ATI COMPREHESIVE EXIT [NCLEX
2019/2022]; LOTS OF PICS
Do not delegate - Answer- What you can EAT E-evaluate A-assess T-teach
Addison's & Cushings - Answer- Addison's = down down down up down
Cushings= up up up down up
hypo/hypernatremia, hypo/hypertension, blood volume, hypo/hyperkalemia,
hypo/hyperglycemia
Addisons - Answer-
Better peripheral perfusion? - Answer- EleVate Veins, DAngle Arteries
APGAR - Answer- Appearance (all pink, pink and blue, blue (pale)
Pulse (>100, <100, absent)
Grimace (cough, grimace, no response)
Activity (flexed, flaccid, limp)
Respirations (strong cry, weak cry, absent)
Airborne precautions - Answer- MTV or My chicken hez tbSmeasles(Rubeola),
chickenpox (varicella) Herpes zoster/shingles TB
Airborne precautions protective equip - Answer- private room, neg pressure with 6-
12 air exchanges/hr mask & respirator N95 for TB
Droplet precautions - Answer- spiderman! sepsis, scarlet fever, streptococcal
pharyngitis, parvovirus, pneumonia, pertussis,
influenza,
diptheria,
epiglottitis,
rubella (German measles),
mumps, meningitis, mycoplasma or meningeal pneumonia, adeNovirus
(Private room and mask)
Contact precaution - Answer- MRS WHISE
protect visitors & caregivers when 3 ft of the pt.
Multidrug-resistant organisms
RSV, Shigella, Wound infections, Herpes simplex, Impetigo, Scabies, Enteric
diseases caused by micro-organisms (C diff),
Gloves and gowns worn by the caregivers and visitors
Disposal of infectious dressing material into a single, nonporous bag without
touching the outside of the bag
PMGG= Private room/ share same illness, mask, gown and gloves
Skin infection - Answer- VCHIPS
,Varicella zoster
Cutaneous diptheria
Herpes simplez
Impetigo
Peduculosis
Scabies
Air or Pulmonary Embolism - Answer- S/S chest pain, dyspnea, tachycardia,
pale/cyanotic, sense of impending doom. (turn pt to LEFT side and LOWER the head
of bed.)
Woman in labor (un-reassuring FHR) - Answer- (late decels, decreased variability,
fetal bradycardia, etc) Turn pt on Left side, give O2, stop pitocin, Increase IV fluids!
Tube feeding with decreased LOC - Answer- Pt on Right side (promotes emptying of
the stomach) Head of bed elevated (prevent aspiration)
After lumbar puncture and oil based myelogram - Answer- pt is flat SUPINE (prevent
headache and leaking of CSF)
Pt with heat stroke - Answer- flat with legs elevated
during Continuous Bladder Irrigation (CBI) - Answer- catheter is taped to the thigh.
leg must be kept straight.
After Myringotomy - Answer- position on the side of AFFECTED ear, allows
drainage.
After Cateract surgery - Answer- pt sleep on UNAFFECTED side with a night shield
for 1-4 weeks
after Thyroidectomy - Answer- low or semi-fowler's position, support head, neck and
shoulders.
Infant with Spina Bifida - Answer- Prone so that sac does not rupture
Buck's Traction (skin) - Answer- elevate foot of bed for counter traction
After total hip replacement - Answer- don't sleep on side of surgery, don't flex hip
more than 45-60 degress, don't elevate Head Of Bed more than 45 degrees.
Maintain hip abduction by separating thighs with pillows.
Prolapsed cord - Answer- Knee to chest or Trendelenburg
oxygen 8 to 10 L
Cleft Lip - Answer- position on back or in infant seat to prevent trauma to the suture
line. while feeding hold in upright position.
, To prevent dumping syndrome - Answer- (post operative ulcer/stomach surgeries)
eat in reclining position. Lie down after meals for 20-30 min. also restrict fluids during
meals, low CHO and fiber diet. small, frequent meals.
AKA (above knee amputation) - Answer- elevate for first 24 hours on pillow. position
prone daily to maintain hip extension.
BKA (below knee amputation) - Answer- foot of bed elevated for first 24 hours.
position prone to provide hip extension.
detached retina - Answer- area of detachment should be in the dependent position
administration of enema - Answer- pt should be left side lying (Sim's) with knee
flexed.
After supratentorial surgery - Answer- (incision behind hairline on forhead) elevate
HOB 30-40 degrees
After infratentorial surgery - Answer- (incision at the nape of neck) position pt flat and
lateral on either side.
During internal radiation - Answer- on bed rest while implant in place
Autonomic Dysreflexia/Hyperreflexia - Answer- S/S pounding headache, profuse
sweating, nasal congestion, chills, bradycardia, hypertension. Place client in sitting
position (elevate HOB) FIRST!
Shock - Answer- bedrest with extremities elevated 20 degrees. knees straight, head
slightly elevated (modified Trendelenberg)
Head Injury - Answer- elevate HOB 30 degrees to decrease ICP
Peritoneal Dialysis (when outflow is inadequate) - Answer- turn pt from side to side
BEFORE checking for kinks in tubing
Lumbar Puncture - Answer- After the procedure, the pt should be supine for 4-12
hours as prescribed.
Myesthenia Gravis - Answer- worsens with exercise and improves with rest
Myesthenia Gravis - Answer- a positive reaction to Tensilon---will improve symptoms
Cholinergic Crisis - Answer- Caused by excessive medication ---stop giving
Tensilon...will make it worse.
Liver biopsy (prior) - Answer- must have lab results for prothrombin time
Myxedema/ hypothyroidism - Answer- slowed physical and mental function,
sensitivity to cold, dry skin and hair.
2019/2022]; LOTS OF PICS
Do not delegate - Answer- What you can EAT E-evaluate A-assess T-teach
Addison's & Cushings - Answer- Addison's = down down down up down
Cushings= up up up down up
hypo/hypernatremia, hypo/hypertension, blood volume, hypo/hyperkalemia,
hypo/hyperglycemia
Addisons - Answer-
Better peripheral perfusion? - Answer- EleVate Veins, DAngle Arteries
APGAR - Answer- Appearance (all pink, pink and blue, blue (pale)
Pulse (>100, <100, absent)
Grimace (cough, grimace, no response)
Activity (flexed, flaccid, limp)
Respirations (strong cry, weak cry, absent)
Airborne precautions - Answer- MTV or My chicken hez tbSmeasles(Rubeola),
chickenpox (varicella) Herpes zoster/shingles TB
Airborne precautions protective equip - Answer- private room, neg pressure with 6-
12 air exchanges/hr mask & respirator N95 for TB
Droplet precautions - Answer- spiderman! sepsis, scarlet fever, streptococcal
pharyngitis, parvovirus, pneumonia, pertussis,
influenza,
diptheria,
epiglottitis,
rubella (German measles),
mumps, meningitis, mycoplasma or meningeal pneumonia, adeNovirus
(Private room and mask)
Contact precaution - Answer- MRS WHISE
protect visitors & caregivers when 3 ft of the pt.
Multidrug-resistant organisms
RSV, Shigella, Wound infections, Herpes simplex, Impetigo, Scabies, Enteric
diseases caused by micro-organisms (C diff),
Gloves and gowns worn by the caregivers and visitors
Disposal of infectious dressing material into a single, nonporous bag without
touching the outside of the bag
PMGG= Private room/ share same illness, mask, gown and gloves
Skin infection - Answer- VCHIPS
,Varicella zoster
Cutaneous diptheria
Herpes simplez
Impetigo
Peduculosis
Scabies
Air or Pulmonary Embolism - Answer- S/S chest pain, dyspnea, tachycardia,
pale/cyanotic, sense of impending doom. (turn pt to LEFT side and LOWER the head
of bed.)
Woman in labor (un-reassuring FHR) - Answer- (late decels, decreased variability,
fetal bradycardia, etc) Turn pt on Left side, give O2, stop pitocin, Increase IV fluids!
Tube feeding with decreased LOC - Answer- Pt on Right side (promotes emptying of
the stomach) Head of bed elevated (prevent aspiration)
After lumbar puncture and oil based myelogram - Answer- pt is flat SUPINE (prevent
headache and leaking of CSF)
Pt with heat stroke - Answer- flat with legs elevated
during Continuous Bladder Irrigation (CBI) - Answer- catheter is taped to the thigh.
leg must be kept straight.
After Myringotomy - Answer- position on the side of AFFECTED ear, allows
drainage.
After Cateract surgery - Answer- pt sleep on UNAFFECTED side with a night shield
for 1-4 weeks
after Thyroidectomy - Answer- low or semi-fowler's position, support head, neck and
shoulders.
Infant with Spina Bifida - Answer- Prone so that sac does not rupture
Buck's Traction (skin) - Answer- elevate foot of bed for counter traction
After total hip replacement - Answer- don't sleep on side of surgery, don't flex hip
more than 45-60 degress, don't elevate Head Of Bed more than 45 degrees.
Maintain hip abduction by separating thighs with pillows.
Prolapsed cord - Answer- Knee to chest or Trendelenburg
oxygen 8 to 10 L
Cleft Lip - Answer- position on back or in infant seat to prevent trauma to the suture
line. while feeding hold in upright position.
, To prevent dumping syndrome - Answer- (post operative ulcer/stomach surgeries)
eat in reclining position. Lie down after meals for 20-30 min. also restrict fluids during
meals, low CHO and fiber diet. small, frequent meals.
AKA (above knee amputation) - Answer- elevate for first 24 hours on pillow. position
prone daily to maintain hip extension.
BKA (below knee amputation) - Answer- foot of bed elevated for first 24 hours.
position prone to provide hip extension.
detached retina - Answer- area of detachment should be in the dependent position
administration of enema - Answer- pt should be left side lying (Sim's) with knee
flexed.
After supratentorial surgery - Answer- (incision behind hairline on forhead) elevate
HOB 30-40 degrees
After infratentorial surgery - Answer- (incision at the nape of neck) position pt flat and
lateral on either side.
During internal radiation - Answer- on bed rest while implant in place
Autonomic Dysreflexia/Hyperreflexia - Answer- S/S pounding headache, profuse
sweating, nasal congestion, chills, bradycardia, hypertension. Place client in sitting
position (elevate HOB) FIRST!
Shock - Answer- bedrest with extremities elevated 20 degrees. knees straight, head
slightly elevated (modified Trendelenberg)
Head Injury - Answer- elevate HOB 30 degrees to decrease ICP
Peritoneal Dialysis (when outflow is inadequate) - Answer- turn pt from side to side
BEFORE checking for kinks in tubing
Lumbar Puncture - Answer- After the procedure, the pt should be supine for 4-12
hours as prescribed.
Myesthenia Gravis - Answer- worsens with exercise and improves with rest
Myesthenia Gravis - Answer- a positive reaction to Tensilon---will improve symptoms
Cholinergic Crisis - Answer- Caused by excessive medication ---stop giving
Tensilon...will make it worse.
Liver biopsy (prior) - Answer- must have lab results for prothrombin time
Myxedema/ hypothyroidism - Answer- slowed physical and mental function,
sensitivity to cold, dry skin and hair.
