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2025 RN ATI ADULT MEDICAL-SURGICAL PROCTORED EXAM (REAL TEST BANK WITH NGN STYLE QUESTIONS) – 100% VERIFIED QUESTIONS AND ANSWERS | LATEST UPDATED Q2-Q3 2025 | TRUSTED NURSING STUDY GUIDE FOR EXAM PREPARATION: GET YOUR (A+) WITH COMFORT
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Creatinine Clearance to Estimate GFR - << ANSWER IS>> -- Cockcroft-Gault equation: (140-age)x(ideal body wt)/72 x serum creatinine ~multiply by 0.85 if female
Transitions - << ANSWER IS>> --Focus on work, role of individual/spouse/partner
life or when capable of working (total support or supplements) ~pay portion of paycheck towards retirement; once retire claim $ as paycheck Other Income - << ANSWER IS>> ---private retirement or pension plans (401k)
What are the age-related changes in cardiovascular function? - << ANSWER IS>> --decreased beta-adrenergic responsiveness increased afterload decreased early diastolic filling increased dependency on atrial contraction prolonged relaxation time increased L ventricular end-diastolic pressure increased vascular tone True or False: Cardiac output can be maintained if heart rate or stroke volume are able to compensate for each other - << ANSWER IS>> --True True or False: Pulmonary system age-related changes are typically some of the first ones to be noticed - << ANSWER IS>> --False: they are slow and not noticed until the 60-80s What are the pulmonary system age-related FUNCTION changes? - << ANSWER IS>> --increased ventilation- perfusion mismatch decreased diffusion capacity increased physiological dead space decreased lung emptying decreased inspiratory muscle strength What are the pulmonary system age-related MEASUREMENT changes? - << ANSWER IS>> --increased residual volume and functional residual capacity decreased total lung capacity decreased max voluntary ventilation decreased vital capacity decreased forced expiratory volume decreased oxygen saturation
reduced exercise tolerance angina Angina - << ANSWER IS>> --chest pain due to a temporary oxygen supply/demand imbalance usually precedes an MI what are the 3 types of angina - << ANSWER IS>> --unstable - at rest, increases in severity, frequency, and duration and requires immediate attention stable - during activity, relieved by decreasing effort or nitroglycerin variant - caused by vasospasm of coronary arteries, short term relief with nitroglycerin What is the angina rating scale - << ANSWER IS>> -- 0 - no angina 1 - light, barely noticable 2 - moderate, bothersome 3 - more severe, very uncomfortable (pre-infarction pain) 4 - most severe or intense pain ever experienced (infarction pain) STEMI - << ANSWER IS>> --ST-segment Elevation Myocardial Infarction a severe type of heart attack characterized by a complete blockage of a coronary artery, leading to significant damage to the heart muscle NSTEMI - << ANSWER IS>> --non-ST-elevation myocardial infarction a type of heart attack where a portion of the heart muscle experiences reduced blood flow, leading to damage
angioplasty - implications for PT - << ANSWER IS>> --no strict guidelines but generally wait 2 weeks for aerobic exercise to allow for inflammation process Sternal Precautions - << ANSWER IS>> --no lifting/pulling/pushing >5lbs splint for cough/sneeze avoid pushing for STS, bed mobility, raising UE above 90 which type of heart failure will EF not be changed - << ANSWER IS>> --Diastolic BNP - << ANSWER IS>> -->500 typically indicates CHF EF - << ANSWER IS>> --normal 55-70% Digoxin - << ANSWER IS>> --increases contractility of the heart - used to treat heart failure decrease the workload of the heart to treat heart failure - << ANSWER IS>> --diuretics, vasodilators ACE inhibitors or ARB, vasodilators COPD stage - mild - << ANSWER IS>> --FEV/FVC <70% FEV1>80% predicted with/without cough, sputum production COPD stage - moderate - << ANSWER IS>> --FEV/FVC <70% 50% <FEV1<80% predicted SOB with exertion, with/without cough, sputum production COPD stage - severe - << ANSWER IS>> --FEV/FVC <70% 30% <FEV1 <50% predicted greater SOB with exertion, decreased exercise capacity, repeated exacerbations
change in cardiac rhythm CHF indicators to modify or terminate treatment - << ANSWER IS>> --marked dyspnea or fatigue RR> 40bpm development of S3 heart sound increase in crackles decrease in HR or BP >10mmHg during steadystate or progression diaphoresis, pale, confusion CVP increase by 10 mmHg Pursed lip breathing - << ANSWER IS>> --may delay or prevent airway collapse in for 2 out for 4 renal system age related changes - << ANSWER IS>> -- reduced bloodflow to the kidneys reduction of the number of nephrons increased urine volume hyponatremia common reduction of bladder capacity more urine production at night chronic kidney disease - << ANSWER IS>> --alteration of kidney function or structure for 3 or more months the 5 stages of CKD - << ANSWER IS>> --stage 1 - 90+ GFR stage 2 - 60 - 89 GFR stage 3 - 30 - 59 GFR stage 4 - 15 - 29 GFR stage 5 - <15 GFR
what symptoms are called uremia and when do they manifest
how does the normal aging process affect drug excretion - << ANSWER IS>> --Decreased renal blood flow, decreased glomerular filtration rate, decreased tubular secretion. This can lead to increased half life and decreased drug clearance for renally excreted drugs ADRs - << ANSWER IS>> --noxious unintended reactions to drugs that occur at normal doses for drugs what are some common ADRs in older populations - << ANSWER IS>> --anticholinergic effects, confusion, constipation, dehydration, depression, dizziness, extrapyramidal signs, fatigue and weakness, GI upset, hypertension, hypocoagulation, postural hypotension, urinary incontinence, urinary retention what are anticholinergic activity effects and how do they affect older adults - << ANSWER IS>> --These block cholinergic responses (diaphoresis, GI motility, reduced CO), and causes delirium, drowsiness, blurred vision, tachycardia, dry mouth, urinary retention, constipation, and impaired diaphoretic response. the concept of prescribing cascades and how they affect older adults - << ANSWER IS>> --When a new drug is prescribed to address a side effect of another drug. This increases likelihood of adverse effects or cause new symptoms. It is better to adjust the original medication (either changing dose or switching to another drug). recommendations to improve drug related problems and medical errors in older adults - << ANSWER IS>> --Make a Medication profile including the drug name, strength, route, dose, frequency, status (when it was prescribed and changed), indication for taking it.
Blister packs to help with memory and prevent over or undertaking Have one provider be the one to prescribe the drugs Double check with a pharmacist if there are any issues All providers should check medication usage Reduce number of medications the patient is on if able Secreted by the hypothalamus and gastric glands of the stomach - << ANSWER IS>> --Somatostatin Somatostatin is released by_______ cells - << ANSWER IS>> -
Destruction of beta cells, thin at diagnosis, little or no endogenous insulin, ketosis prone, must have exogenous insulin to survive - << ANSWER IS>> --Type 1 Diabetes Obese, environmental cause, impaired insulin secretion, insulin resistance, may control with diet/excercise, oral antidiabetic drug (metformin), Ketosis uncommon - << ANSWER IS>> --Type 2 diabetes A1c 5.7%- 6.4%, fasting glucose 100- 125 - << ANSWER IS>> -- Prediabetes Secondary causes of DM - << ANSWER IS>> --pancreatitis and cushings Clinical symptoms of DM - << ANSWER IS>> --polyuria, polydipsia, polyphagia A1c of greater than or equal to 6.5%, FBG >126 - << ANSWER IS>> --DM 15 g of carbohydrates are equal to_____carb exchange - << ANSWER IS>> -- 1 Alcohol on empty stomach (DM) - << ANSWER IS>> --increase hypoglcemia have an osmotic effefct on the body - << ANSWER IS>> -- Sugar free foods (mannitol, sorbitol, xylitol, maltitol) Patients on_______ should eat 15 g of carbs before moderate exercise to prevent hypoglycemia - << ANSWER IS>> -- exogenous insulin
Should eat complex carbs/protein..... - << ANSWER IS>> --at end of exercise and bedtime Rapid acting inhaled insulin given beginning of meals - << ANSWER IS>> --Afrezza dimpling or pitting, raised hard tissue mass - << ANSWER IS>> --lipodystrophy SNS hunger, sweating, tremor, tachcardia, palpation, anxiety, headache, lightheaded, numbness of lips and tongue, impaired vision, lethargic - << ANSWER IS>> --hypoglycemia Inhibits hepatic glucose production - << ANSWER IS>> -- Alcohol What produces insulin? - << ANSWER IS>> --Beta Cells in pancreas Where is glucose stored? - << ANSWER IS>> --Liver and muscle cells What hormone stimulates the release of glycogen? - << ANSWER IS>> --Glucagon What is released by the delta cells? - << ANSWER IS>> -- Somatostatin Does somatostatin have a hypoglycemic effect? - << ANSWER IS>> --Yes, it interferes with the release of growth hormone from the pituitary gland and interferes with glucagon release from the pancrease