Medical surgical ATI proctored exam
2019
What would you do for wound Evisceration ( removal of internal organs) , Emergency
management? - Answer Saline cover wound
What would you do for an ASTHMA emergency management of a bee sting allergies? -
Answer Epi Pen
Seizures and Epilepsy: Seizure precautions - Answer During a seizure:
1) Position client on the floor
2)Provide a patent airway
3) Turn client to side
4) Loosen restrictive clothing
Cancer treatment options: Protective Isolation - Answer If WBC drops below 1,000,
place the client in a private room and initiate neutropenic precautions.
- Have client remain in his room unless he needs to leave for a diagnostic procedure, in
that case transport patient and place a mask on him.
- Protect from possible sources of infection (plants, change water in equipment daily)
- Have client, staff and visitors perform frequent hand hygiene, restrict ill visitors
- Avoid invasive procedures (rectal temps, injections)
- Administer (neupogen, neulasta) to stimulate WBC production
Infection control: Appropriate room assignment - Answer Standard Precautions:
1. applies to all patients
2. Hand washing
a. alcohol based preferred unless hands visually soiled ( then soap and water )
3. Gloves - when touching anything that has the potential to contaminate.
4. Masks, eye protection & face shields when care may cause splashing or spraying of
body fluids
Droplet:
1. private room or with someone with same illness
2. masks
Airborne:
1. private room
,Medical surgical ATI proctored exam
2019
2. masks or respiratory protection devices
a. use an N95 respirator for tuberculosis
3. Negative pressure airflow
4. full face protection if splashing or spraying is possible
Contact:
1. private room or room with same illness
2. gloves & gowns
3. disposal of infections dressing materials into a single, nonporous bag without
touching the outside of the bag
TB: Priority action for a client in the emergency department - Answer -Wear an N95 or
HEPA respirator
-Place client in negative airflow room and implement airborne precautions
-use barrier protection when the risk of hand or clothing contamination exists
Immunizations: Recommended vaccinations for older adult clients - Answer Adults age
50 or older:
- Pneumococcal Vaccine (PPSV)
- Influenza vaccine
- Herpes Zoster Vaccine
- Hepatitis A
- Hepatitis B
- Meningococcal Vaccine
Pulmonary Embolism: Risk factors for DVT - Answer - Long term immobility
- Oral contraceptives
- Pregnancy
- Tobacco use
- Hypercoagulabilty
- Obesity
- Surgery
- Heart failure or chronic A-Fib
- Autoimmune hemolytic anemia (sickle cell)
- Long bone fractures
- Advanced age
Disorders of the male reproductive system: Complications of continuous irrigation
following Trans-urethral Resection - Answer - Urethral trauma
- Urinary retention
- Bleeding
- Infection
,Medical surgical ATI proctored exam
2019
Non-modifiable risk factors ( Page 3 ATI ) - Answer 1) Age
2) Gender
3) Genetics
4) Developmental level
Modifiable risk factors ( Page 3 ATI ) - Answer 1) Smoking
2) Exercise
3) Health education and awareness
4) Nutrition
5) Sex practices
Emergency nursing - Triage - Answer BASED ON ACUITY
1) Emergent- Life threatening situation going on.
2) Urgent - Need to be treated soon but not life threatening.
3) Non urgent- The patient can wait for an extended period of time , without big issues.
Mass casualty event - Answer Class 1 - RED TAG - Immediate threat to life
Examples:
1) Breathing issues
2) Chest pain
3) Heart attack coming on
4) Airway problem
Class II - YELLOW TAG - Major injuries that require immediate treatment but not life
threatening.
Examples:
1) Major fracture
Class III - GREEN TAG - Minor injury that does not require immediate attention.
EXAMPLES:
1) Abrasion
2) Laceration
Class IV - BLACK TAG - Expected to die
EXAMPLES:
1) Penetrating head wound
Triage priority setting - Answer 1) Red tag
, Medical surgical ATI proctored exam
2019
2) Yellow Tag
3) Green tag
4) Black tag
Priorities: general rule - Answer A - Airway - Secure the airway by head tilt , chin lift
maneuver unless a fracture in cervical spinal. Brain injury or death in 3 - 5 minutes if
airway not patent.
B- Breathing - Auscultation of breath sounds, Chest expansion and respiratory effort,
Rate and depth of respiration's, Look for chest trauma, Determine tracheal position,
Check for jugular vein distension.
C- Circulation - Heart rate, BP, Peripheral pulses, Cap refill.
D - Disability - Clients level of consciousness with:
1) Glasgow coma scale
a) <<< 8 Comatose state
b) 3 Client totally unresponsive
c) 15 A client within normal limits.
E- Exposure - Hypothermia - Patient in cold icy water:
1) Remove wet clothing
2) Provide blankets
3) Increase the temperature of the room
4) Warm IV fluid going into the patient
IF patient has had accidental or purposeful poisoning:
1) Activated charcoal
2) Gastric lavage
3) Whole bowel irrigation
*** DO NOT INDUCE VOMITING OR SYRUP OF IPECAC
Call rapid response team when client is rapidly declining.
Cardiac Emergencies - Answer If V fib or ventricular tachycardia you would initiate:
1) Basic life support ( BLS) and CPR
2) Establish IV access
3) Epinephrine is used to get the heart up and moving.
2019
What would you do for wound Evisceration ( removal of internal organs) , Emergency
management? - Answer Saline cover wound
What would you do for an ASTHMA emergency management of a bee sting allergies? -
Answer Epi Pen
Seizures and Epilepsy: Seizure precautions - Answer During a seizure:
1) Position client on the floor
2)Provide a patent airway
3) Turn client to side
4) Loosen restrictive clothing
Cancer treatment options: Protective Isolation - Answer If WBC drops below 1,000,
place the client in a private room and initiate neutropenic precautions.
- Have client remain in his room unless he needs to leave for a diagnostic procedure, in
that case transport patient and place a mask on him.
- Protect from possible sources of infection (plants, change water in equipment daily)
- Have client, staff and visitors perform frequent hand hygiene, restrict ill visitors
- Avoid invasive procedures (rectal temps, injections)
- Administer (neupogen, neulasta) to stimulate WBC production
Infection control: Appropriate room assignment - Answer Standard Precautions:
1. applies to all patients
2. Hand washing
a. alcohol based preferred unless hands visually soiled ( then soap and water )
3. Gloves - when touching anything that has the potential to contaminate.
4. Masks, eye protection & face shields when care may cause splashing or spraying of
body fluids
Droplet:
1. private room or with someone with same illness
2. masks
Airborne:
1. private room
,Medical surgical ATI proctored exam
2019
2. masks or respiratory protection devices
a. use an N95 respirator for tuberculosis
3. Negative pressure airflow
4. full face protection if splashing or spraying is possible
Contact:
1. private room or room with same illness
2. gloves & gowns
3. disposal of infections dressing materials into a single, nonporous bag without
touching the outside of the bag
TB: Priority action for a client in the emergency department - Answer -Wear an N95 or
HEPA respirator
-Place client in negative airflow room and implement airborne precautions
-use barrier protection when the risk of hand or clothing contamination exists
Immunizations: Recommended vaccinations for older adult clients - Answer Adults age
50 or older:
- Pneumococcal Vaccine (PPSV)
- Influenza vaccine
- Herpes Zoster Vaccine
- Hepatitis A
- Hepatitis B
- Meningococcal Vaccine
Pulmonary Embolism: Risk factors for DVT - Answer - Long term immobility
- Oral contraceptives
- Pregnancy
- Tobacco use
- Hypercoagulabilty
- Obesity
- Surgery
- Heart failure or chronic A-Fib
- Autoimmune hemolytic anemia (sickle cell)
- Long bone fractures
- Advanced age
Disorders of the male reproductive system: Complications of continuous irrigation
following Trans-urethral Resection - Answer - Urethral trauma
- Urinary retention
- Bleeding
- Infection
,Medical surgical ATI proctored exam
2019
Non-modifiable risk factors ( Page 3 ATI ) - Answer 1) Age
2) Gender
3) Genetics
4) Developmental level
Modifiable risk factors ( Page 3 ATI ) - Answer 1) Smoking
2) Exercise
3) Health education and awareness
4) Nutrition
5) Sex practices
Emergency nursing - Triage - Answer BASED ON ACUITY
1) Emergent- Life threatening situation going on.
2) Urgent - Need to be treated soon but not life threatening.
3) Non urgent- The patient can wait for an extended period of time , without big issues.
Mass casualty event - Answer Class 1 - RED TAG - Immediate threat to life
Examples:
1) Breathing issues
2) Chest pain
3) Heart attack coming on
4) Airway problem
Class II - YELLOW TAG - Major injuries that require immediate treatment but not life
threatening.
Examples:
1) Major fracture
Class III - GREEN TAG - Minor injury that does not require immediate attention.
EXAMPLES:
1) Abrasion
2) Laceration
Class IV - BLACK TAG - Expected to die
EXAMPLES:
1) Penetrating head wound
Triage priority setting - Answer 1) Red tag
, Medical surgical ATI proctored exam
2019
2) Yellow Tag
3) Green tag
4) Black tag
Priorities: general rule - Answer A - Airway - Secure the airway by head tilt , chin lift
maneuver unless a fracture in cervical spinal. Brain injury or death in 3 - 5 minutes if
airway not patent.
B- Breathing - Auscultation of breath sounds, Chest expansion and respiratory effort,
Rate and depth of respiration's, Look for chest trauma, Determine tracheal position,
Check for jugular vein distension.
C- Circulation - Heart rate, BP, Peripheral pulses, Cap refill.
D - Disability - Clients level of consciousness with:
1) Glasgow coma scale
a) <<< 8 Comatose state
b) 3 Client totally unresponsive
c) 15 A client within normal limits.
E- Exposure - Hypothermia - Patient in cold icy water:
1) Remove wet clothing
2) Provide blankets
3) Increase the temperature of the room
4) Warm IV fluid going into the patient
IF patient has had accidental or purposeful poisoning:
1) Activated charcoal
2) Gastric lavage
3) Whole bowel irrigation
*** DO NOT INDUCE VOMITING OR SYRUP OF IPECAC
Call rapid response team when client is rapidly declining.
Cardiac Emergencies - Answer If V fib or ventricular tachycardia you would initiate:
1) Basic life support ( BLS) and CPR
2) Establish IV access
3) Epinephrine is used to get the heart up and moving.
