ATI Comprehensive practice predictor

kidowise's version from 2016-01-20 14:43

Section 1

Question Answer
Most common cause of hyperthyrpodismGrave's Disease
S/S of thyroid stormhyperthermia, HTN, delirium, vomiting, abdominal pain, hyperglycemia, tachydysrhythmias
Antidote for valium intoxicationFlumazenil (Romazicon)
Admin. Valium, monitor for what?decreased respirations
Appropriate actions for bacerial meningitisdroplet precautions, decrease environmental stimuli, maintain best rest w/ HOB at 30, seizure precautions, replace fluid and electrolytes
position crutches on affected or unaffected side when sitting or rising from chair?unaffected
Intervention for sprain(PRINCE) Protect, Rest, Ice, NSAIDs, Compress, Elevate
Contact Precaution mnemonic(MRS WEE) Multidrug resistant organism, respiratory infection, skin infection (varicella, diphteria, shingle, impetigo, scabies), wound infection, enteric infection (c-diff), eye infection
use of restraintsprovider must rewrite order every 24h, Toileting and ROM exercises q2h, don't tie to bed rales
Care for Pt who has clostridium difficilecontact precautions, encourage increased fluid intake, antipyretics, antimicrobial therapy
clinical manifestations of smallpoxhigh fever, fatgue, sever headache, rash (starts centrally and spreads outward) that turns to pus-filled lesions, vomiting, delirium, excessive bleeding
sealed radiation implantpt in private room, nurse should wear dosimeter film badge, visitors limited to 30m visits and maintain distance of 6ft, visitors who are pregnant or under 16yoa should not contact Pt, lead container in room, instruct pt to call nurse for assistance with elimination

Section 2

Question Answer
Latent phase of labor1st part of the 1st stage of labor, lasts 4-6h, cervix 0-3cm, contractions irregular, mild to mod freuqency 5-30m and duration of 30-45s, some dilation and effacement, pt talkative and eager
equation for calculating due date1st day of last period - 3m +7d +1yr = due date
grains per day6 oz
veggies per day2.5 cups
fruits per day2 cups
milk per day3 cups
protein per day5.5oz
nutrients for healthy nervous systemB complex vitamins (thiamine, niacin, B6 & B12, Ca, and Na
daily % calories from protein10%
daily % calories from carbs45-65%
daily % calories from fat20-35%
expected physioligical changes of agingdecreased EVERYTHING (skin turgor, wt, chest wall movement, senses, ht, subQ fat)
measures to prevent injury with osteoporosisCa supplementation, adequate amounts of protein, mag, vit. K, Vit D, wt-bearing exercises, remove throw rugs, pride adequate lighting, clear walkways, mark threshholds, doorways and steps
African American women are at increased risk for what?cervical cancer
African americans are at increased risk for what?heart disease and stroke
What populations are at greater risk for diabetes?american indians, alaskan natives, african americans & hispanics
Discharge teaching on engorgementavoid breast stimulation & running warm water over breasts, apply cold compresses 15m on and 45m off, cabbage leaves placed inside bra
to lose 1 lb of body fat per week, an adult must ahve an energy deficit of ____ cals/day500 or 3,500 cal/wk

Section 3

Question Answer
Positive symptoms of schizophreniahallucinations, delusions, alterations in speech, bizarre behavior
Negative symptoms of schizophreniaflat, blunt affect; algoia (poervty of thought/speech); avolition (lack of motivation); anhedonia (lack of pleasure/joy); anergia (lack of energy)
NI for domestic partner abusehelp Pt develop a safety plan, identify behaviors and situations that might trigger violence and provide information regarding safe places to live; enoucrage participation in support groups
NI for Pt who is manicdecrease stimulation, frequent rest periods, observe for escalating behavior, provide otlets for physical activity, provide protable nturitious food, us a calm, matter-of-fact approach, give concise explanaitions
NI for alcohol withdrawal syndromeself-assess ones own feelings regarding abuses; use open-ended questions, close/one-on-one observation; low-stimulation enviro, encourage attandance of self-help gorups
NI for Pt with PTSDprovide safety and comfort, remain w/ Pt through episode, give reassurance, group/family therapy is best, assist cleint to eval. coping mechanisms that work, assist Pt in determining triggers
Nursing interventions for dementiareinforce reality, orientation to TPP, encourage reminiscence about happy times, talk about familiar things, minimize need for decision making and abstract thinking to avoid frustration

Section 4

Question Answer
Ileostomy Careapply skin barriers to stoma, empty back when it is 1/3 full, assess for fluid and electrolyte imbalances
Normal post-op output for an ileostomy is what?1L/d; may be bile colored and liquid; normal to see small amounts of blood
Stomal appearance should normally lookpink or red and moist
Steps in performing closed intermittent irrigationclam catheter b/w injeciton port and extension tubing, cleanse port, slowly inject irrigant into catheter, remove syringe and unclamp, allow irrigant to drain into drainage bag
Benefits of applying ice to extremitydecreases inflammation, bleeding, fever, swelling, msucle spasms and pain
Kosher foodsanimals which chew cud and have split hooves (cattle, sheep, goats, & deer), seafood with fins and scales, NO PORK (hotdogs, sausage, gelatin), and no meats mixed with milk
Nutritional needs for hepatic encephalopathyhigh carb, high cal, low to mod fat, and low to mod protein; small, frequent meals; supplement w/ vits (B complex), folic acid, and iron
NI for Pt receving TPNmonitor serum and urine glucose, monitor for "cracking" of solution, use sterile technique when changing central line, bag and tubing should be changed q24h
TPN fluid overload is evidenced by what?wt gain > 1kg/d and edema
Interventions for chronic renal failurediet high in carbs and mod. fat, control protein intake, restrict Na, K, Ph, and Mg
Sleep promotiionbedtime routine, min number of times pt is awakened, assist w/ personal hygiene or back rub, exercise 2hr before bed, limit fluids 2-4hr before bed
Intermittent tube feedingsHOB @ 30 degress for at least 30m after feeding, admin. solution at room temp, formula is administered q4-6h in equal protions of 200-300mL over a 30-60m time frame
How often should feeding bags be discardedq24h
How often should gastric residuals be checked?q4-6h
Bariatric surgeries Dietary planninglimited to liquids or pureed foods for first 6wks, meal size shouldn't exceed 1c, vit & min supplements
Fodds that can cause odor for ostomyfish, eggs, asparagus, garlic, beans, and dark green leafy veggies
Foods that can cause gas for ostomy ptdark green leafy veggies, beer, carbonated beverages, dairy products, and corn
What type of diet should a client who has dysphasia be on?Pureed or mechanical soft diet

Section 5

Question Answer
Contraindications for the use of Isosorbide Mononitrate (IMDUR)hypersensitivity to nitrates, traumatic head injury b/c med can increase ICP, use causiously in Pt taking antiHTN meds or have renal or liver disfucntion
If Pt develops reflex tachycardia from taking Imdur give waht?metoprolol (lopressor)
Atorvastatin (lipitor) purposedecrease manufacture of LDL and VLDL and increase HDLs; promotes vasodilation, decreased plaque site inflammation, and decreased risk of thromboembolism
S/E of LipitorHepatotoxicity (liver fxn tests after 12wks then q6m); myopathy (obtain baseline CK levels); peripheral neuropathy (notify provider)
Teaching for lipitordon't take with grape fruit juice, take in evening
S/E of Metoclopramide (Reglan)EPS (notify Ph, admin benadryl), hypotension, sedation, anticholinergic effects
prupose of doxazosin (cardura)venous & arterial dilation, smooth muscle relaxation of prostatic capsule and bladder neck
S/E of Cardura1st dose orthostatic hypotension
Teaching about carduratake 1st dose at night and monitor BP 2hr after 1st dose, avoid activities requiring mental alertness for first 12-24h, instruct pt to change position slowly, take with food
purpose of clozapine (clozaril)neg and pos s/s of schizophrenia, relief of psychotic symptoms
S/E of ClozarilNew onset diabetes/loss of glucose control (report s/s of increased thirst, urination, appetite), wt gain, hypercholesterolemia, orthostatic hypotension, anticholinergic effects, symptoms of agitation, dizziness, sedation, and sleep disruption, mild EPS such as tremor, risk for dyslipidemia, risk for fatal agranulocytosis (baseline & wkly monitor of WBC, notify of S/S of infection)
Therapeutic effect of Levothyroxine (Synthroid)decreased TSH, normal T4 levels, absense of hypothyroidism symptoms (depression, wt gain, bradycardia, anorexia, cold intolerance, dry skin, menorrhagia); takes several wks to notice a therapeutic effect
Long-term adverse effects of Haloperidol (Haldol)Tardive dyskinesia (involuntary movements of tongue and face, sip smacking, involuntary movments of arms, legs, and trunk)
Effectiveness of Allopurinal (Zyloprim) is evidenced byImprovement in pain caused by gout attack (decreased joint sweeling, redness), decreased number of gout attacks, decreased uric acid levels
Purpose of leukotrien modifiers (Singulair)suppress inflammation, bronchoconstriciton, airway edema, and mucus production
uses for singularlong-term therapy for asthma and to prevent exercise-induced bronchospasm
Teaching about singulairtake once daily at bedtime
Use of desmopressin (DDAVP)promote rabsorption of water within the kidneys; cause vasoconstriction; tx of diabetes insipidus
Effectiveness of DDAVP is evidenced byreduciton in the large volumes of urine output associated with diabetes insipidus to normal levels
Contraindications to MMR Immunizationpregnancy, allergy to gelatin and neomycin, hx of thrombocytopenia, immunosuppression, recent blood transfusion; common cold NOT a contraindication
Administration of Enoxaparin (lovenox)subq q12h for 2-8d; use 20-22G needle to draw up; 25-26G needle to admin; admin in abdomen at least 2" away from umbilicus; apply pressure for 1-2m after injeciton; DON"T RUB
Teaching about iron supplementstake with orange juice on empty stomach; may cause constipation, N/V/D, can tern stool a dark green/black color
Purpose of furosemide (lasix)block reabsorption of Na and chloride and prevent reabsorption of water; cause extensive diuresis
Uses of furosemide (lasix)pulmonary edema caused by HF, emergent need for rapid mobilization of fluid
S/E of Lasixdehydration, hypoNa, hypoCl, hypoTN, ototoxicity, hypoK
Teaching on Lasixavoid admin late in day, report significant wt loss, lightheadedness, dizziness, GI distress, and general weakness, observe for signs of low Mg levels such as muscle twitching and tremors
When should admin RhoGAMwhen mom is Rh-negative and had Rh-positive infant; admin w/n 72h
Does does Magnesium Sulfate do?relaxes smooth muscle of the uterus and inhibits uterine activity by suppressing contractions
What are s/s of Mag sulfate toxicity?loss of DTRs, urinary output < 30ml/hr, resp depression, pulmonary edema, and/or chest pain
What is the antidote for Mag sulfate?Calcium gluconate
What are the contraindications for Mag sulfate?active vagninal bleeding, dilation of cervix is > 6cm, chorioamnionitis, > 34 wks gestation, acute fetal distress, severe pregnancy induced HTN or eclampsia
Indicaitons to with hold Propranolol (inderal)bradycardia, SOB, edema, fatigue, AV block, Pt has asthma
Uses for methadone (Dolophine)relief of mod to severe pain; sedation; reduction of bowel motility