ATI COMPREHENSIVE EXAM QUESTIONS AND ANSWERS

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ATI COMPREHENSIVE EXAM QUESTIONS AND ANSWERS How do you walk up stairs with crutches? Use railing if there is one; lead with good leg, using crutches for support of bad leg What are signs of co... mpartment syndrome? MEDICAL EMERGENCY! tingling, numbness, worsening pain, edema, pain on passive movement, unequal pulses What should you do for suspected compartment syndrome? Call doctor immediately, loosen dressings, and prepare to assist with fasciotomy What interventions do you do for suspected enterocolitis? Assess and measure abdominal girth, monitor/manage fluid, electrolyte, and blood replacement, monitor for sepsis/peritonitis/shock, and give antibiotics What are some signs and symptoms of Hirschsprung's disease? Newborn: failure to pass meconium in 24-48 hours, vomiting bile, refusing to eat, abdominal distention; infant: FTT, vomiting, constipation; child: undernourished, anemic appearance, abdominal distention, visible peristalsis, palpable fecal mass, constipation What should you advise your patient of who has peripheral vascular disease? Sleep with legs in a dependent position (hanging off the bed) to reduce swelling and discomfort of legs; avoid crossing legs, avoid restrictive clothing, and elevate legs but not above heart level; exercise and eat low fat diet What is intermittent claudication? Burning, cramping, and pain in the legs during exercise; present in peripheral vascular disease What are some expected findings of Peripheral Vascular Disease? bruit over femoral/aortic arteries, decreased capillary refill, diminished pulses, loss of hair on ankle/calf/foot, dry/scaly/mottled skin, thick toe nails, RUBOR!, cold/cyanotic extremity, and ulcers/gangrene of toes What is a cardiac stress test? Measures the patient's heart ability to respond to external stress in a controlled clinical environment; patient will exercise for 10-15 minutes; doctor will use an EKG, BP, HR and O2 level; shows pumping ability; used in PVD What are expected findings of pulmonary edema? Crackles in lungs, edema, cough with pink/frothy sputum, cyanosis, confusion/stupor, tachycardia, tachypnea/dyspnea/orthopnea, anxiety, inability to sleep, hypoxemia, decreased urine output What would you advise a patient with pulmonary edema? Fluid restriction and low sodium diet, high fowler's position, daily weights at same time of day, effective breathing techniques, report SOB, swelling and angina; stay compliant with meds even if patient starts to feel better! Nursing interventions for pulmonary edema? High fowlers, vitals q15 min, hourly urine output, monitor ABGs and electrolytes, monitor I & O, hemodynamic status Why might someone have pulmonary edema? Most common cause is cardiogenic! Patient will have increased pulmonary vascular pressure; patient may also be in opiate OD, inhaled irritants, too rapid of IV fluids, head injury What are some expected findings of cataracts? Blurry vision! decreased visual acuity, diplopia (double vision), ABSENT RED REFLEX; visual opacity; cloudy pupils What would you educate a patient with cataracts? Annual eye exams after 40!; Wear sunglasses anytime outside, avoid activities that increase IOP (bending, sneezing, coughing, straining, sex, restrictive clothing, head hyperflexion); report pain with n/v, limit activities (cooking, driving, sports) What laboratory test would you order to confirm diagnosis of HF? hBNP (level will be elevated if patient has HF); heart is working harder, so more BNP in the blood What is cystic fibrosis? mucus glands that secrete an increase in thick mucous, leading to an obstruction of organs; the nurse will see and increase in SODIUM + CHLORIDE IN THE SWEAT What is the goal of case management? Avoid fragmentation of care and control cost What is Rifampin and what should one warn the patient about? Rifampin is used to treat TB; educate client to expect orange urine What is Isoniazid and what should one warn the patient about? Isoniazid is used to treat TB; educate client to avoid all alcohol and that the liver will need to be monitored due to hepatotoxicity; monitor for tingling hands What are expected findings of TB? persistent cough (longer than 3 weeks), purulent sputum (or blood-streaked), fatigue/lethargy, weight loss, night sweats, low-grade fever in the afternoon, older adults: confusion/altered mentation and unusual behavior Why should people be tested for TB? People may have it and not know it; It may be latent for years and become active when older or when immunocompromised; IT IS AIRBORNE!! What are the diagnostic procedures for TB? -Mantoux test or "PPD" (read 48 to 72 hr) 10mm is +; 5mm is + for immunocompromised -chest x-ray -acid-fast bacilli smear can culture Why is it important to remain compliant with TB medications? Noncompliance is the one significant contributing factor in the development of resistant strains How would you describe sanguineous and purulent? Sanguineous=fresh/bloody Purulent=pus/milky/thick What are some examples of airborne diseases? TB, measles, varicella What are the isolation guidelines for airborne diseases? Nurses and visitors must wear mask to prevent transfer through mouth and if splashing is possible, wear full face PPE; Patient needs a private and negative pressure room, so germs do not spread in hallway. What are some examples of droplet diseases? PNEUMONIA, strep, pharyngitis, Haemophilus influenzae, scarlet fever, rubella, pertussis, mumps, sepsis What are the isolation guidelines for droplet diseases? patient placed in private room or with another patient w/ same disease; masks for nurses and visitors What are some examples of contact diseases? RSV, Shigella, enteric diseases, wound infections, herpes, scabies, impetigo, multi-drug resistant organisms What are the isolation guidelines for contact diseases? For all of those within 3 feet of patient: masks and gown; disposal of all materials in nonporous bag, and patient needs private room or shared with another What is an example of protective disease? [Show More]

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