lOMoAR cPSD| 26582732
1
ATI – NCLEX PREDICTOR REMEDIATION STUDY
NOTES 2025
flank pain → kidney or ureter (if pain radiates → stones in ureter or bladder)
renal calculi -
pain: : sterile technique, warm meds, pull up & back, tilt toward affected ear
Performing ear irrigation
reteplase recombinant (rtpa – clot buster) w/ in 4.5 hours of initial symptoms
Thrombolytic therapy
(stroke): dressing ∆, inner cannula ½ hydrogen peroxide, & stoma □ knot
Trach
care:
Head injury (changes in loc): length of time unconscious & gcs
general anesthesia (post- Abc’s – full body assessment, vitals every 15 minutes, lateral position (if unresponsive or unconscious
op): - monitor loc), fluids/electrolytes
Superficial burns: painful, pink, red, mild edema (3-6 day healing), damage to epidermis
Dialysis (reporting unexpected findings)
: temp of 100 degrees, ↓ bp, bleeding, 1 l of fluid = 1kg, clotting, h/a, nausea,
Disequilibrium syndrome (rapid ↓ bun & fluid volume), anemia, peritonitis, ↑ bg, ↑ cholesterol
Pacemaker infection, hematoma, pneumothorax, hemo-thorax, arrhythmias, pacer spikes before p or qrs,
(complications): Hiccups / muscle twitching
magnesium (mg) sulfate → increase mg+ > 1.3 mg/dl
↑ mg foods = (dairy, dark leafy greens veges)
↓ mg causes → hyperactive deep tendon reflexes
* paresthesia’s, muscle tetany, positive chvostek’s & trousseau’s sign, hypoactive bowels, constipation,
abdominal distention, paralytic ileus.
tpn admin: (total parenteral nutrition) -feeding that bypasses the gi tract. Fluids are given into a vein to provide most of the
nutrients the body needs. Given when person cannot/ should not receive feedings or fluids by mouth.
Hypertonic (20-50% dextrose) , used in chronic pain, peritonitis, burns, infection, etc
No more than 10% hourly, ↑ in rate for body adjustment, check bg
Hyperglycemia, hypoglycemia, vitamin deficiencies, air embolism (clamp, place in trendelenburg pos., o2)
fluid imbalance → fluid volume excess
Wound culture sterile field, press / rotate over wound surface inside the wound (center) in drainage
specimen:
diabetes mellitus ( nephropathy ): kidney damage d/t prolonged ↑ bg & dehydration
Monitor i & o, creatinine, bp
Avoid soda, alcohol, acetaminophen/nsaids / 2 – 3 l fluid from food / beverages
kidney biopsy ( post op ):
Monitor vs → client receives sedation
Assess dressings & urinary output (hematuria- blood in urine )
labs: hgb & hct values, admin prn pain meds, complications hemorrhage / infection
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, lOMoAR cPSD| 26582732
2
thyroidectomy ( post op : needs thyroid hormone replacement
) Client in high fowler’s position, respiratory (trach supplies) present, check for laryngeal nerve damage
Pain management, hypocalcemia / tetany can occur
Prioritization : apply knowledge to standards to determine priority action
Systemic before local – “life before limb”
Acute before chronic
Actual problems before potential future
Listen carefully to clients & don’t assume
Recognize & respond - trends vs. Transient findings
Recognize indications - emergencies vs. Expected
delegate to lpn : monitoring findings, reinforcing teaching, performing trach care, suctioning, checking ng tube patency, administer
tube feedings, inserting urinary catheter, administering meds (no iv)
delegate to : adls, bathing, grooming, dressing, toileting, ambulating, feeding w/out swallowing
ap precautions, positioning, routine tasks, bed making, specimen collection, i & o, vs for stable clients, After initial rn
monitoring clinical manifestations
. Assess/eval
Paracentesis Take out fluid from (peritoneal have client void
(prep) - belly fluid)
Bariatric Weight loss – semi fowlers, 6 small meals/day, liquid/pureed
surgery: ( surgery) food for first 6 weeks (not to exceed 1cup), vitamin / mineral supplements, & 2 servings of
protein daily.
Ostomy (in small intestine) avoid odorous & gas foods (dark green veges, dairy, fish, eggs, beans, corn),
yogurt ↓ gas avoid ↑ fiber foods for first 2 months, ↑ fluid intake
dumping syndrome: happens within 15mins of eating.
Sx: cramps, diarrhea, tachycardia, dizziness, fatigue, hypoglycemia
Interventions: small frequent meals, drink liquids 1hr b4/after
Parkinson’s disease: tremor, muscle rigidity, bradykinesia (slowness in movement) , postural instability
stages:
1. Unilateral shaking / tremor of one limb
2. Bilateral limb involvement, difficulty walking/balance
3. Slowed physical movements
4. Akinesia & rigidity make adl’s difficult
5. Unable to stand/walk, dependent of cares, dementia
Assault: threat battery: touching
hypo glycemia shakiness, confusion, sweating, tachycardia, diaphoresis, palpitations, h/a, lack of coordination, blurred vision,
sx: Seizures, coma
oral hypoglycemic agents : promote insulin release from pancreas (type2 dm)
Glipizide (glucotrol), chlorpropamide (diabines), glyburide (diabinese),
* med for insulin metformin (glucophage). = glucagon
overdose
skin changes, hair loss, debilitating fatigue, 30 minute visits / stays 6ft away / private room
good hygiene, avoid crowded areas, avoid raw foods (veges/meats), avoid cleaning litter boxes,
Downloaded by NELSON KIIRU ()
, lOMoAR cPSD| 26582732
Radiation adverse
effects: 3
Infection control in clients
home: Clean home and avoid sick family.
Client evacuation in response to fire : greatest good for the greatest amount of people
Client in 18 yo+ → 4 hours, 9 – 17 yo →2 hours, 8 yo & younger →1 hour
seclusion:
: lack of remorse, bullies, threatens, low self-esteem, tempers, physical cruelty, destroys property, truant,
Conduct disorders and
Shoplifts
manic phase: ↑ mood, irritable, lasts at least a week, euphoria, agitation, restless, ↑ in talking, flight of ideas, grandiose view of
self, impulsive, manipulative, poor judgement, attention seeking.
Paranoid: distrust / suspiciousness
schiz oid: emotional detachment, disinterest in relationships, indifferent to praise/criticism, uncooperative
schizo typal: odd beliefs, eccentric appearance, magical thinking, perceptual distortions
antisocial: disregard for others, lack of empathy, unlawful, failure to accept responsibility, manipulative, impulsive, seductive
borderline: instability of affect, identity & relationships, splitting behaviors, fear of abandonment, self-injurious, impulsive
histrionic: attention seeking, seductive, flirtatious
Narcissist: arrogant, constant admiration, lack of empathy
Avoidant: anxious, wants close relationships, fear of rejection
Dependent: dependency on another individual
Ocd: perfectionist, orderly, and control
Anti-psychotic
clozapine ( atypical )
Adverse effects: metabolic syndrome, orthostatic hypotension, anti-cholinergic effects, agitation, dizziness,
sedation, mild eps, ↑ prolactin levels(galactorrhea, amenorrhea, gynecomastia), & sexual dysfunction
anti-lipemic agents: ( statins) – treats high levels of fats/cholesterol in blood -called lipid-lowering drugs
Monitor liver enzyme levels (hepatotoxicity) and muscles – monitor ck levels (myopathy & peripheral
neuropathy)
Med interactions: fibrates (genfibrozil) - ↑ myopathy risk, erythroycin & ketoconazole,
amiodarone, Grapefruit juice &
Cyclosprine = can ↑ statin levels
Gentamicin (effects urine output) -causes ototoxicity w/ diuretics, digoxin, lithium, ototoxic meds, nsaids, & anti-hypertensives
long term therapy for : dmards (methotrexate, etanercept, infliximab, adalimubrab, azathioprine, cyclosporine)
ra ** slow joint degradation
Glucocorticoids (prednisone) & nsaids provide symptom relief from inflammation & pain
bulb syringe ( for mouth first, then nose, depress. Then insert into mouth, avoid center of mouth- may stim. Gag
babies): reflex.
priority action to an allergic response:
Mild rashes/hives – benadryl
Anaphylaxis - treat with epi, bronchodilators, and anti-histamines provide
respiratory support & notify hcp
Downloaded by NELSON KIIRU ()
, lOMoAR cPSD| 26582732
4
losartan (arbs -anti-hypertensive (htn) & kidney disease) - cough & hyperkalemia are for ace inhibitors.
Side effects: angioedema, hypotension, dizziness
Tracheostomy 2 xtra tubes, adequate humidification, oral care every 2 hours, trach care every 8 hours, sterile suctioning,
care: Surgical asepsis to remove / clean inner cannula, secure trach ties before removing old, square knot, clean from
stoma outward
Appropriate subjective/objective data, accurate/concise, complete/current, organized/ date/ time/ blk ink
doc.:
support bodyweight at hand grips with elbows at 30 degrees, position crutches on unaffected side when sitting
Crutch or
safety: Rising from a chair
Varicella (chicken pox) transmission : direct contact, droplet, from person with shingles, 10-21 days, 1-2 days before lesions
appear
And all lesions have sabs
Scoliosis: lateral curvature of spine & spinal/truncal rotation that causes ribs asymmetry. Curve needs to be at least 10 degrees
one
screening for idiopathic scoliosis: Leg shorter than the other. Asymmetry in scapula, ribs, flanks, shoulders, hips.
during pre-adolescence - observe child from back
Bend at waist with arms handing down & observe for asymmetry of ribs and flank
Measure truncal rotation with a scolio-meter
Use cobb technique to determine degree of curvature
Use riser scale to determine skeletal maturity
Maintain bedrest, semi fowler’s/ fowler’s ↓ cardiac output ( position while awake, sleep w/ pillows
interventions ):
cardiac output positioning for optimal
left lateral side, semi fowlers, supine with wedge
output: under one hip
infant car seat : position infant in car seat at 45 degree angle, safety restraints loose and low on abdomen
Correct use of on erect penis, empty space at tip for sperm reservoir (may be used with spermicidal gel to ↑
condoms: Effectiveness), protects against sti’s, only water soluble lube with latex condoms
amnio-infusion for : (not enough amniotic fluid around fetus )
oligohydramnios Infusion or ns or lr into amniotic cavity to reduce severity of variable decelerations caused by
cord compression
Scant amount or absence of amniotic fluid, membranes must have ruptured to perform - warm fluid
rhogam for clients who are rh-negative : ( antibodies from human plasma injected into rh+ mother to
protect fetus ) chadwick’s sign – violet/blue color or cervix & Goodell’s vaginal mucosa – softening of cervical tip
sign
hsv ( herpes simplex direct contact transmission to fetus is greatest during vaginal birth if woman has active lesions, lesions
virus ): & tender lymph nodes, obtain cultures from women who have hsv or are at or near term
urinary frequency ↓ fluid intake b-4 bed, use perineal pads, and kegel exercises ↓ stress incontinence
interventions:
vegetarian, nuts, legumes (dried peas/cooked beans), no eggs, no milk products
anthrax, botulism, cholera, diphtheria, gonorrhea, hep a/b/c, hiv, legionaries, lymes, malaria,
Downloaded by NELSON KIIRU ()
1
ATI – NCLEX PREDICTOR REMEDIATION STUDY
NOTES 2025
flank pain → kidney or ureter (if pain radiates → stones in ureter or bladder)
renal calculi -
pain: : sterile technique, warm meds, pull up & back, tilt toward affected ear
Performing ear irrigation
reteplase recombinant (rtpa – clot buster) w/ in 4.5 hours of initial symptoms
Thrombolytic therapy
(stroke): dressing ∆, inner cannula ½ hydrogen peroxide, & stoma □ knot
Trach
care:
Head injury (changes in loc): length of time unconscious & gcs
general anesthesia (post- Abc’s – full body assessment, vitals every 15 minutes, lateral position (if unresponsive or unconscious
op): - monitor loc), fluids/electrolytes
Superficial burns: painful, pink, red, mild edema (3-6 day healing), damage to epidermis
Dialysis (reporting unexpected findings)
: temp of 100 degrees, ↓ bp, bleeding, 1 l of fluid = 1kg, clotting, h/a, nausea,
Disequilibrium syndrome (rapid ↓ bun & fluid volume), anemia, peritonitis, ↑ bg, ↑ cholesterol
Pacemaker infection, hematoma, pneumothorax, hemo-thorax, arrhythmias, pacer spikes before p or qrs,
(complications): Hiccups / muscle twitching
magnesium (mg) sulfate → increase mg+ > 1.3 mg/dl
↑ mg foods = (dairy, dark leafy greens veges)
↓ mg causes → hyperactive deep tendon reflexes
* paresthesia’s, muscle tetany, positive chvostek’s & trousseau’s sign, hypoactive bowels, constipation,
abdominal distention, paralytic ileus.
tpn admin: (total parenteral nutrition) -feeding that bypasses the gi tract. Fluids are given into a vein to provide most of the
nutrients the body needs. Given when person cannot/ should not receive feedings or fluids by mouth.
Hypertonic (20-50% dextrose) , used in chronic pain, peritonitis, burns, infection, etc
No more than 10% hourly, ↑ in rate for body adjustment, check bg
Hyperglycemia, hypoglycemia, vitamin deficiencies, air embolism (clamp, place in trendelenburg pos., o2)
fluid imbalance → fluid volume excess
Wound culture sterile field, press / rotate over wound surface inside the wound (center) in drainage
specimen:
diabetes mellitus ( nephropathy ): kidney damage d/t prolonged ↑ bg & dehydration
Monitor i & o, creatinine, bp
Avoid soda, alcohol, acetaminophen/nsaids / 2 – 3 l fluid from food / beverages
kidney biopsy ( post op ):
Monitor vs → client receives sedation
Assess dressings & urinary output (hematuria- blood in urine )
labs: hgb & hct values, admin prn pain meds, complications hemorrhage / infection
Downloaded by NELSON KIIRU ()
, lOMoAR cPSD| 26582732
2
thyroidectomy ( post op : needs thyroid hormone replacement
) Client in high fowler’s position, respiratory (trach supplies) present, check for laryngeal nerve damage
Pain management, hypocalcemia / tetany can occur
Prioritization : apply knowledge to standards to determine priority action
Systemic before local – “life before limb”
Acute before chronic
Actual problems before potential future
Listen carefully to clients & don’t assume
Recognize & respond - trends vs. Transient findings
Recognize indications - emergencies vs. Expected
delegate to lpn : monitoring findings, reinforcing teaching, performing trach care, suctioning, checking ng tube patency, administer
tube feedings, inserting urinary catheter, administering meds (no iv)
delegate to : adls, bathing, grooming, dressing, toileting, ambulating, feeding w/out swallowing
ap precautions, positioning, routine tasks, bed making, specimen collection, i & o, vs for stable clients, After initial rn
monitoring clinical manifestations
. Assess/eval
Paracentesis Take out fluid from (peritoneal have client void
(prep) - belly fluid)
Bariatric Weight loss – semi fowlers, 6 small meals/day, liquid/pureed
surgery: ( surgery) food for first 6 weeks (not to exceed 1cup), vitamin / mineral supplements, & 2 servings of
protein daily.
Ostomy (in small intestine) avoid odorous & gas foods (dark green veges, dairy, fish, eggs, beans, corn),
yogurt ↓ gas avoid ↑ fiber foods for first 2 months, ↑ fluid intake
dumping syndrome: happens within 15mins of eating.
Sx: cramps, diarrhea, tachycardia, dizziness, fatigue, hypoglycemia
Interventions: small frequent meals, drink liquids 1hr b4/after
Parkinson’s disease: tremor, muscle rigidity, bradykinesia (slowness in movement) , postural instability
stages:
1. Unilateral shaking / tremor of one limb
2. Bilateral limb involvement, difficulty walking/balance
3. Slowed physical movements
4. Akinesia & rigidity make adl’s difficult
5. Unable to stand/walk, dependent of cares, dementia
Assault: threat battery: touching
hypo glycemia shakiness, confusion, sweating, tachycardia, diaphoresis, palpitations, h/a, lack of coordination, blurred vision,
sx: Seizures, coma
oral hypoglycemic agents : promote insulin release from pancreas (type2 dm)
Glipizide (glucotrol), chlorpropamide (diabines), glyburide (diabinese),
* med for insulin metformin (glucophage). = glucagon
overdose
skin changes, hair loss, debilitating fatigue, 30 minute visits / stays 6ft away / private room
good hygiene, avoid crowded areas, avoid raw foods (veges/meats), avoid cleaning litter boxes,
Downloaded by NELSON KIIRU ()
, lOMoAR cPSD| 26582732
Radiation adverse
effects: 3
Infection control in clients
home: Clean home and avoid sick family.
Client evacuation in response to fire : greatest good for the greatest amount of people
Client in 18 yo+ → 4 hours, 9 – 17 yo →2 hours, 8 yo & younger →1 hour
seclusion:
: lack of remorse, bullies, threatens, low self-esteem, tempers, physical cruelty, destroys property, truant,
Conduct disorders and
Shoplifts
manic phase: ↑ mood, irritable, lasts at least a week, euphoria, agitation, restless, ↑ in talking, flight of ideas, grandiose view of
self, impulsive, manipulative, poor judgement, attention seeking.
Paranoid: distrust / suspiciousness
schiz oid: emotional detachment, disinterest in relationships, indifferent to praise/criticism, uncooperative
schizo typal: odd beliefs, eccentric appearance, magical thinking, perceptual distortions
antisocial: disregard for others, lack of empathy, unlawful, failure to accept responsibility, manipulative, impulsive, seductive
borderline: instability of affect, identity & relationships, splitting behaviors, fear of abandonment, self-injurious, impulsive
histrionic: attention seeking, seductive, flirtatious
Narcissist: arrogant, constant admiration, lack of empathy
Avoidant: anxious, wants close relationships, fear of rejection
Dependent: dependency on another individual
Ocd: perfectionist, orderly, and control
Anti-psychotic
clozapine ( atypical )
Adverse effects: metabolic syndrome, orthostatic hypotension, anti-cholinergic effects, agitation, dizziness,
sedation, mild eps, ↑ prolactin levels(galactorrhea, amenorrhea, gynecomastia), & sexual dysfunction
anti-lipemic agents: ( statins) – treats high levels of fats/cholesterol in blood -called lipid-lowering drugs
Monitor liver enzyme levels (hepatotoxicity) and muscles – monitor ck levels (myopathy & peripheral
neuropathy)
Med interactions: fibrates (genfibrozil) - ↑ myopathy risk, erythroycin & ketoconazole,
amiodarone, Grapefruit juice &
Cyclosprine = can ↑ statin levels
Gentamicin (effects urine output) -causes ototoxicity w/ diuretics, digoxin, lithium, ototoxic meds, nsaids, & anti-hypertensives
long term therapy for : dmards (methotrexate, etanercept, infliximab, adalimubrab, azathioprine, cyclosporine)
ra ** slow joint degradation
Glucocorticoids (prednisone) & nsaids provide symptom relief from inflammation & pain
bulb syringe ( for mouth first, then nose, depress. Then insert into mouth, avoid center of mouth- may stim. Gag
babies): reflex.
priority action to an allergic response:
Mild rashes/hives – benadryl
Anaphylaxis - treat with epi, bronchodilators, and anti-histamines provide
respiratory support & notify hcp
Downloaded by NELSON KIIRU ()
, lOMoAR cPSD| 26582732
4
losartan (arbs -anti-hypertensive (htn) & kidney disease) - cough & hyperkalemia are for ace inhibitors.
Side effects: angioedema, hypotension, dizziness
Tracheostomy 2 xtra tubes, adequate humidification, oral care every 2 hours, trach care every 8 hours, sterile suctioning,
care: Surgical asepsis to remove / clean inner cannula, secure trach ties before removing old, square knot, clean from
stoma outward
Appropriate subjective/objective data, accurate/concise, complete/current, organized/ date/ time/ blk ink
doc.:
support bodyweight at hand grips with elbows at 30 degrees, position crutches on unaffected side when sitting
Crutch or
safety: Rising from a chair
Varicella (chicken pox) transmission : direct contact, droplet, from person with shingles, 10-21 days, 1-2 days before lesions
appear
And all lesions have sabs
Scoliosis: lateral curvature of spine & spinal/truncal rotation that causes ribs asymmetry. Curve needs to be at least 10 degrees
one
screening for idiopathic scoliosis: Leg shorter than the other. Asymmetry in scapula, ribs, flanks, shoulders, hips.
during pre-adolescence - observe child from back
Bend at waist with arms handing down & observe for asymmetry of ribs and flank
Measure truncal rotation with a scolio-meter
Use cobb technique to determine degree of curvature
Use riser scale to determine skeletal maturity
Maintain bedrest, semi fowler’s/ fowler’s ↓ cardiac output ( position while awake, sleep w/ pillows
interventions ):
cardiac output positioning for optimal
left lateral side, semi fowlers, supine with wedge
output: under one hip
infant car seat : position infant in car seat at 45 degree angle, safety restraints loose and low on abdomen
Correct use of on erect penis, empty space at tip for sperm reservoir (may be used with spermicidal gel to ↑
condoms: Effectiveness), protects against sti’s, only water soluble lube with latex condoms
amnio-infusion for : (not enough amniotic fluid around fetus )
oligohydramnios Infusion or ns or lr into amniotic cavity to reduce severity of variable decelerations caused by
cord compression
Scant amount or absence of amniotic fluid, membranes must have ruptured to perform - warm fluid
rhogam for clients who are rh-negative : ( antibodies from human plasma injected into rh+ mother to
protect fetus ) chadwick’s sign – violet/blue color or cervix & Goodell’s vaginal mucosa – softening of cervical tip
sign
hsv ( herpes simplex direct contact transmission to fetus is greatest during vaginal birth if woman has active lesions, lesions
virus ): & tender lymph nodes, obtain cultures from women who have hsv or are at or near term
urinary frequency ↓ fluid intake b-4 bed, use perineal pads, and kegel exercises ↓ stress incontinence
interventions:
vegetarian, nuts, legumes (dried peas/cooked beans), no eggs, no milk products
anthrax, botulism, cholera, diphtheria, gonorrhea, hep a/b/c, hiv, legionaries, lymes, malaria,
Downloaded by NELSON KIIRU ()
