ATI ADULT MEDICAL SURGICAL RETAKE 1 ADULT MED SURG ATI
CERTIFIED QUALITY EXAM UPDATED 2025/26 A+ SCORE REVIEW.
Cardiovascular diagnostic and therapeutic procedures: caring for
a client who has a picc
-assessing site every 8 hours. Note redness, swelling, drainage,
tenderness and condition of dressing
-change tube and positive pressure cap per facility protocol
-using 10ml or larger syringe to flush the line
-cleanse with alcohol for 3 seconds before accessing it
-use transparent dressing
Cardiovascular diagnostic and therapeutic procedures: teaching
about a picc
-advise client not to immerse arm in water, to cover dressing
site to avoid water exposure
-avoid bp in the arm with picc
Cardiovascular diagnostic and therapeutic procedures: picc care
- apply an initial dressing of gauze and replace with transparent
dressing within 24 hours
- an initial x-ray should be taken to ensure proper placement
,Cardiovascular and hematologic disorders: teaching client about
food interaction with warfarin
-kale, spinach
-brussels sprouts
-collard greens, mustard greens
-green tea
-grapefruit juice, alcohol
Angina and mi: client teaching about nitroglycerin
Nitrogylcerin prevents coronary artery vasospasm and reduces
preload and afterload. Used to treat angina and help with bp.
- place nitro under tongue to dissolve
- take up to two more doses of nitro at 5-min intervals
- stop activity and rest
Headache is a common side effect
Orthostatic hypotension
Osteoporosis: teaching about self administration of alendronate
Take with 8oz water in the early morning before eating
Remain upright for 30 minutes after taking medication
Diabetes mellitus management: teaching about self
administration of insulin
- rotate injection sites
- inject at a 90 degree angle. Aspiration is not necessary
- advise client to eat at regular intervals, avoid alcohol intake
and adjust insulin to exercise and diet to avoid hypoglycemia
,- when mixing insulin's, draw up the shorter acting insulin into
the syringe first and then the longer acting insulin.
Iv therapy: performing venipuncture on an older adult client
A 22-24 gauge catheter is best to use on older adults
Tie the tourniquet sparingly and try to avoid veins in the hand
Dosage calculations: calculating iv infusion rate
Ex: nurse is preparing to administer dextrose 5% in water 500 ml
iv to infuse over 4 hours. The nurse should set the iv infusion
pump to deliver how many ml/hr>
-volume (ml)/time (hr) = x
-500 ml/5hr = 125 ml/hr
Iv therapy: medication administration
Know
-right patient
-right drug
-right dose
-right time
-right route
Arthoplasty: pain control
Analgesics - opiods (epidural, pca, iv, oral) nsaids
Continuous peripheral nerve block
, Ice or cold therapy to reduce swelling
Head of bed slightly elevated and the affected leg in a neutral
position. Place a pillow or abduction device between the legs
when turning to the unaffectedne side
Pain management: pca
Small frequent dosing ensure consistent plasma levels
Morphine and dilaudid
Let nurse know if the pump doesn't control the pain
Client is the only person to push the button
Pain management: interventions to promote postoperative
recovery
Managing acute severe pain with short term around the clock
administration of opiods
Parental route is best for immediate short term relief
Gi therapeutic procedures: d/c tpn therapy
Never abruptly stop tpn, gradually decrease (10%) to allow body
adjustment.
Monitor vital signs q 4-8 hours
Gi therapeutic procedures: shortage of tpn solution
Clients receiving tpn frequently need supplemental regular
insulin.
CERTIFIED QUALITY EXAM UPDATED 2025/26 A+ SCORE REVIEW.
Cardiovascular diagnostic and therapeutic procedures: caring for
a client who has a picc
-assessing site every 8 hours. Note redness, swelling, drainage,
tenderness and condition of dressing
-change tube and positive pressure cap per facility protocol
-using 10ml or larger syringe to flush the line
-cleanse with alcohol for 3 seconds before accessing it
-use transparent dressing
Cardiovascular diagnostic and therapeutic procedures: teaching
about a picc
-advise client not to immerse arm in water, to cover dressing
site to avoid water exposure
-avoid bp in the arm with picc
Cardiovascular diagnostic and therapeutic procedures: picc care
- apply an initial dressing of gauze and replace with transparent
dressing within 24 hours
- an initial x-ray should be taken to ensure proper placement
,Cardiovascular and hematologic disorders: teaching client about
food interaction with warfarin
-kale, spinach
-brussels sprouts
-collard greens, mustard greens
-green tea
-grapefruit juice, alcohol
Angina and mi: client teaching about nitroglycerin
Nitrogylcerin prevents coronary artery vasospasm and reduces
preload and afterload. Used to treat angina and help with bp.
- place nitro under tongue to dissolve
- take up to two more doses of nitro at 5-min intervals
- stop activity and rest
Headache is a common side effect
Orthostatic hypotension
Osteoporosis: teaching about self administration of alendronate
Take with 8oz water in the early morning before eating
Remain upright for 30 minutes after taking medication
Diabetes mellitus management: teaching about self
administration of insulin
- rotate injection sites
- inject at a 90 degree angle. Aspiration is not necessary
- advise client to eat at regular intervals, avoid alcohol intake
and adjust insulin to exercise and diet to avoid hypoglycemia
,- when mixing insulin's, draw up the shorter acting insulin into
the syringe first and then the longer acting insulin.
Iv therapy: performing venipuncture on an older adult client
A 22-24 gauge catheter is best to use on older adults
Tie the tourniquet sparingly and try to avoid veins in the hand
Dosage calculations: calculating iv infusion rate
Ex: nurse is preparing to administer dextrose 5% in water 500 ml
iv to infuse over 4 hours. The nurse should set the iv infusion
pump to deliver how many ml/hr>
-volume (ml)/time (hr) = x
-500 ml/5hr = 125 ml/hr
Iv therapy: medication administration
Know
-right patient
-right drug
-right dose
-right time
-right route
Arthoplasty: pain control
Analgesics - opiods (epidural, pca, iv, oral) nsaids
Continuous peripheral nerve block
, Ice or cold therapy to reduce swelling
Head of bed slightly elevated and the affected leg in a neutral
position. Place a pillow or abduction device between the legs
when turning to the unaffectedne side
Pain management: pca
Small frequent dosing ensure consistent plasma levels
Morphine and dilaudid
Let nurse know if the pump doesn't control the pain
Client is the only person to push the button
Pain management: interventions to promote postoperative
recovery
Managing acute severe pain with short term around the clock
administration of opiods
Parental route is best for immediate short term relief
Gi therapeutic procedures: d/c tpn therapy
Never abruptly stop tpn, gradually decrease (10%) to allow body
adjustment.
Monitor vital signs q 4-8 hours
Gi therapeutic procedures: shortage of tpn solution
Clients receiving tpn frequently need supplemental regular
insulin.
