ATI PN MEDICAL SURGICAL PROCTORED ACTUAL EXAM
A nurse has prepared a sterile field for assisting a provider with a chest tube
insertion. Which of the following events should the nurse recognize as
contaminating the field (Select all that apply)
A. provider drops a sterile instrument onto the near side of the sterile field
B. nurse moistens a cotton ball with sterile normal saline and places it on sterile field
C. procedure is delayed 1hr because the provider receives an emergency call
D. nurse turns to speak to someone who enters through the door behind the nurse
E. clients hand brushes against the outer edge of the sterile field - ANSWER: B, C, D
Endoscopy (EGD) positioning - ANSWER: left side lying
Before an Endoscopy (EGD): - ANSWER: -NPO 6-8 hr
-remove dentures
Gastroenteritis care plan: - ANSWER: -restrict dairy, caffeine, milk
-eat foods high in potassium
-increase fluid intake
-contact precautions
In what order do you open the sterile package? - ANSWER: flap furthest from body,
side flaps, then closest
A nurse has removed a sterile pack from its outside cover and place it on a clean
work surface in preparation for an invasive procedure. Which of the following flaps
should the nurse unfold first:
A. closest to body
B. right side
C. left side
D. farthest from body - ANSWER: D
A nurse is wearing sterile gloves in prep for performing a sterile procedure. Which of
the following objects can the nurse touch without breaking sterile technique (Select
all that apply)
A. bottle containing sterile solution
B. edge of sterile drape at the base of the field
C. inner wrapping of an item on the sterile field
D. irrigation syringe on the sterile field
E. one gloved hand with the other gloved hand - ANSWER: C, D, E
,TB is suspected, what precautionary actions to do? - ANSWER: -negative airflow
room, airborne precautions
-nurses wear N95 mask, client wears if going out of the room
-admin heat & humidified O2 therapy as prescribed
TB interventions: - ANSWER: -family members should be screened
-4 meds taken for 6-12 months
-not contagious when they have 3 negative sputum cultures
What to watch for when on Isoniazid: - ANSWER: numb/tingling in the hands & feet
What to watch for when on Rifampin: - ANSWER: -orange secretions normal
-watch for jaundice
-interferes with birth control
What to watch for when on Ethambutol: - ANSWER: vision changes
Client teaching for genital herpes: - ANSWER: -can be transmitted with or w/out
blisters
-sexual partners should be informed & screened
-no cure, just meds to help w/symptoms
-abstain from intercourse until lesions are completely healed
-gently clean areas w/mild soap & water
Caring for a client following a stroke of the right side with left-sided hemipalegia: -
ANSWER: -thicken liquids/foods
-high fowlers
-speech therapist for helping w/eating & speech
-monitor gag reflex/swallowing abilities
-have suction equipment available
-occupational therapy
-support left arm with pillows, slings, etc
High sodium foods clients with HF & Pulmonary edema should avoid: - ANSWER: -
cheese
-soups
-bread
-cold cuts/cured meats
-pizza
-eggs & omelets
-hot dogs
-baked ham
Which non-opioid drug decreases the effect of aspirin? - ANSWER: ibuprofen
Ketorolac should not be used concurrently with... - ANSWER: other NSAIDS
,Glucocorticoids increase the risk of gastric bleeding when taken with... - ANSWER:
non-opioid analgesics
To access an implanted port, you must use a... - ANSWER: noncoring (Huber) needle
When done accessing an implanted port... - ANSWER: flush with 10 mL 0.9% sodium
chloride
Therapeutic effects of furosemide (Lasix) - ANSWER: -decreases preload of the heart
-decreases potassium levels
-increases urine output
-decrease BP
-decrease edema
Valsartan for HF expected outcomes/findings: - ANSWER: -vasodilation
-excretion of sodium & water
-reduces BP
-reduces risk of mortality in post-MI pts left w/vent dysfunction
Expected findings of meds that increase urinary output (diuretics): - ANSWER: -
decreased potassium
-weight loss
-decrease in edema
-decreased calcium
-increased urine output
-decreased BP
-decrease in ICP & IOP
Client teaching for Nitroglycerin: - ANSWER: 1. stop activity & rest
2. place nitro tab under tongue
3. if pain is unrelieved in 5 min, call 911 or go to ED
4. take 2 or more doses at 5 min intervals
-headache is a common side effect of nitro
Which foods should the client on Warfarin avoid? - ANSWER: dark leafy green
veggies
Client teaching for anticoagulant therapy: - ANSWER: -bleeding precautions
-no added meds that increase bleeding
-on it for 6-8 weeks prior to hematologic dx procedure
-must have blood levels checked often
-monitor vitamin K in their diet
Expected prescriptions for Hypertension: - ANSWER: -furosemide (Lasix)
-aldactone (potassium sparing diuretic)
-hydrochlorothiazide (diuretic)
, -verapamil, dilitiazem (CCB)
-captopril, lisinopril (ACE inhibitors)
-losartan, telmisartan (ARBs)
-eplerenone
-atenolol, metoprolol (Beta blockers)
-clonidine
-prazosin (minipress)
Contraindications for Nadolol: - ANSWER: -asthma
-sinus bradycardia
-cardiogenic shock
-cardiac failure
-diabetes
-pregnancy
-right side HF
-emphysema
-severe COPD
Treatment for diabetes insipidus: - ANSWER: -daily weights
-no caffeine or alcohol
-desmopressin acetate/DDVAP
-aqueous vasopressin/Pitressin
-carbamazepine (tegretol)
-high fiber diet
Meds for DI, what to look out for/do: - ANSWER: -adjust based on urine output
-daily weights
-inform of weight gain of 2 lb in 24 hr
-notify if headaches or confusion occur
-monitor for infection
-monitor for dizziness/drowsiness
Protein requirement of an adult: _____g of protein per kg - ANSWER: 0.8 g
Caring for a client who has pancreatitis: - ANSWER: -keep NPO
-NG tube to suction gastric contents
-low fat, high protein, high carb diet
Risk factors:
-high fat diet
-excessive alcohol consumption
-age
Expected lab findings for a client with pancreatitis: - ANSWER: -increased amylase &
lipase
-increased WBC
-decreased platelets
A nurse has prepared a sterile field for assisting a provider with a chest tube
insertion. Which of the following events should the nurse recognize as
contaminating the field (Select all that apply)
A. provider drops a sterile instrument onto the near side of the sterile field
B. nurse moistens a cotton ball with sterile normal saline and places it on sterile field
C. procedure is delayed 1hr because the provider receives an emergency call
D. nurse turns to speak to someone who enters through the door behind the nurse
E. clients hand brushes against the outer edge of the sterile field - ANSWER: B, C, D
Endoscopy (EGD) positioning - ANSWER: left side lying
Before an Endoscopy (EGD): - ANSWER: -NPO 6-8 hr
-remove dentures
Gastroenteritis care plan: - ANSWER: -restrict dairy, caffeine, milk
-eat foods high in potassium
-increase fluid intake
-contact precautions
In what order do you open the sterile package? - ANSWER: flap furthest from body,
side flaps, then closest
A nurse has removed a sterile pack from its outside cover and place it on a clean
work surface in preparation for an invasive procedure. Which of the following flaps
should the nurse unfold first:
A. closest to body
B. right side
C. left side
D. farthest from body - ANSWER: D
A nurse is wearing sterile gloves in prep for performing a sterile procedure. Which of
the following objects can the nurse touch without breaking sterile technique (Select
all that apply)
A. bottle containing sterile solution
B. edge of sterile drape at the base of the field
C. inner wrapping of an item on the sterile field
D. irrigation syringe on the sterile field
E. one gloved hand with the other gloved hand - ANSWER: C, D, E
,TB is suspected, what precautionary actions to do? - ANSWER: -negative airflow
room, airborne precautions
-nurses wear N95 mask, client wears if going out of the room
-admin heat & humidified O2 therapy as prescribed
TB interventions: - ANSWER: -family members should be screened
-4 meds taken for 6-12 months
-not contagious when they have 3 negative sputum cultures
What to watch for when on Isoniazid: - ANSWER: numb/tingling in the hands & feet
What to watch for when on Rifampin: - ANSWER: -orange secretions normal
-watch for jaundice
-interferes with birth control
What to watch for when on Ethambutol: - ANSWER: vision changes
Client teaching for genital herpes: - ANSWER: -can be transmitted with or w/out
blisters
-sexual partners should be informed & screened
-no cure, just meds to help w/symptoms
-abstain from intercourse until lesions are completely healed
-gently clean areas w/mild soap & water
Caring for a client following a stroke of the right side with left-sided hemipalegia: -
ANSWER: -thicken liquids/foods
-high fowlers
-speech therapist for helping w/eating & speech
-monitor gag reflex/swallowing abilities
-have suction equipment available
-occupational therapy
-support left arm with pillows, slings, etc
High sodium foods clients with HF & Pulmonary edema should avoid: - ANSWER: -
cheese
-soups
-bread
-cold cuts/cured meats
-pizza
-eggs & omelets
-hot dogs
-baked ham
Which non-opioid drug decreases the effect of aspirin? - ANSWER: ibuprofen
Ketorolac should not be used concurrently with... - ANSWER: other NSAIDS
,Glucocorticoids increase the risk of gastric bleeding when taken with... - ANSWER:
non-opioid analgesics
To access an implanted port, you must use a... - ANSWER: noncoring (Huber) needle
When done accessing an implanted port... - ANSWER: flush with 10 mL 0.9% sodium
chloride
Therapeutic effects of furosemide (Lasix) - ANSWER: -decreases preload of the heart
-decreases potassium levels
-increases urine output
-decrease BP
-decrease edema
Valsartan for HF expected outcomes/findings: - ANSWER: -vasodilation
-excretion of sodium & water
-reduces BP
-reduces risk of mortality in post-MI pts left w/vent dysfunction
Expected findings of meds that increase urinary output (diuretics): - ANSWER: -
decreased potassium
-weight loss
-decrease in edema
-decreased calcium
-increased urine output
-decreased BP
-decrease in ICP & IOP
Client teaching for Nitroglycerin: - ANSWER: 1. stop activity & rest
2. place nitro tab under tongue
3. if pain is unrelieved in 5 min, call 911 or go to ED
4. take 2 or more doses at 5 min intervals
-headache is a common side effect of nitro
Which foods should the client on Warfarin avoid? - ANSWER: dark leafy green
veggies
Client teaching for anticoagulant therapy: - ANSWER: -bleeding precautions
-no added meds that increase bleeding
-on it for 6-8 weeks prior to hematologic dx procedure
-must have blood levels checked often
-monitor vitamin K in their diet
Expected prescriptions for Hypertension: - ANSWER: -furosemide (Lasix)
-aldactone (potassium sparing diuretic)
-hydrochlorothiazide (diuretic)
, -verapamil, dilitiazem (CCB)
-captopril, lisinopril (ACE inhibitors)
-losartan, telmisartan (ARBs)
-eplerenone
-atenolol, metoprolol (Beta blockers)
-clonidine
-prazosin (minipress)
Contraindications for Nadolol: - ANSWER: -asthma
-sinus bradycardia
-cardiogenic shock
-cardiac failure
-diabetes
-pregnancy
-right side HF
-emphysema
-severe COPD
Treatment for diabetes insipidus: - ANSWER: -daily weights
-no caffeine or alcohol
-desmopressin acetate/DDVAP
-aqueous vasopressin/Pitressin
-carbamazepine (tegretol)
-high fiber diet
Meds for DI, what to look out for/do: - ANSWER: -adjust based on urine output
-daily weights
-inform of weight gain of 2 lb in 24 hr
-notify if headaches or confusion occur
-monitor for infection
-monitor for dizziness/drowsiness
Protein requirement of an adult: _____g of protein per kg - ANSWER: 0.8 g
Caring for a client who has pancreatitis: - ANSWER: -keep NPO
-NG tube to suction gastric contents
-low fat, high protein, high carb diet
Risk factors:
-high fat diet
-excessive alcohol consumption
-age
Expected lab findings for a client with pancreatitis: - ANSWER: -increased amylase &
lipase
-increased WBC
-decreased platelets
