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ATI PN Comprehensive Predictor Review
questions and answers verified&
updated 2023
DO NOT delegate what you can...EAT (Acronym) - 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 Better peripheral perfusion? - answer Elevate veins, D-Angle 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 tb measles, 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 sepsis, scarlet fever, streptococcal pharyngitis, parvovirus, pneumonia, pertussis, influenza, diptheria, epiglottitis, rubella, 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- VCHIPS - answer Varicella zoster Cutaneous diptheria Herpes simplez Impetigo Peduculosis Scabies
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 dependent position - answer supported administration of enema - answer pt should be left side lying (Sim's) with knee flexed.
supratentorial - answer (incision behind hairline on forhead) e After supratentorial surgery - answer elevate HOB 30-40 degrees HOB - answer head of bed infratentorial - answer (incision at the nape of neck) After infratentorial surgery - answer 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
Diabetes insipidus (decreased ADH) - answer excessive urine output and thirst, dehydration, weakness, administer Pitressin SIADH (increased ADH) - answer change in LOC, decreased deep tendon reflexes, tachycardia. N/V HA administer Declomycin, diuretics hypokalemia - answer muscle weakness, dysrhythmias, increase K (raisins, bananas, apricots, oranges, beans, potatoes, carrots, celery) Hyperkalemia - answer MURDER Muscle weakness, Urine (olig, anuria) Resp depression, decreased cardiac contractility, ECG changes, reflexes Hyponatremia - answer nausea, muscle cramps, increased ICP, muscular twitching, convulsions. give osmotic diuretics (Mannitol) and fluids Hypernatremia - answer increased temp, weakness, disorientation, dilusions, hypotension, tachycardia. give hypotonic solution. Hypocalcemia - answer CATS Convulsions, Arrythmias, Tetany, spasms and stridor Hypercalcemia - answer muscle weakness, lack of coordination, abdominal pain, confusion, absent tendon reflexes, shallow respirations, emergency! Hypo Mg - answer Tremors, tetany, seizures, dysthythmias, depression, confusion, dysphagia, (dig toxicity) Hyper Mg - answer depresses the CNS. Hypotension, facial flushing, muscle weakness, absent deep tendon reflexes, shallow respirations. EMERGENCY
Addison's - answer Hypo Na, Hyper K, Hypoglycemia, dark pigmentation, decreased resistance to stress fx, alopecia, weight loss. GI stress. Cushings - answer Hyper Na, Hypo K, hyperglycemia, prone to infection, muscle wasting, weakness, edema, HTN, hirsutism, moonface/buffalo hump Addesonian crisis - answer N/V confusion, abdominal pain, extreme weakness, hypoglycemia, dehydration, decreased BP Pheochromocytoma - answer hypersecretion of epi/norepi. persistent HTN, increased HR, hyperglycemia, diaphoresis, tremor, pounding HA; avoid stress, frequent bathing and rest breaks, avoid cold and stimulating foods (surgery to remove tumor) Tetrology of Fallot - answer DROP (Defect, septal, Right ventricular hypertrophy, Overriding aortas, Pulmonary stenosis) Autonomic Dysreflexia - answer (potentially life threatening emergency!) HOB elevate 90 degrees, loosen constrictive clothing, assess for full bladder or bowel impaction, (trigger) administer antihypertensives (may cause stroke, MI, seizure) FHR patterns for OB - answer Think VEAL CHOP! V-variable decels; C- cord compression caused E-early decels; H- head compression caused A-accels; O-okay, no problem L- late decels; P- placental insufficiency, can't fill what to check with pregnancy - answer Never check the monitor or machine as a first action. Always assess the patient first. Ex.. listen to fetal heart tones with stethoscope. Position of the baby by fetal heart sounds - answer Posterior --heard at sides
NCLEX answer tips - answer choose assessment first! (assess, collect, auscultate, monitor, palpate) only choose intervention in an emergency or stress situation. If the answer has an absolute, discard it. Give priority to the answers that deal with the patient's body, not machines, or equipment. ARDS and DIC - answer are always secondary to another disease or trauma In an emergency - answer patients with a greater chance to live are treated first Cardinal sign of ARDS - answer hypoxemia Edema is located - answer in the interstitial space, not the cardiovascular space (outside of the circulatory system) the best indicator of dehydration? - answer weight---and skin turgor heat/cold - answer hot for chronic pain; cold for accute pain (sprain etc) When pt is in distress....medication administration - answer is rarely a good choice pneumonia - answer fever and chills are usually present. For the elderly confusion is often present. before IV antibiotics? - answer check allergies (esp. penicillin) make sure cultures and sensitivity has been done before first dose. COPD and O2 - answer with COPD baroreceptors that detect CO2 level are destroyed, therefore, O2 must be low because high O2 concentration takes away the pt's stimulation to breathe.
Prednisone toxicity - answer Cushings (buffalo hump, moon face, high blood sugar, HTN) Neutropenic pts - answer no fresh fruits or flowers Chest tubes are placed - answer in the pleural space Preload/Afterload - answer Preload affects the amount of blood going into Right ventricle. Afterload is the systemic resistance after leaving the heart. CABG - answer Great Saphenous vein in leg is taken and turned inside out (because of valves inside). Used for bypass surgery of the heart. Unstable Angina - answer not relieved by nitro PVC's - answer can turn into V fib. 1 tsp - answer 5 mL 1 oz - answer 30 mL 1 cup - answer 8 oz 1 quart - answer 2 pints 1 pint - answer 2 cups 1 g (gram) - answer 1000 mg
Glaucoma patients lose - answer peripheral vision. Autonomic dysreflexia - answer patients with spinal cord injuries are at risk for developing autonomic dyreflexia (T-7 or above) Spinal shock occurs - answer immediately after injury multiple sclerosis - answer myelin sheath destruction. disruptions in nerve impulse conduction Myasthenia gravis - answer decrease in receptor sites for acetylcholine. weakness observed in muscles, eyes mastication and pharyngeal musles. watch for aspiration. Gullian -Barre syndrome - answer ascending paralysis. watch for respiratory problems. TIA - answer transient ischemic attack....mini stroke, no dead tissue. CVA - answer cerebriovascular accident. brain tissue dies. Hodgkin's disease - answer cancer of the lymph. very curable in early stages burns rule of Nines - answer head and neck 9% each upper ext 9% each lower ext 9% front trunk 18% back trunk 18% genitalia 1%
birth weight - answer doubles by 6 months triples by 1 year if HR is <100 (children) - answer Hold Dig early sign of cystic fibrosis - answer meconium in ileus at birth Meningitis--check for - answer Kernig's/ brudinski's signs wilm's tumor - answer encapsulated above kidneys...causes flank pain hemophilia is x linked - answer passed from mother to son when phenylaline increases - answer brain problems occur buck's traction - answer knee immobility russell traction - answer femur or lower leg dunlap traction - answer skeletal or skin bryant's traction - answer children <3 y <35 lbs with femur fx eclampsia is - answer a seizure perform amniocentesis - answer before 20 weeks to check for cardiac and pulmonary abnormalities
SSRI's - answer take about 3 weeks to work patients with hallucinations patients with delusions - answer redirect them distract them Thorazine and Haldol - answer can cause EPS Alzheimer's - answer 60% of all dementias, chronic, progressive degenerative cognitive disorder. draw up regular and NHP? - answer Air into NHP, air into Regular. Draw regular, then NHP Cranial nerves - answer S=sensory M=motor B=both Oh (Olfactory I) Some Oh (Optic II ) Say Oh (Oculomotor III) Marry To (trochlear IV) Money Touch (trigeminal V) But And (Abducens VI ) My Feel (facial VII) Brother A (auditory VIII) Says Girl's (glossopharyngeal IX) Big Vagina (vagus X) Bras And (accessory XI) Matter Hymen (Hypoglossal XII) More
Hypernatremia - answer S (Skin flushed) A (agitation) L (low grade fever ) T (thirst) Developmental - answer 2-3 months: turns head side to side 4-5 months: grasps, switch and roll 6-7 months: sit at 6 and waves bye bye 8-9 months: stands straight at 8 10-11 months: belly to butt 12-13 months: 12 and up, drink from a cup Hepatitis A - answer Ends in a vowel, comes from the bowel Hepatitis b - answer B= blood and body fluids (hep c is the same) Apgar measures - answer HR RR Muscle tone, reflexes, skin color. Each 0-2 points. 8-10 ok, 0-3 resuscitate Glasgow coma scale - answer eyes, verbal, motor Max- 15 pts, below 8= coma Addison's disease: Cushing's syndrome: - answer "add" hormone have extra "cushion" of hormone
INH can cause peripheral neuritis - answer Take vitamin B6 to prevent. Hepatotoxic pancreatitis pts - answer put them in fetal position, NPO, gut rest, Prepare anticubital site for PICC, they are probably going to get TPN/Lipids Murphy's sign - answer Pain with palplation of gall bladder (seen with cholecystitis) Cullen's sign - answer ecchymosis in umbilical area, seen with pancreatitis Turner's sign - answer Flank--greyish blue. (turn around to see your flanks) Seen with pancreatitis McBurney's point - answer Pain in RLQ with appendicitis LLQ - answer Diverticulitis RLQ - answer appendicitis watch for peritonitis Guthrie test - answer Tests for PKU. Baby should have eaten protein first shilling test - answer Test for pernicious anemia Peritoneal dialysis - answer Its ok to have abd cramps, blood tinged outflow and leaking around site if the cath (tenkoff) was placed in the last 1-2 weeks. Cloudy outflow is never ok Hyper reflexes absent reflexes - answer upper motor neuron issue (your reflexes are over the top) Lower motor neuron issue
Latex allergies - answer assess for allergies to bananas, apricots, cherries, grapes, kiwis, passion fruit, avocados, chestnuts, tomatoes and peaches Tensilon - answer used in myesthenia gravis to confirm diagnosis ALS - answer (amyotrophic lateral sclerosis) degeneration of motor neurons in both upper and lower motor neuron systems Transesophageal fistula - answer esophagus doesn't fully develop. This is a surgical emergency (3 signs in newborn: choking, coughing, cyanosis) MMR - answer is given SQ not IM codes for pt care - answer Red- unstable, ie.. occluded airway, actively bleeding...see first Yellow--stable, can wait up to an hour for treatment Green--stable can wait even longer to be seen---walking wounded Black--unstable, probably will not make it, need comfort care DOA--dead on arrival Contraindication for Hep B vaccine - answer anaphylactic reaction to baker's yeast what to ask before flu shot - answer allergy to eggs what to ask before MMR - answer allergy to eggs or neomycin when on nitroprusside monitor: - answer cyanide. normal value should be 1.
