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ATI 2019 RN Comprehensive Predictor Study Guide

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ATI 2019 RN Comprehensive Predictor Study Guide

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ATI 2019 RN Comprehensive Predictor
Study Guide
Testing for TB
- 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
- 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: (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 - 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?
- To adults 60 years or older whether or not they report a previous episode of herpes
zoster.
Rotavirus should be given at what age? - During the child's first year of life.
Alendronate (Fosamax) - 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? - 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?
- 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? 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 - 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.

Kernig's sign
- 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
- 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 - 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 - 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 - Administer an antibiotic prophylaxis to all pt's
newly exposed

**Those exposed to anthrax do not require decontamination and are not considered
contagious**


Botulism treatment
- Give an antitoxin
Why would lidocaine (Xylocaine) be given to someone following cardiac arrest? - Lidocaine
is an antiarrhythmic med that is commonly used to restore a regular heartbeat in a client who
has arrhythmia. This effect is produced by delaying abnormal nerve pulses to the heart and
reducing irritability of the heart tissue.

What diagnostic test would help the nurse monitor and evaluate the effectiveness of the
aspirin medication for an Rhematoid arthritis patient?
- Erythrocyte sedimentation rate (ESR)

** RA is a chronic inflammatory disease. ESR is useful in detecting and monitoring tissue
inflammation in clients with RA.**
Antinuclear antibody (ANA) - ANAs are frequently present in pts who have autoimmune
disorders such as systemic lupus erythematosus, RA, and scleroderma
Rheumatoid factor (RF) diagnostic test Helpful in diagnosing RA, but the levels do not
always correlate with the severity of the disease
Cheyne-Stokes Respirations - Is characterized by a rhythmic increase (to the point of
hyperventilation) and decrease (to the point of apnea) in the rate and depth of respirations.
- It is commonly seen in pts who are unconscious, comatose or moribund (approaching
death).
Cryoprecipitate - Clients with hemophilia (deficiency of clotting factor), are given
cryoprecipitate to replace the deficient factor as a prophylactic measure before any invasive
procedure, surgery or when actively bleeding.
Cryoprecipitate continue - 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) - 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 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.

, Ataxia Jerky movements of the extremities
RAST testing - 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?
- First, test it for glucose
- Second, notify doctor
What is a complication that you should frequently assess if a patient is suspected of having
diabetes insipidus? - 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? A 6-9 month regimen consisting of two meds is
frequently used.

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.

Chlorpromazine (Thorazine) Chlorpromazine is used to treat psychotic disorders
such as:
-schizophrenia
- manic-depression
- 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
- symptoms of tetanus
Chlorpromazine continue. - 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 continue The bag should be emptied approx. every 2 hours to prevent leakage,
skin irritation and infection.
Ileal conduit - 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.
Manifestations of tardive dyskinesia - Tongue thrusting and lip smacking
- Facial grimacing and eye blinking
- Repetitive involuntary movements
Ulcerative Colitis - 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.
To assess for cyanosis in a patient with dark skin where is the most appropriate areas to
assess for this?- Examine body areas with the least melanin, such as the underarm, soles of
the feet, conjunctiva and mucous membranes.

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