theraputic touch and relaxation techniques -PIN SITE CARE AT LEAST 1-2X/DAY (CHLORHEXIDINE USUALLY USED) -ONE COTTON SWAB IS DESIGNATED FOR EACH PIN pain management for pt. in bucks traction - --muscle relaxant is used to relieve muscle spasms -analgesics, or opioids to control pain -NSAIDS for inflammation -stool softener for constipation How often do you monitor neurovascular status for a cast? - --every hour for the first 24 hours and asses pain promoting comfort for a pt. with a cast - --Use cloth pillow instead of plastic while the cast is drying -allow on finger between skin and cast -handle plaster cast with palms and not fingers Teachings for a cast - -- do not place any foreign objects into cast -if itching= hair drying on cool setting What is the position to prevent aspiration for a client with dysphagia? - --high fowlers MEDSURG MEDSURG teaching for dysphagia - --add thickness to liquids -place the spoon on the strong side -mechanical soft diet -speech pathologist for swallowing -give the pt. enough time to chew For short term dysphagia provide - -NGT **do not use syringe to feed for chronic dysphagia - -consider a g-tube placement What is the DASH diet? - -low salt low fat high potassium high calcium When is DASH diet used? - -in cardiovascular pt. and for weight loss Interventions to promote sleep? - --sleep medicines are last resort -maintain bed time -diuretics in the morning - no coffee in afternoon -excerise in morning Teaching for joint protection in RA - --low impact excerises -Glucosamine Chondrotin is a nutritional supplement that improves the joint Position for a pt. in Bucks Traction? - -neutral position Priority for pt. in bucks traction? - -check for sensation, ability to move the toes, foot, pulses, color, cap refill, and temperature of extremity What helps with the absorption of iron? - -Vitamin C from citrus fruits Diet for preventing pressure ulcer? - -increase protein, fluids, vitamins, and minerals Interventions for preventing pressure ulcers - --turn pt. every 2 hours if in bed -turn pt. every hour if in chair use pressure relieving mattress What does granulation tissue indicate? - --signs of healing -beefy red in appearance Foods high in protein - -meat, fish, poultry, eggs, dairy, beans, nuts, and whole grains MEDSURG MEDSURG What is a low albumin level? - --below 3.5 What does a low albumin level indicate? - -poor wound healing Teaching for hip arthroplasty - --use elevated seat -use straight chairs with arms -use an abduction pillow between the legs while in bed -externally rotate the toes -do not cross legs -avoid tuning to opposite side unless prescribed What is the normal sodium levels? - -135-145 mEq/L What does a low sodium diet consist of? - --decreased processed foods, fried foods, fast foods, and canned foods Precautions following hip replacement - --monitor Hgb levels of less than 9 -monitor NVS status every 2-4hrs -provide early ambulation (use assistive devices) -do not turn the pt. on op. side -place pillow or abduction device between the legs Signs of dislocation - --"popping" sound