Medical surgical ATI proctored exam 2019 questions with correct
answers
What would you do for wound Evisceration ( removal of internal organs) , Emergency management? -
Ans>>Saline cover wound
What would you do for an ASTHMA emergency management of a bee sting allergies? -Ans>>Epi Pen
Seizures and Epilepsy: Seizure precautions -Ans>>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 -Ans>>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 -Ans>>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
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 -Ans>>-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 -Ans>>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 -Ans>>- 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 -Ans>>- Urethral trauma
- Urinary retention
- Bleeding
- Infection
Non-modifiable risk factors ( Page 3 ATI ) -Ans>>1) Age
2) Gender
3) Genetics
4) Developmental level
Modifiable risk factors ( Page 3 ATI ) -Ans>>1) Smoking
2) Exercise
3) Health education and awareness
4) Nutrition
5) Sex practices
Emergency nursing - Triage -Ans>>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 -Ans>>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 -Ans>>1) Red tag
2) Yellow Tag
3) Green tag
4) Black tag
Priorities: general rule -Ans>>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 -Ans>>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.
, Alpha 1 receptors -Ans>>Activation Causes the skin , mucus membranes and veins to vasoconstrict.
Help with:
1) Congestion
2) Superficial bleeding
3) In general help raise blood pressure by constricting the veins.
DRUG:
Epinephrine:Triggers the Alpha 1 receptors
Causing vasoconstriction and increase blood pressure.
Epinephrine side effects -Ans>>Increases blood pressure
1) Hypertensive crisis
2) Dysrhythmia
3) Angina
Dopamine side effects -Ans>>1) Dysrhythmia
2) Angina
Dobutamine side effects -Ans>>Increased heart rate
Beta 1 receptors -Ans>>Help stimulate the heart
Beta I - You have 1 heart
Stimulate the heart and increase the heart rate
Used for treating:
1) AV block
2) Cardiac arrest
DRUG:
Epinephrine:Triggers the Beta 1 receptors
Cause increase heart rate
Beta II receptors -Ans>>Help stimulate the heart and lungs
Beta II You have 2 Lungs
Causes:
1) Bronchodilation in the lungs
2) Causes uterine smooth muscle to relax
3) Asthma situation
DRUG:
Epinephrine:Triggers the Beta II receptors
Cause bronchodilation and treat Asthma
Dopamine -Ans>>Causes renal blood vessels to dilate.
DRUG:
Epinephrine: Dopamine receptors and if given a little more Beta I
answers
What would you do for wound Evisceration ( removal of internal organs) , Emergency management? -
Ans>>Saline cover wound
What would you do for an ASTHMA emergency management of a bee sting allergies? -Ans>>Epi Pen
Seizures and Epilepsy: Seizure precautions -Ans>>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 -Ans>>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 -Ans>>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
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 -Ans>>-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 -Ans>>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 -Ans>>- 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 -Ans>>- Urethral trauma
- Urinary retention
- Bleeding
- Infection
Non-modifiable risk factors ( Page 3 ATI ) -Ans>>1) Age
2) Gender
3) Genetics
4) Developmental level
Modifiable risk factors ( Page 3 ATI ) -Ans>>1) Smoking
2) Exercise
3) Health education and awareness
4) Nutrition
5) Sex practices
Emergency nursing - Triage -Ans>>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 -Ans>>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 -Ans>>1) Red tag
2) Yellow Tag
3) Green tag
4) Black tag
Priorities: general rule -Ans>>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 -Ans>>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.
, Alpha 1 receptors -Ans>>Activation Causes the skin , mucus membranes and veins to vasoconstrict.
Help with:
1) Congestion
2) Superficial bleeding
3) In general help raise blood pressure by constricting the veins.
DRUG:
Epinephrine:Triggers the Alpha 1 receptors
Causing vasoconstriction and increase blood pressure.
Epinephrine side effects -Ans>>Increases blood pressure
1) Hypertensive crisis
2) Dysrhythmia
3) Angina
Dopamine side effects -Ans>>1) Dysrhythmia
2) Angina
Dobutamine side effects -Ans>>Increased heart rate
Beta 1 receptors -Ans>>Help stimulate the heart
Beta I - You have 1 heart
Stimulate the heart and increase the heart rate
Used for treating:
1) AV block
2) Cardiac arrest
DRUG:
Epinephrine:Triggers the Beta 1 receptors
Cause increase heart rate
Beta II receptors -Ans>>Help stimulate the heart and lungs
Beta II You have 2 Lungs
Causes:
1) Bronchodilation in the lungs
2) Causes uterine smooth muscle to relax
3) Asthma situation
DRUG:
Epinephrine:Triggers the Beta II receptors
Cause bronchodilation and treat Asthma
Dopamine -Ans>>Causes renal blood vessels to dilate.
DRUG:
Epinephrine: Dopamine receptors and if given a little more Beta I
