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ATI RN COMPREHENSIVE EXIT EXAM
diet for chronic renal failure low protein & potassium DM pt teaching change shoes, wash feet w/soap & water pulse pressure subtract systolic value from diastolic value lantus never mix, long lasting, no peak rhogam given @ 28 weeks & 72 hours post delivery when mom is negative & baby positive indication of baby dehydration improving smooth fontanel pt w/orthostatic hypotension put near nursing station cleaning a wound clean to dirty use bulb syringe peripheral arterial disease cramp in leg while walking intermittent claudication seizure precautions supine position
20 weeks gestation, having urinary frequency u/a & c/s report to new nurse @ shift change pt @ xray s/s of hemolytic blood transfusion flank pain ER rape victim priority acess anxiety nutrition carbs 45%, protein 10-15% latex allergy tape up cords first ingredient on a food label most content thoracentesis, & painful w/breathing put pt on UNAFFECTED side for 1 hour or longer pt w/IV sedation check LOC if not responsive help older brother get used to baby get a gift for big brother early decelerations head compressions methergine contraindication HTN delegate to AP I & O
total gastrectomy lack b 12 takes 30-60 meal to eat a meal stoma color pink or red is normal MAOI's diet no pepperoni, no tyramine, COTTAGE CHEESE OKJ give iron w/? OJ statins contraindication Grapefruit juice haldol lip smacking mag sulfate decreased urine output decreased respirations decreased pulmonary edema antidote for mag sulfate calcium gluconate clozaril interventions monitor WBC valproic acid liver function thyroid med effectiveness weight loss diuretics don't skip doses
DIG adverse effects N/V & HA prednisone take with milk hemo/peritoneal dialysis pt teaching medical asepsis cranial nerve 11 shoulder peripheral catheter insertion advance catheter when you see flash back of blood return dispose of insulin needles @ home in coffee container confirmation of ng placement x ray swallowing difficulty referral speech therapy acrabose skip a meal, skip dose, give w/1st bite of food sprains & strains RICE pt DNR-CC & family asking questions related to. therapeutic communication: THERAPEUTIC RESPONSE What did the dr tell you? delegating to AP about skeletal traction: NEEDS MORE TEACHING AP places weight on bed daughter feeling guilty about admitting parent into long-term facility: THERAPEUTIC RESPONSE
nutrition- thicken liquids pt receiving radiation, what should you wear? lead apron pt suffering from hyperthermia seizure precautions pt refuses last minute for a procedure he already consented for okay to stop procedure s/s of smallpox rash on tongue xerostoma humidifier vagina procedure, cervical cancer place catheter Lyme disease report it lice (pediculodis capitis) can survive on surfaces for up to 48 hours RSV keep stethescope in room (droplet) 16 weeks gestation can get AFP test done bacterial meningitis droplet precautions when can kid return to school for chicken pox when lesions are crusted over kicks a ball: developmental stage
24 months baby w/cleft lip untie arms & perform ROM wrong ostomy care changing everyday may lead to skin irritation after male circumcision apply petroleum jelly w/every diaper change breastfeeding w/hep c don't breast feed if you have cracked nipples contraindication w/oral contraceptives HTN combination contraceptives contraindications pt w/migraines when percussing RUQ, what should we feel dullness dementia pt offer finger foods black males @ great risk for CVA med for alcohol withdrawal disulfiran (antabuse) better nutririon canola oil healthy eating 45 % carbs to prevent neuro tube defects
IV technique advance catheter Refeeding syndrome 60% Low fat diet canola oil instead of vegetable oil Prior to amniocentesis empty bladder Radiation implant limit visitors to 30 minutes Levothyroxine take on empty stomach, in am; increases tsh Metformin contraindication kidney disease, severe infection, shock, hypoxic conditions Mastectomy lay of affected side to promote drainage, support arm on pillow, HOB 30 Circumcision use petroleum jelly with every diaper change Check for NG tube placement in the jejunum X-ray Colostomy care cut the bag Seizure precautions saline lock IV Ethical medical error veracity
Early decelerations head compressions Magnesium sulfate interventions (select all) calcium gluconate, stop infusion, UO less than 30, RR less than 12, decreased reflexes Thoracentesis causes pneumothorax expected finding not friction rub; tracheal deviation AP's talking in cafeteria tell them to stop talking Safety for parkinson's clear area Warfarin vitamin k for toxicity; INR 2-3; PT 11-12. Contraindication of MMR blood transfusion Diabetic foot care (select all) change shoes frequently, wash feet with soap and water Sprains avoid warm compress Expected finding of small pox rash in mouth 16 weeks pregnant alpha protein Psych med lip smacking Where to start IV first (picture) hand
Statin grapefruit Preventing uric acid stones yogurt RSV have own stethoscope in room Change of shift report orthostatic hypotension by nurses station Confused patient raise 1 side rail Hypoglycemia cool and clammy skin Hyperglycemia thirst Glycosylated blood test HbA1C Priority for patient in seclusion document Buddhist patient vegetarian Positive TB hard raised bump Heart murmur sound blowing or swishing Dehydration oliguria
NST
PAD
pain/cramping when walking, calf muscle atrophy, shiny cool extremities; elevate legs Cast with white extremity compartment syndrome Alcohol withdrawal expected finding n&v, tachycardia, diaphoresis, tremors, seizures Varicella scabs okay Hyperthermia not blanket or ice Purpose of ice decrease inflammation Sexual assault assess anxiety THA avoid flexion greater than 90 Beta blocker teaching don't stop abruptly; avoid in asthma; take with food Combination contraceptives increase BP Myelosuppression flu shot Glucocorticoid increase dose in DM; take with meals; avoid NSAIDs; Addison's crisis if stopped abruptly
Informed consent signed willingly Sibling bonding offer gift each time sibling gets one TURP complication hematuria African american over Caucasian heart disease Sickle cell priority hydration Sickle cell complication SOB Respite care give caretaker break Acarbuse take with first bite of each meal Hallucination I understand you are scared Fire extinguisher PASS Advanced directive don't need a lawyer Breastfeeding and hepatitis c as long as you don't have cracked nipples ICP keep HOB midline
Long term use of proton pump inhibitors osteoporosis Diabetes insipidus polyuria Difficulty voiding warm water ACE inhibitors cough What do you hear when you palpate abdomen resonance Negotiation strategy understand both sides Dying patient wants to be alone depression or dysfunctional Wife progressing quickly can you tell me more Pregnant non-pharmacological pain management aromatherapy, breathing techniques, imagery, music, use of focal points, subdued lighting Hypnosis purpose alter perception of pain Complication of conscious sedation with RR 6 stop infusion or give something Major depression, OCD give fluoxetine What causes constipation iron
Give RhoGAM in second pregnancy protect future pregnancy Swallow problem refer to speech therapist Nutrition for heart failure Decrease Na, increase fluids, increase fiber; increase K with diuretic Adverse affects of dogoxin Bleeding gums, bloody urine and stools, arrhythmias, petichiae NG nutrition Increase K Methotrexate adverse affect High blood pressure I.M. site for children VASTUS LATERALIS or antelolateral thigh is the site for IM injections in children < 2 yrs. of age Peak Levels show the highest concentration Time for drawing Peak levels: Oral Intake 1 to 2 hour after administration Time for drawing Peak levels: I.M. 1 hour after administration Time for drawing Peak levels: I.V. 30 minutes after administration Trough Levels show the lowest concentration or residual level, usually obtained within 15 minutes before next dose. Do not administer until confirmed. Can meds be administered through blood tubing?
NO. Never administer meds through tubing being used for blood administration How long should fluids be infused? Fluids should be infused within 24 hours, discard unused potion, to prevent infection Complications associated with IV infusion infiltration, extravasation, phlebitis, thrombophlebitis, hematoma, venous spasm Preventing Infiltration use smallest catheter for prescribed therapy, stabilize port-access, assess blood return Treatment of Infiltration stop, remove, cold compress, elevate extremity, insert new cath in opposite extremity Preventing Extravasation know vesicant potential before giving medication Treatment of Extravasation stop, discontinue, aspirate med if possible, cold compress, document Preventing Phlebitis & Thrombophlebitis rotate sites every 72 to 96 hrs, secure catheter, aseptic technique for PICC lines, limit activity with extremity Treatment of Phlebitis & Thrombophlebitis stop, remove, heat compress, insert new cath in opposite extremity Preventing Hematoma avoid veins not easily seen or palpated, obtain hemostasis after insertion Treatment of Hematoma remove, apply pressure, monitor for signs of phlebitis and treat Preventing Venous Spasm allow time for vein diameter to return after tourniquet removed, infuse fluids at room temp Treatment of Venous Spasm temporarily slow infusion rate, warm compress
