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ATI RN Predictor Study, Exams of Nursing

DeVry University - Virginia Nursing

ATI RN Predictor Study 2019 Graded A+

Typology: Exams

2023/2024

Available from 10/01/2024

peter-githongo 🇺🇸

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ATI RN Predictor Study 2019

Testing for TB Correct answer- - A Mantoux skin test is the most

accurate and valuable screening tool available for TB. A positive

result means only that the client has been exposed to TB; it does not

meant that the client has active TB.

Testing for TB continue Correct answer- - A sputum culture for acid

fast bacillus (AFB) is used to confirm the diagnosis of pulmonary TB

after a screening test and chest x-ray come back positive.

Teaching instructions for the use of a cane: Correct answer- (1) The

cane is moved forward about 12 inches.

(2) Then, the weak leg is moved even with the cane.

(3) Finally, the strong leg is brought forward and ahead of the cane

and weak leg.

- Cane is held on stronger side.

- The gripper of the cane should be level with the trochanter of the

femur.

Meningococcal vaccine Correct answer- - Recommended that this vaccine

be given to children who are 11 through 12 years of age and then given

a booster dose at age 16.

When should the single dose of Herpes zoster vaccine be given? Correct

answer- - To adults 60 years or older whether or not they report a

previous episode of herpes zoster.

Rotavirus should be given at what age? Correct answer- - During the

child's first year of life.

Alendronate (Fosamax) Correct answer- - This medication is used to

prevent and treat postmenopausal osteoporosis and Paget's Disease.

- Alendronate-taken in morning on an empty stomach.

- The patient must be instructed to wait at least 30 minutes after

taking Alendronate before eating, drinking, or taking other

medications.

What to expect with a patient having a chest tube? Correct answer- -

Continuous gentle bubbling in the suction control chamber.

- Crepitus (with a pneumothorax, this will persist for several hours

depending)

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ATI RN Predictor Study 2019

Testing for TB Correct answer- - A Mantoux skin test is the most accurate and valuable screening tool available for TB. A positive result means only that the client has been exposed to TB; it does not meant that the client has active TB. Testing for TB continue Correct answer- - A sputum culture for acid fast bacillus (AFB) is used to confirm the diagnosis of pulmonary TB after a screening test and chest x-ray come back positive. Teaching instructions for the use of a cane: Correct answer- (1) The cane is moved forward about 12 inches. (2) Then, the weak leg is moved even with the cane. (3) Finally, the strong leg is brought forward and ahead of the cane and weak leg.

Cane is held on stronger side.
The gripper of the cane should be level with the trochanter of the femur. Meningococcal vaccine Correct answer- - Recommended that this vaccine be given to children who are 11 through 12 years of age and then given a booster dose at age 16. When should the single dose of Herpes zoster vaccine be given? Correct answer- - To adults 60 years or older whether or not they report a previous episode of herpes zoster. Rotavirus should be given at what age? Correct answer- - During the child's first year of life. Alendronate (Fosamax) Correct answer- - This medication is used to prevent and treat postmenopausal osteoporosis and Paget's Disease.
Alendronate-taken in morning on an empty stomach.
The patient must be instructed to wait at least 30 minutes after taking Alendronate before eating, drinking, or taking other medications. What to expect with a patient having a chest tube? Correct answer- - Continuous gentle bubbling in the suction control chamber.
Crepitus (with a pneumothorax, this will persist for several hours depending)

Oscillations-tidaling in the water seal chamber upon respiration are expected. What is a potential complication of a thyroidectomy? Correct answer- - Hypocalcemia: numbness and tingling in the hands, soles of the feet and around the lips. What is Chvostek's sign? And how is it done? Correct answer- Tap on the pt's face at a point just anterior to the ear and just below the zygomatic bone. A positive response would be twitching of the ipsilateral (same side only) facial muscles, suggestive of neuromuscular excitability caused by hypocalcemia. Brudzinski's sign Correct answer- - Is an indication of meningeal irritation, which may be positive in patient's with meningitis.
To perform this, the client needs to be supine. The nurse: - places one hand behind patient's head.
places the other hand on the client's chest. Brudzinski's sign continue Correct answer- - raises the clients head (with the hand behind the head) while the hand on the chest restrains the clients and prevents the client from rising. Flexion of the clients lower extremities constitutes a positive sign. Kernig's sign Correct answer- - Is an indication of meningeal irritation. The maneuver is usually performed with the client supine with hips and knees in flexion. Extension of the knees is attempted and the inability to extend the clients knee beyond 135 degrees w/out causing pain constitutes a positive test. Babinski sign Correct answer- - This is used to test for brain damage or upper motor neuron damage. It is considered positive if the toes flare up upon stroking the plantar aspect of the foot. Cataract surgery discharge instructions Correct answer- - Do not lift anything heavier than 10lbs for at least one week
Sleep on your back or unaffected side to lessen the pressure.
Need to report any pain, decrease in vision or increase in discharge in the eye. Cataract continue Correct answer- - It is normal to feel itching and mild discomfort after surgery, but the pt should be instructed not to rub or place pressure on the eye. Exposure or possible exposure to anthrax Correct answer- - Administer an antibiotic prophylaxis to all pt's newly exposed

deficient factor as a prophylactic measure before any invasive procedure, surgery or when actively bleeding. Cryoprecipitate continue Correct answer- - Cryoprecipitate provides therapeutic amounts of Facto 8, Factor 13, von Willebrand factor and fibrinogen. These concentrates are made with recombinant DNA technology and are the treatment of choice with hemophilic A and von Willebrands disease. Cisplatin (Platinol) Correct answer- - Treatment for cancer.

If a client has reported fatigue it is important to check the patients most recent CBC. The client I likely to be anemic as a result of myelosuppression (bone marrow suppression) from the chem. Cisplatin continue Correct answer- The pt may require tx for the anemia (transfusion, medications) and further chemo may be need to be delayed until the blood counts are higher. Jerking movements of the extremities Correct answer- - Such as ataxia, may be seen with many neurologic conditions affecting the clients ability to produce a smooth movement. Ataxia Correct answer- Jerky movements of the extremities Spasm of the extremities Correct answer- - Involuntary spasms may be found with such conditions as cerebral palsy, trauma, cerebral infection and certain degenerative disorders. Peripheral neuropathy Correct answer- - Is a neurological disorder resulting from damage to the peripheral nerves. It may be caused by diseases of the nerves, systemic illness or a side-effect from chemo. Peripheral neuropathy continue Correct answer- If sensory nerve is damaged, the client is likely to experience pain, numbness, tingling, burning or a loss of feeling in the extremities. RAST testing Correct answer- - Involves measuring the quantity of IgE present in the serum after exposure to specific antigens that are selected based on the pts symptom hx. An elevated IgE indicates a positive response to RAST testing and is seen in pts who have a hx of allergic manifestations, anaphylaxis and asthma. If clear drainage is coming out of a patient and you suspect that it could be CSF, first action is to? Correct answer- - Test it for glucose, then notify doctor

What is a complication that you should frequently assess if a patient is suspected of having diabetes insipidus? Correct answer- - Hypotension A pt who has diabetes insipidus will continue to excrete urine even though there is no intake. Hypovolemia, with resulting hypotension is possible. Active TB treatment duration? Correct answer- - Active TB is usually treated with the simultaneous administration of a combo of meds to which the organisms are susceptible. Such therapy is continued until the disease is controlled. A 6-9 month regimen consisting of two meds is frequently used. Chlorpromazine (Thorazine) Correct answer- - Chlorpromazine is used to treat psychotic disorders such as schizophrenia or manic-depression, and severe behavioral problems in children ages 1 through 12. Chlorpromazine is also used to treat nausea and vomiting, anxiety before surgery, chronic hiccups, acute intermittent porphyria, and symptoms of tetanus. Chlorpromazine continue. Correct answer- - This medication can cause photo-phobic skin reactions and damage to the retina of the eye if exposed to direct sunlight. Patients taking this should be reminded to wear protective clothing, apply sunscreen and wear sunglasses when they are outside. Ileal conduit Correct answer- - It is used to divert urine outside of the body when the urinary bladder has been removed. The conduit cannot store urine the way the bladder did; therefore, urine will be flowing continuously and an appliance must be worn as a collection device. Ileal conduit continue Correct answer- The bag should be emptied approx. every 2 hours to prevent leakage, skin irritation and infection. Manifestations of tardive dyskinesia Correct answer- - Tongue thrusting and lip smacking

Facial grimacing and eye blinking
Repetitive involuntary movements Ulcerative Colitis Correct answer- - Is a chronic, episodic, inflammatory disease of the large intestines and rectum characterized by bloody diarrhea.
Maintaining fluids and electrolyte balance is one of the most important nursing goals.

Left-sided CVA Correct answer- - Could have some aphasia and would need speech therapy

Will also demonstrate hemiplegia of the right side Right-sided Lesion (CVA) Correct answer- - Most likely to have impulsive like behaviors Late signs of ICP Correct answer- - Alterations in VS (Including increased systolic pressure)
Widening pulse pressures
Bradycardia Early signs of ICP Correct answer- - Lethargy
Headache
Neck pain
Generalized muscle aches Pediculosis Capitis Correct answer- - Head lice ** Nits shed into the environment and are able to hatch up to 7- 10 days** Scabies Correct answer- - Appear as grayish brown, threadlike burrows on the skin Cocaine intoxication Correct answer- - Dilated pupils Hemianopsia Correct answer- Blindness in one half of the field, a functional defect that can affect the right or left side. Hypothyrdoism expected lab results Correct answer- - Elevated TSH levels
Decreased T4, T3 & free thyroxine Specific & Sensitive indicator for renal function Correct answer- - Creatinine males 0.6 - 1.2 mg/dL female 0.5-1. Emphysema expected findings Correct answer- - Dyspnea
Tachycardia
Barrel chested
Clubbing of the fingers
Shallow respirations

Rescue breathing Correct answer- - When someone is not breathing but has a pulse Deliver a breath every 5 seconds for a adult Addison's Disease Treatment: Correct answer- - High protein, high carb diet

Weigh daily
Injectable IV fast acting steroid may be ordered or indicated for a patients experiencing an Addisonian crisis until the pt is no longer at risk for dehydration, hypotension and shock. SSRIs Correct answer- - Citalopram (Celexa) an example of an SSRI
Used to treat depression
Can take 3-4 weeks before patients starts to experience signs of improvement and in some cases up to 8 weeks. Agoraphobia Correct answer- - Fear of being in places in which help may not be available Pernicious anemia Correct answer- - Caused by a lack of intrinsic factor, a substance needed to absorb Vit B12 from the GI tract.
Often has a red beefy looking tongue
Vit B12 is needed for the formation of RBCs. Iron deficiency Anemia Correct answer- - Is a condition in which RBCs contain decreased level of hemoglobin Aplastic Anemia Correct answer- - Caused by a failure of the bone marrow to produce sufficient number of RBC's. Hemolytic Anemia Correct answer- - Hemolytic anemia involves erythrocyte destruction and maybe medication induced or caused by sickle cell disease, transfusion reaction or kidney disease. Hematuria (blood in the urine) or hemoglobin present in the urine may indicate hemolytic anemia Diphenhydramine's such as Benadryl can also be given to treat what? Correct answer- - They also have an anticholinergic effect that can help control tremors in the early stages of Parkinson's. Agranulocytosis Correct answer- Is a rare adverse reaction to Clozapine (Clozaril) in which WBC's drop causing pt to become susceptible to acute infections.

Mechanical restraints Correct answer- - Patient needs to be assessed every 15-30 minutes and document findings, check for a new prescription every 4 hrs for clients >18 years, every 2 hrs for children 9-17 & every 1 hr for children younger than 9 years. Pulse paradoxus Correct answer- - A finding in which systolic BP is 10 mmHg or greater on expiration than inspiration. Pt also may present with JVD, bradycardia & hypotension. A symptom of cardiac tamponade Estradiol Correct answer- - Estradiol is used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Other uses include prevention of osteoporosis in postmenopausal women, and replacement of estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body. Estradiol is sometimes used as part of cancer treatment in women and men. Estradiol continue Correct answer- - Adverse effect of a headache needs to be reported as medication can cause thromboembolism. Monitor for swelling & tenderness of the calf, monitor for hypertension and report as well. Hemolytic transfusion reaction Correct answer- - Back pain is an adverse reaction, hypotension, tachycardia Stages of Kawasakis Disease Correct answer- - Acute

Subacute
Convalescent Acute phase of Kawasakis Correct answer- - Beginning stage
Starts with high fever uncontrolled by antipyretics
Tachycardia
Irritability
Strawberry tongue
Conjunctival redness Sub-acute phase of Kawasakis Correct answer- - Pain in childs weight bearing joints
Peeling of soles of feet and hands Post-op of Tonsillectomy Correct answer- - Should position pt so that the head is lower than the chest.
Avoid having pt cough & clear throat, avoid using straw in the first 24 - 48 hours.

Administer analgesics q4hours for the first 24-48 hours.
No red liquids (including red-popsicles)
No diary products Abruptio placentae Correct answer- - Persistent uterine contractions
Painful
Placenta separates from the uterus
Bleeding inside the uterus
Life-threatening to the fetus Herbal supplement Saw Palmetto Correct answer- - This can result in a false low prostrate specific antigen level Herbal supplement Valerian Correct answer- - Can lower BP Ginsing Correct answer- - Used to stimulate mental activity and increase appetite
This can interact with caffeine and cause irritability Flaxseed Correct answer- - This can be used for migraine prophylaxis can lead to GI symptoms such as bloating, abd pain and flatulence Lithium expected side/adverse effects (non-urgent) Correct answer- - Headache
Polyuria
Hyperglycemia Signs of lithium toxicity (Urgent) Correct answer- - Confusion
Coarse hand tremors
ECG change
Sedation Macular Degeneration Correct answer- - Decrease in central vision Double vision Correct answer- - Can be a symptom of cataracts Floating dark spots Correct answer- - Retinal detachment Glaucoma Correct answer- ICP Misoprostol Correct answer- - This med reduces gastric acid secretions so that ulcers can heal.
Pt's taking this should avoid taking magnesium containing antacids as this will increase the risk of diarrhea.
Misoprostol tends to cause diarrhea.

Blood Transfusion Correct answer- - Normal Saline ONLY!

Only collect one unit of blood @ a time.
Want a 20 gauge needle or larger.
Initiate blood transfusion 30 minutes or less after obtaining blood. Warfarin Correct answer- - Daily blood draws are needed for the 1st 5 days of starting this medication.
Pt should not take calcium supplements
Do not take acetaminophen for headaches (increases risk for bleeding) Permanent Trach Care Steps Correct answer- 1st: Remove inner cannula. 2nd: Remove soiled dressing. 3rd: Clean stoma. 4th: Change collar. Newborn Care Correct answer- - dry newborn 1st unless suction mouth is there as AIRWAY is most important, then dry! Safety Teachings for parents Correct answer- - No more than 120 degrees for water heater
Crib slates should be no more than 2.25 in apart
Car seat should face the rear until 2 years of age
Newborn car seat should be at 45 degree angle. Myasthenia gravis care (with attention to improving nutrition) Correct answer- - Monitor weight each week
Take your anticholinesterase medications 45-60 minutes before meals to prevent aspiration
Cut food into small bites & eat slowly
Choose snacks that are high in calorie Acupressure band Correct answer- - These bands can be worn on the wrists and can help alleviate nausea and vomiting.
An alternative therapy option for pregnancy n/v. Rheumatoid Arthritis (RA) Correct answer- - Want to balance exercise/activity and rest
Pain, stiffness and swelling are worse in the morning BRAT diet Correct answer- B = Bananas R = Rice A = Applesauce T = Toast

This may be suggested if the child is having a hard time keeping things down from vomiting or GI upset. This is high in carbs but has little nutritional value Infectious Gastroenteritis (Diarrhea) rehydration Correct answer- - Should initiate oral rehydration therapy that should contain sodium, potassium, chloride, citrate or bicarb and glucose. With PTSD, type of alternative therapy Correct answer- - Guided imagery Upper chest petechiae after a long bone fracture Correct answer- - Purple/red small dots that are caused by minor bleeding from capillary blood vessels.

This indicates that the pt is at great risk for a fat emboli a life- threatening complication of fractures. Diabetes Insipidus Correct answer- - A deficiency in antidiuretic hormone
Increase in urine output (polyuria) If a pt has a hx of a stroke and we want to decrease risk of ICP while caring for them, what are some interventions to reduce the risk? Correct answer- - Keep the bed no more than 25 degrees
Place pt in a quiet room Fluoxetine nursing manifestations Correct answer- - This can cause serotonin syndrome within 2-72 hours of starting treatment.
Pt could experience tremors, agitation, confusion, anxiety and hallucinations and need to be reported.
Educate pt to monitor and report any black tarry stools.
Weight gain is an adverse effect and can cause a rash. Pressure ulcer stage 2 Correct answer- - Partial thickness (some skin loss or blistering) Pressure ulcer stage 3 Correct answer- - Subcutaneous tissue visible Pressure ulcer stage 4 Correct answer- - Muscle damage, tendon exposure True Labor signs & symptoms Correct answer- - The cervix transitions to the anterior position
Contractions increase with ambulation

Clonidine may be prescribed for some experiencing? Correct answer- - Alcohol withdrawal, this will help diaphoresis Chlordiazepoxide Correct answer- - This med is used to prevent delirium tremens for someone experiencing alcohol withdrawal Acetazolamide Correct answer- - This is a med used for open angle glaucoma

Adverse effect of this med is tingling of fingers and hyperglycemia Donepezil Correct answer- - Used for Alzheimer's
Side Effects: Dyspepsia, diarrhea, dizziness
Adverse effect: Dyspnea (NEED TO REPORT TO PROVIDER) Furosemide Correct answer- - Puts pt at risk for hypokalemia, dizziness (can cause drop in BP which leads to the dizziness) & urinary frequency Decreased LOC signs Correct answer- - Depressed deep tendon reflexes
Decreased BP
Lethargy Methotrexate Correct answer- - This med is an immune suppressant and can cause bone marrow suppression. Should advised pt about monitoring for fever or sore throat. Tetracycline Correct answer- - Can cause GI upset, suggest to take with applesauce.
Should advise pt to take med in the morning to prevent esophageal ulceration.
Do not take with antacids, will alter absorption Flumazenil Correct answer- - Used for Benzo reversal (antidote) Albuterol Correct answer- - Used for acute asthma attacks Long-term tx of asthma Correct answer- - Montelukast (Leukotine)
Beclomethasone (corticoseteriod)
Nedocromil (Mast-cell) Phenytoin (Dilantin) Correct answer- - Medication for seizures (anticonvulsant)
Should not take with other calcium containing foods.
Commonly causes gingival hyperplasia

Phenytoin continue Correct answer- - Nystagmus-a serious reaction and should be reported.

Levels less than 10 mcg/mL are sub therapeutic and can result in seizure activity. Levels more than 20 mcg/mL can produce toxic effects. Enalapril Correct answer- (ACE Inhibitor)
Should monitor for hyperkalemia (due to potassium retention by the kidneys) Insulin glargine Correct answer- - This should NOT be mixed in a syringe with any other insulins
This med should be injected once a day and does not cause peaks, instead it maintains a steady blood level for 24 hours, which reduces the risk of hypoglycemia Salmeterol Correct answer- - Bronchodilator that is used to treatment exercise induced bronchospasm, prevention of asthma attacks, COPD and chronic bronchitis & emphysema Helps improve breathing Oxybutynin Correct answer- - Med is used for treatment of urinary incontinence
Can expect these common side effects: Tachycardia, constipation, dry mouth, blurred vision, photophobia Common medication given for Graves Disease Correct answer- - Propylthiouracil
This medication increases the ability to focus which is a symptom of graves disease (inability to focus).
An increase in ability to focus would indicate that this medication is working. Propylthiouracil Correct answer- - This medication is used to tx of Graves Disease (hyperthyroidism), but should not be of first choice with this disease. (In patients with Graves' disease with hyperthyroidism or toxic multinodular goiter who are intolerant of methimazole and for whom surgery or radioactive iodine therapy is not an appropriate treatment option)
Should not be used if patient has liver failure, or pregnant
Watch out for and report : Black tarry stools, chills, chest pain, fever, cough, sore throat or SOB.

Medications prescribed for UTI's: Correct answer- - Sufamethoxazole- trimethoprim

Ciprofloxacin
Phenazopyridine Medications to fight bone marrow suppression (typically due to cancer treatment) Correct answer- - Erthropoietin
Filgrastim Growth factors Atorvastatin Correct answer- - Watch for muscle pain (stop med & contact provider)
Watch liver enzymes Digoxin Correct answer- - Cardiac glycoside
Common side effect: Bradycardia
Watch Potassium levels (if too low=toxicity)
Check HR & hold if under 60 bpm
Toxicity symptoms: Anorexia, N/V, blurred/yellow haze vision
Normal Dig levels: 0.5-0. Digoxin Toxicity manifestations Correct answer- - Anorexia
N/V
Blurred vision
Yellow haze
Fatigue/weakness
Normal Dig levels: 0.5-0. Reasons to hold BP meds Correct answer- - HR <60 bpm
Systolic BP < Ace Inhibitors Correct answer- - Watch for dry cough (discontinue and report)
Hypotension
Increased K+ levels (can cause hyperkalemia)
Common meds: Captopril, Enalapril (Ends in "pril") Beta- Blockers Correct answer- - End in "olol"
Metoprolol, propranolol
Watch for bradycardia & hypotension
Metroprolol can decrease cardiac output and needs to be cautioned with CHF. No grapefruit.

Propranolol can cause bronchoconstriction (so don't want to give to someone with asthmatics) Oprelevekin Correct answer- - This med is used to tx adverse effect of chemo ( low platelet count)
This med is a thrombopoletic growth factor and therefore a platelet count within the expected range would mean it is therapeutic Carbamazepine Correct answer- - This medication can be used to treat bipolar as well as seizures
This med can affect oral contraceptives Neostigmine Correct answer- - This medication is used to treat myasthenia gravis
An adverse effect of this med is nausea, bradycardia, and salvation at the mouth. Valproic Acid Correct answer- - Valproic acid is used to treat various types of seizure disorders. It is also used to treat manic episodes related to bipolar disorder (manic depression), and to prevent migraine headaches.
This medication can cause liver failure so watch for jaundice Side effects of inhaled corticosteroids Correct answer- - Dysphonia
Oral candidiasis Pt will need spacer and need to rinse the mouth after inhalation, this will help reduce the risk Verapamil Correct answer- - This is a calcium channel blocker used to decrease workload and lower BP. So changing positions slowly will prevent orthostatic hypotension and dizziness.
Should take with food
Palpitations should be discussed with pcp but not stopped w/out addressing with doc first Metronidazole Correct answer- - Metronidazole is used to treat bacterial infections of the vagina, stomach, skin, joints, and respiratory tract. This medication will NOT treat a vaginal yeast infection.
This should not be taken with alcohol When a patient is taking epoetin alfa, what should you watch for? Correct answer- - Increase in BP if the patient hematocrit levels rise too rapidly, hypertension and seizures could result

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