ATI RN Adult Medical-Surgical (Advanced Med-Surg) CMS
Proctored Exam NGN 2023–2025 | Complete Study Guide to
Pass on First Attempt
Young Adult (20-35) - <<<Answer>>>-growth has peaked around age 20
-memory peaks in 20s
-critical thinking increases
-intimacy vs isolation
-adult commitments and responsibilities (occupation)
Young Adult (Self Concept) - <<<Answer>>>-avoidance of substance use disorders
-family formation
-social interactions
-ethical behavior
-at risk for alterations in health due to risky behavior
Middle Adult (36-65) - <<<Answer>>>-Changes in physical appearance and ability (
visual/ auditory,respiratory)
-memory and stored knowledge intact
-slight decline in processing/reaction time
-generativity vs stagnation
-strong concern for others
Middle Adult ( Self Concept) - <<<Answer>>>-menopause
-sexuality
-job performance/support
-marital changes
-at risk for alteration in health
Purpose of Health Teaching - <<<Answer>>>-promote,maintain and restore client
health (essential)
-support informed decision making and self care preventive meds
-promote adherence to the plan of care ( to save cost of future care and longer hospital
stays and promote early discharge)
Adherence Factors - <<<Answer>>>-demographic values
-illness variable (severity)
-therapeutic regimen variables (side effects uncomfortable)
-psychosocial variables-support system
-financial variables
-motivation
,(If in pain, do not educate at that time*)
Gerontological Considerations - <<<Answer>>>-numeros chronic illnesses/meds
-medication sensitivity
-inadequate support systems
-lifetime habits-compromise
-impairment/
limitations (hear or see)
-collaboration is essential
Learning - <<<Answer>>>act of gaining knowledge,skill
Teaching - <<<Answer>>>imparting of knowledge
Factors that effect learning - <<<Answer>>>-readiness
-environment
-technique of teaching
Learning Readiness - <<<Answer>>>-teachable moment
-affected by many factors: culture, personal values, physical/emotional status/ past
experience
-positive feedback
-asking questions helps promote readiness
Learning Environment - <<<Answer>>>-minimize factors that interfere (noise)
-time selection
-presence of additional support system
-appropriate technique
-collaborate
Nursing Process in Learning Process - <<<Answer>>>Assess
Diagnosis
Plan and Goals
Implement
Evaluation
Health Promotion - <<<Answer>>>-develop resources that maintain or enhance well
being and improve QOL
-focus on potential for wellness
-encourage appropriate alterations as necessary
Health Promotion Components - <<<Answer>>>-self responsibility
-nutritional awareness
-stress reduction and management
-physical fitness
,Adolescent Health Promotion - <<<Answer>>>-focus on creating healthy habits early to
prevent negative results of risky behavior
-healthy diet
Young/Middle adult Health Promotion - <<<Answer>>>-healthy behavior, pregnancy
and family
-cancer screenings, chronic illness, activities offered at workplace
Older Adult Health Promotion - <<<Answer>>>-very health conscious, benefit from
activities that help them maintain their independence and achieve optimal health
Primary Health Prevention - <<<Answer>>>-promote health/ prevent disease
-shots,nutrition, health education and fitness
Secondary Health promotion - <<<Answer>>>-ID illness and provide treatment
-communicable disease screening, early detection
Tertiary Health promotion - <<<Answer>>>-prevent long term consequences to promote
optimal functioning
-promote independence
Health Assessment Considerations - <<<Answer>>>-role of the nurse
-effective communication
-assessment data
-role of technology
Assign - <<<Answer>>>transfer the authority, accountability and responsibility
Delegate - <<<Answer>>>transfer the authority and responsibility
(most common)
Supervising - <<<Answer>>>monitor and evaluate
-RN may be responsible for supervision and delegation
-delegate decisions based upon facility policies, state nurse practice acts and standards
of care
RN Can not Delegate... - <<<Answer>>>-nursing process
-client education
-clinical judgement situations
Example of Erikson Task for Psychosocial development in middle adulthood -
<<<Answer>>>client expresses concerns about the next generation
Peri-operative phase - <<<Answer>>>decision for surgery until patient transferred to
OR
, Intra Operative - <<<Answer>>>OR to PACU
Post Operative - <<<Answer>>>-PACU to follow up
-surgery in hospital,surgery center
-communication,team work and assessment are very important
-new innovative surgeries not as invasive
Responsibilities of the Surgeon - <<<Answer>>>-informed consent: autonomous
decision to undergo surgery
-describe procedure
-explain risks,benefits
alternatives
-offer to answer questions about procedure
-instructions that patient may withdraw consent
-statement informing patient if protocol differs from customary
Voluntary Consent - <<<Answer>>>-valid consent must be freely given without coercion
-patient must be 18 unless emancipated
-consent must be obtained by the physician
-patient's signature must be witnessed by professional ( nurse responsibility)
Responsibility of Nurse - <<<Answer>>>-clarify information but contact surgeon if
additional information is needed
-witness patient signature
-ensure client signature obtained prior to meds
Incompetent Patient - <<<Answer>>>-not autonomous
-can not give or withhold consent
-cognitive impairment
-mental illness
-neuro incapacitated
Psychosocial Assessment - <<<Answer>>>-support system
-anxiety/fear
-past
-knowledge deficit
-altered health maintenance
Pre Op Checklist - <<<Answer>>>-medical history
-allergies/rx
-all meds: last taken OTC/herbal too
-smoking,ETOH,substance history ( risk during and post surgery with delayed healing)
-psychosocial factor
( fear and anxiety)
Proctored Exam NGN 2023–2025 | Complete Study Guide to
Pass on First Attempt
Young Adult (20-35) - <<<Answer>>>-growth has peaked around age 20
-memory peaks in 20s
-critical thinking increases
-intimacy vs isolation
-adult commitments and responsibilities (occupation)
Young Adult (Self Concept) - <<<Answer>>>-avoidance of substance use disorders
-family formation
-social interactions
-ethical behavior
-at risk for alterations in health due to risky behavior
Middle Adult (36-65) - <<<Answer>>>-Changes in physical appearance and ability (
visual/ auditory,respiratory)
-memory and stored knowledge intact
-slight decline in processing/reaction time
-generativity vs stagnation
-strong concern for others
Middle Adult ( Self Concept) - <<<Answer>>>-menopause
-sexuality
-job performance/support
-marital changes
-at risk for alteration in health
Purpose of Health Teaching - <<<Answer>>>-promote,maintain and restore client
health (essential)
-support informed decision making and self care preventive meds
-promote adherence to the plan of care ( to save cost of future care and longer hospital
stays and promote early discharge)
Adherence Factors - <<<Answer>>>-demographic values
-illness variable (severity)
-therapeutic regimen variables (side effects uncomfortable)
-psychosocial variables-support system
-financial variables
-motivation
,(If in pain, do not educate at that time*)
Gerontological Considerations - <<<Answer>>>-numeros chronic illnesses/meds
-medication sensitivity
-inadequate support systems
-lifetime habits-compromise
-impairment/
limitations (hear or see)
-collaboration is essential
Learning - <<<Answer>>>act of gaining knowledge,skill
Teaching - <<<Answer>>>imparting of knowledge
Factors that effect learning - <<<Answer>>>-readiness
-environment
-technique of teaching
Learning Readiness - <<<Answer>>>-teachable moment
-affected by many factors: culture, personal values, physical/emotional status/ past
experience
-positive feedback
-asking questions helps promote readiness
Learning Environment - <<<Answer>>>-minimize factors that interfere (noise)
-time selection
-presence of additional support system
-appropriate technique
-collaborate
Nursing Process in Learning Process - <<<Answer>>>Assess
Diagnosis
Plan and Goals
Implement
Evaluation
Health Promotion - <<<Answer>>>-develop resources that maintain or enhance well
being and improve QOL
-focus on potential for wellness
-encourage appropriate alterations as necessary
Health Promotion Components - <<<Answer>>>-self responsibility
-nutritional awareness
-stress reduction and management
-physical fitness
,Adolescent Health Promotion - <<<Answer>>>-focus on creating healthy habits early to
prevent negative results of risky behavior
-healthy diet
Young/Middle adult Health Promotion - <<<Answer>>>-healthy behavior, pregnancy
and family
-cancer screenings, chronic illness, activities offered at workplace
Older Adult Health Promotion - <<<Answer>>>-very health conscious, benefit from
activities that help them maintain their independence and achieve optimal health
Primary Health Prevention - <<<Answer>>>-promote health/ prevent disease
-shots,nutrition, health education and fitness
Secondary Health promotion - <<<Answer>>>-ID illness and provide treatment
-communicable disease screening, early detection
Tertiary Health promotion - <<<Answer>>>-prevent long term consequences to promote
optimal functioning
-promote independence
Health Assessment Considerations - <<<Answer>>>-role of the nurse
-effective communication
-assessment data
-role of technology
Assign - <<<Answer>>>transfer the authority, accountability and responsibility
Delegate - <<<Answer>>>transfer the authority and responsibility
(most common)
Supervising - <<<Answer>>>monitor and evaluate
-RN may be responsible for supervision and delegation
-delegate decisions based upon facility policies, state nurse practice acts and standards
of care
RN Can not Delegate... - <<<Answer>>>-nursing process
-client education
-clinical judgement situations
Example of Erikson Task for Psychosocial development in middle adulthood -
<<<Answer>>>client expresses concerns about the next generation
Peri-operative phase - <<<Answer>>>decision for surgery until patient transferred to
OR
, Intra Operative - <<<Answer>>>OR to PACU
Post Operative - <<<Answer>>>-PACU to follow up
-surgery in hospital,surgery center
-communication,team work and assessment are very important
-new innovative surgeries not as invasive
Responsibilities of the Surgeon - <<<Answer>>>-informed consent: autonomous
decision to undergo surgery
-describe procedure
-explain risks,benefits
alternatives
-offer to answer questions about procedure
-instructions that patient may withdraw consent
-statement informing patient if protocol differs from customary
Voluntary Consent - <<<Answer>>>-valid consent must be freely given without coercion
-patient must be 18 unless emancipated
-consent must be obtained by the physician
-patient's signature must be witnessed by professional ( nurse responsibility)
Responsibility of Nurse - <<<Answer>>>-clarify information but contact surgeon if
additional information is needed
-witness patient signature
-ensure client signature obtained prior to meds
Incompetent Patient - <<<Answer>>>-not autonomous
-can not give or withhold consent
-cognitive impairment
-mental illness
-neuro incapacitated
Psychosocial Assessment - <<<Answer>>>-support system
-anxiety/fear
-past
-knowledge deficit
-altered health maintenance
Pre Op Checklist - <<<Answer>>>-medical history
-allergies/rx
-all meds: last taken OTC/herbal too
-smoking,ETOH,substance history ( risk during and post surgery with delayed healing)
-psychosocial factor
( fear and anxiety)
