ATI comprehensive predictor C 190+ questions with correct answes latet solution | Exams Health Physics | Docsity (2024)

Download ATI comprehensive predictor C 190+ questions with correct answes latet solution and more Exams Health Physics in PDF only on Docsity! 1 / 47 ATI comprehensive predictor C GRADEDGG 1. What can be delegated to Assistive person- nel (AP)? 2. A nurse on a med surge unit has recieved change of shift report and will care for 4 clients. Which of the following clients needs will the nurse assign to an AP? A. Feeding a client who was admitted 24 hours ago with aspiration pneumonia B. Reinforcing teaching with a client who is learning to walk with a quad cane C. Reapplying a condom catheter for a client who has urinary incontinence D. Applying a sterile dressing to a pressure ulcer 3. A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago to an AP. Which of the following info should the nurse share with the AP? Select all: A. the roommate is up independently B.The client ambulates with his slippers on over his antiembolic stockings C.The client uses a front wheeled walker when ambulating D.The client had pain meds 30 minutes ago E. The client is allergic to codeine F. the client ate 50 % of his breakfast this morning 4. An RN is making assignments for client care to an LPN at the beginning of the shift. Which of the following assignments should the LPN question? ATI comprehensive predictor C 2 / 47 GRADEDGG - ADLs - bathing - grooming - dressing - ambulating - feed- ing (w/o swallow precautions) - positioning - bed making - specimen collection - I&O - VS (stable clients C B C D D ATI comprehensive predictor C 5 / 47 GRADEDGG 10. What are positive actions to help others Beneficience 11. What is an agreement to keep promises Fidelity 12. What is fairness in care delivery and use of resources Justice 13. What is avoidance of harm or injury Non-maleficence 14. A nurse is caring for a client who de- A cides not to have surgery despite signifi- cant blockages in his coronary arteries. The nurse understands that this clients choice is an example of what principles? A. Fidelity B. Autonomy C. Justice D. Nonmalificience 15. A nurse offers pain meds to a client who D is postop prior to ambulation. The nurse understands that this aspect of care deliv- ery is an example of which of the following ethical principles? A. Fidelity B. Autonomy C. Justice D. Beneficience 16. A nurse is instructing a group of nurs- C ing students about the responsibilities in- volved with organ donation and procure- ment. When the nurse explains that all clients waiting for a kidney transplant have to meet the same qualifications, the stu- dents should understand that this aspect of care delivery is an example of which ethical principle A. Fidelity ATI comprehensive predictor C 6 / 47 GRADEDGG B. Autonomy C. Justice D. Nonmaleficence 17. A nurse questions a med prescription as D too extreme and light of the clients ad- vanced age and unstable status. The nurse understands that this action is an example of which ethical principle A. Fidelity B. Autonomy C. Justice D. Nonmalificence 18. Which of the following situations can be C identified as an ethical dilemma? A. A nurse on a med surge unit demon- strates signs of chemical impairment B. A nurse over hears another nurse telling an older adult client that if he doesnt stay in bed she will restrain him C. A family has conflicting feelings about the initiation of enteral tube feedings of their father who is terminally ill D. A client who is terminally ill hesitates to name her spouse on her durable power of attorney form 19. Most managers can be categorized as authoritative, democratic, and laissez faire 20. makes decisions of the group motivates by coercion communication occurs down the chain of command Work output by the staff is usually high-good for crisis situations and bureau- cratic settings Authoritative ATI comprehensive predictor C 7 / 47 GRADEDGG 21. Democratic ATI comprehensive predictor C 10 / GRADEDGG 27. What do the nurse need to keep in mind about the client when being their advocate? 28. When should planning discharge process begin? a. at time of admission b. 2 days after client is admitted c. whenever the nurse has the time to do planning d. when the physician has the discharge order Client's religion & culture A 29. What is an interdisciplinary team? A group of health care pro- fessionals from different dis- ciplines 30. Fill in the blank: 1. is used by interdisciplinary team to make health care decisions about clients with multiple problems. 2. , which may take place at team meetings, allows the achievement of results that the partici- pants would be incapable of accomplishing if working alone. 31. What is the nurse's contribution to an inter- disciplinary team? 32. A four-month-old infant is admitted to the pediatric intensive care unit with a temperature of 105°F (40.5 °C). The infant is irritable, and the nurse observes nuchal rigidity. Which assess- ment finding would indicate an increase in intracranial pressure? 1. Positive Babinski. ATI comprehensive predictor C 11 / GRADEDGG 1 & 2 = collaboration - knowledge of nursing care & its management - a holistic understanding of the client, her/his healthcare needs & healthcare systems. 2 ATI comprehensive predictor C 12 / GRADEDGG 2. High-pitched cry. 3. Bulging posterior fontanelle. 4. Pinpoint pupils. 33. A client is receiving total parenteral nutri- 4 tion (TPN). To determine the client's tolerance of this treatment, the nurse should assess for which of the following? 1. A significant increase in pulse rate. 2. A decrease in diastolic blood pressure. 3. Temperature in excess of 98.6°F (37°C). 4. Urine output of at least 30 cc per hour. 34. The client is exhibiting symptoms of 2 myxedema. The nursing assessment should reveal 1. increased pulse rate. 2. decreased temperature. 3. fine tremors. 4. increased radioactive iodine uptake lev- el. 35. A nonstress test is scheduled for a client at 3 34-weeks gestation who developed hypertension, periorbital ede- ma, and proteinuria. Which of the following nursing actions should be includ- ed in the care plan in order to BEST prepare the client for the diagnostic test? 1. Start an intravenous line for an oxytocin infusion. 2. Obtain a signed consent prior to the pro- cedure. 3. Instruct client to push a button when she feels fetal movement. 4. Attach a spiral electrode to the fetal head. ATI comprehensive predictor C 15 / GRADEDGG 4. limit his fluid intake to reduce the number of times a catheterization is needed. 39. A client is being discharged with sublin- 4 gual nitroglycerin (Nitrostat). The client should be cautioned by the nurse to 1. take the medication five minutes after the pain has started. 2. stop taking the medication if a stinging sensation is absent. 3. take the medication on an empty stom- ach. 4. avoid abrupt changes in posture. 40. A 38-year-old woman is returned to her 1 room after a subtotal thyroidectomy for treatment of hyperthy- roidism. Which of the following, if found by the nurse at the patient's bedside, is nonessential? 1. Potassium chloride for IV administration. 2. Calcium gluconate for IV administration. 3. Tracheostomy set-up. 4. Suction equipment. 41. A nurse recognizes that an initial positive 3 outcome of treatment for a victim of sexual abuse by one parent would be that the client 1. acknowledges willing participation in an incestuous relationship. 2. reestablishes a trusting relationship with his/her other parent. 3. verbalizes that s/he is not responsible for the sexual abuse. 4. describes feelings of anxiety when speaking about sexual abuse. ATI comprehensive predictor C 16 / GRADEDGG 42. 2 ATI comprehensive predictor C 17 / GRADEDGG An adolescent client is ordered to take tetracycline HCL (Achromycin) 250 mg PO bid. Which of the following in- structions should be given to this client by the nurse? 1. "Take the medication on a full stomach, or with a glass of milk." 2. "Wear sunscreen and a hat when out- doors." 3. "Continue taking the medication until you feel better." 4. "Avoid the use of soaps or detergents for two weeks." 43 . After a client develops left-sided hemipare- 2 sis from a cerebral vascular accident (CVA), there is a decrease in mus- cle tone. Which of the following nursing diagnoses would be a priority to include in his care plan? 1. Alteration in mobility related to paralysis. 2. Alteration in skin integrity related to de- crease in tissue oxygenation. 3. Alteration in skin integrity related to im- mobility. 4. Alteration in communication related to decrease in thought processes 44 . A client has a history of oliguria, hyperten- 1 sion, and peripheral edema. Current lab values are: BUN -25, K+ -4.0 mEq/L. Which nutrient should be restricted in the client's diet? 1. Protein. 2. Fats. 3. Carbohydrates. ATI comprehensive predictor C 20 / GRADEDGG physical needs as necessary. ATI comprehensive predictor C 21 / GRADEDGG 3. The staff helps the client identify thoughts or feelings that occurred prior to the onset of the anxiety. 4. The staff assesses the client's need for medication or seclusion if other interventions have failed to reduce anxiety. 48. A 69-year-old client is undergoing his sec- 3 ond exchange of intermittent peritoneal dialysis (IPD). Which of the fol- lowing would require an intervention by the nurse? 1. The client complains of pain during the inflow of the dialysate. 2. The client complains of constipation. 3. The dialysate outflow is cloudy. 4. There is blood-tinged fluid around the intra-abdominal catheter. 49. The clinic nurse is performing diet teaching 1 with a 67-year-old client with acute gout. The nurse should teach the client to limit his intake of 1. red meat and shellfish. 2. cottage cheese and ice cream. 3. fruit juices and milk. 4. fresh fruits and uncooked vegetables. 50. A client is scheduled for a left lower lobec- 3 tomy. The physician has ordered diazepam (Valium) 2 mg IM for anx- iety. The nurse would determine that the medication is appropriate if the client displays which of the following symptoms? 1. Agitation and decreased level of con- sciousness. 2. Lethargy and decreased respiratory rate. ATI comprehensive predictor C 22 / GRADEDGG 3. Restlessness and increased heart rate. 4. Hostility and increased blood pressure. 51. A 59-year-old woman with bipolar disorder 3 is receiving haloperidol (Haldol) 2 mg PO tid. She tells the nurse, "Milk is coming out of my breasts." Which of the following responses by the nurse is BEST? 1. "You are seeing things that aren't real." 2. "Why don't we go make some fudge." 3. "You are experiencing a side effect of Haldol." 4. "I'll contact your physician to change your medication." 52. The physician orders ranitidine hydrochlo- 4 ride (Zantac) 150 mg PO qd for a client. The nurse should advise the client the BEST time to take this medication is 1. before breakfast. 2. with dinner. 3. with food. 4. at hs. 53. . If a client develops cor pulmonale 3 (right-sided heart failure), the nurse would expect to observe 1. increasing respiratory difficulty seen with exertion. 2. cough productive of a large amount of thick, yellow mucus. 3. peripheral edema and anorexia. 4. twitching of extremities. 54. The nurse is performing triage on a group 2 of clients in the emergency department. Which of the following clients should the nurse see FIRST? ATI comprehensive predictor C 25 / assistant. The nurse should consider the assignments appropriate if the nursing assistant is assigned to care for 1. a client with Alzheimer's requiring assis- tance with feeding. 2. a client with osteoporosis complaining of burning on urination. 3. a client with scleroderma receiving a tube feeding. 4. a client with cancer who has Cheyne-Stokes respirations. 61. An elderly client is returned to her room 4 after an open reduction and internal fixation of the left femoral head af- ter a fracture. It is MOST important for the nursing care plan to in- clude that the client 1. eat a high-protein, low-residue diet. 2. lie on her unoperated side. 3. exercise her arms and legs. 4. cough and deep breathe. 62. Which of the following is a correctly stated 4 nursing diagnosis for a client with abruptio placentae? 1. Infection related to obstetrical trauma. 2. Potential for fetal injury related to abrup- tio placentae. 3. Potential alteration in tissue perfusion related to depletion of fibrinogen. 4. Fluid volume deficit related to bleeding. 63. An 8-year-old client is returned to the re- 1 covery room after a bronchoscopy. The nurse should position the client ATI comprehensive predictor C 26 / 1. in semi-Fowler's position. 2. prone, with the head turned to the side. ATI comprehensive predictor C 27 / 3. with the head of the bed elevated 45° and the neck extended. 4. supine, with the head in the midline po- sition. 64. Which of the following assessment find- 1 ings would indicate to the nurse the need for more sedation in a client who is withdrawing from alcohol dependence? 1. Steadily increasing vital signs. 2. Mild tremors and irritability. 3. Decreased respirations and disorienta- tion. 4. Stomach distress and inability to sleep. 65. The home care nurse is instructing a client 4 recently diagnosed with tuberculosis. It is MOST important for the nurse to include which of the following as a part of the teaching plan? 1. During the first two weeks of treatment, the client should cover his mouth and nose when he coughs or sneezes. 2. It is necessary for the client to wear a mask at all times to prevent transmission of the disease. 3. The family should support the client to help reduce feeling of low self-esteem and isolation. 4. The client will be required to take pre- scribed medication for a duration of 6-9 months. 66. The nurse's INITIAL priority when manag- 3 ing a physically assaultive client is to 1. restrict the client to the room. ATI comprehensive predictor C 30 / snack. 4. The staff uses standard precautions. 69. When using restraints for an agitated/ag- 3 gressive patient, which of the following statements should NOT influence the nurse's actions during this intervention? 1. The restraints/seclusion policies set forth by the institution. 2. The patient's competence. 3. The patient's voluntary/involuntary sta- tus. 4. The patient's nursing care plan. 70. The nurse is caring for an 80-year-old client 2 with Parkinson's disease. Which of the following nursing goals is MOST realistic and appropriate in planning care for this client? 1. Return the client to usual activities of daily living. 2. Maintain optimal function within the client's limitations. 3. Prepare the client for a peaceful and dig- nified death. 4. Arrest progression of the disease process in the client. 71. A client with a peptic ulcer had a partial 4 gastrectomy and vagotomy (Billroth I). In planning the discharge teach- ing, the client should be cautioned by the nurse about which of the following? 1. Sit up for at least 30 minutes after eating. 2. Avoid fluids between meals. 3. Increase the intake of high- carbohydrate foods. ATI comprehensive predictor C 31 / 4. Avoid eating large meals that are high in simple sugars and liquids. 72. A nurse is caring for a 37-year-old woman 3 with metastatic ovarian cancer admitted for nausea and vomiting. The physician orders total parenteral nutrition (TPN), a nutritional consult, and diet recall. Which of the following is the BEST indication that the patient's nutritional status has improved after 4 days? 1. The patient eats most of the food served to her. 2. The patient has gained 1 pound since admission. 3. The patient's albumin level is 4.0mg/dL. 4. The patient's hemoglobin is 8.5g/dL. 73. A 23-year-old woman at 32-weeks gestation 1 is seen in the outpatient clinic. Which of the following findings, if assessed by the nurse, would indicate a possible complication? 1. The client's urine test is positive for glu- cose and acetone. 2. The client has 1+ pedal edema in both feet at the end of the day. 3. The client complains of an increase in vagin*l discharge. 4. The client says she feels pressure against her diaphragm when the baby moves. 74. After abdominal surgery, a client has a na- 2 sogastric tube attached to low suctioning. The client becomes nauseated, and the nurse observes a decrease in the flow of gastric secretions. ATI comprehensive predictor C 32 / Which of the following nursing interventions would be MOST appropriate? 1. Irrigate the nasogastric tube with dis- tilled water. 2. Aspirate the gastric contents with a sy- ringe. 3. Administer an antiemetic medicine. 4. Insert a new nasogastric tube. 75. After sustaining a closed head injury and 2 numerous lacerations and abrasions to the face and neck, a five-year-old child is admitted to the emergency room. The client is unconscious and has minimal response to noxious stimuli. Which of the following as- sessments, if observed by the nurse three hours after admission, should be reported to the physician? 1. The client has slight edema of the eye- lids. 2. There is clear fluid draining from the client's right ear. 3. There is some bleeding from the child's lacerations. 4. The client withdraws in response to painful stimuli. 76. The nurse is caring for a manic client in the 4 seclusion room, and it is time for lunch. It is MOST appropriate for the nurse to take which of the following actions? 1.Take the client to the dining room with 1:1 supervision. 2. Inform the client he may go to the dining room when he controls his behavior. ATI comprehensive predictor C 35 / 3 - severe cases of Staphy- lococcus aureus infections including methicillin-resis- tant Staphylococcus aureus (MRSA) Patient name, drug, dose, route, frequency read back for accuracy A B E ATI comprehensive predictor C 36 / 81. A charge nurse is discussing the responsi- D bility of nurses carig for clients who have C. difficile. Which of the following information should the nurse include in the teaching? a) Assign the client to a room with a nega- tive air-flow system b) Use alcohol-based hand sanitizer when leaving the clients room c) clean contaminated surfaces in the clients room with a phenol solution d) have family members wear a gown and gloves when visiting 82. A nurse is caring for a client receiving IV A fluids. During a routine check, the nurse determines that the client has developed phlebitis and removes the IV catheter. Which of the following actions should the nurse take next? a) place a warm compress over the IV site b) record the findings in the client's chart c) notify the client's primary care provider d) prepare to insert a new IV catheter 83. A nurse is caring for a client who has A dementia. Which of the following interven- tions should the nurse take to minimize the risk for injury for this client? a) use a bed exit alarm system b) raise 4 side rails while client is in bed c) apply one soft wrist restraint d) dim the lights in the client's room 84. A nurse is implementing a plan of care for A ATI comprehensive predictor C 37 / a client who is at risk for falls. Which of the following is an appropriate nursing action? ATI comprehensive predictor C 40 / a) use the cane on the weak side of the body b) advance the cane and the atrong leg si- multaneously c) maintain two points of support on the floor d) advance the cane 30 to 45 cm (12-18 in) with each step 91. Which of the following should indicate to A a nurse the need to suction a client's tra- cheostomy? a) irritability b) hypotension c) flushing d) bradycardia 92. A nurse is caring for a client who has a pre- C scription for wound irrigation. Which of the following actions should the nurse take? a) wear sterile gloves when removing the old dressing b) warm the irrigation solution to 40.5C (105F) c) cleanse the wound from the center out- wards d) use a 20 mL syringe to irrigate the wound 93. A nurse is providing teaching about a clear D liquid diet. Which of the following should the nurse instruct the client to avoid? a) lemon-lime sports drinks b) ginger ale c) black coffee d) orange sherbet 94. D ATI comprehensive predictor C 41 / A nurse is caring for a client who is having difficulty voiding following the removal in an indwelling urinary catheter. Which of the following interventions should the nurse take? a) assess for bladder distention after 6 hr b) encourage the client to use a bed pan in the supine position c) restrict the clients intake of oral fluids d) pour warm water over the clients per- ineum 95. When caring for the client diagnosed with 3 delirium, which condition is the most im- portant for the nurse to investigate? 1. Cancer of any kind. 2. Impaired hearing. 3. Prescription drug intoxication. 4. Heart failure. 96. Which of the following is essential when 2 caring for a client who is experiencing delir- ium? 1. Controlling behavioral symptoms with low-dose psychotropics. 2. Identifying the underlying causative con- dition or illness. 3. Manipulating the envi- ronment to increase orientation. 4. Decreasing or discontinuing all previ- ously prescribed medications. 97. Which of the following is a realistic 3 short-term goal to be accomplished in 2 to 3 days for a client with delirium? 1. Explain the experience of having deliri- um. 2. Resume a normal sleep-wake cycle. 3. Regain orientation to time and place. ATI comprehensive predictor C 42 / 4. Establish normal bowel and bladder function. 98. A client diagnosed with dementia wanders 2 the halls of the locked nursing unit during the day. To ensure the client's safety while walking in the halls, the nurse should do which of the following? 1. Administer PRN haloperidol (Haldol) to decrease the need to walk. 2. Assess the client's gait for steadiness. 3. Restrain the client in a geriatric chair. 4. Administer PRN lorazepam (Ativan) to provide sedation. 99. During a home visit to an elderly client 2 with mild dementia, the client's daughter re- 3 ports that she has one major problem with 4 her mother. She says, "She sleeps most of the day and is up most of the night. I can't get a decent night's sleep anymore." Which suggestions should the nurse make to the daughter? Select all that apply. 1. Ask the client's physician for a strong sleep medicine. 2. Establish a set routine for rising, hygiene, meals, short rest peri- ods, and bedtime. 3. Engage the client in simple, brief exercis- es or a short walk when she gets drowsy during the day. 4. Promote relaxation before bedtime with a warm bath or relaxing music. 5. Have the daughter encourage the use of caffeinated beverages during the day to keep her mother awake. 100. The physician orders risperidone 3 (Risperdal) for a client with Alzheimer's dis- ease. The nurse anticipates ATI comprehensive predictor C 45 / medications. - clients name ATI comprehensive predictor C 46 / 104. What are some things to teach about home safety with elderly patients? 105. A nurse is providing discharge instructions to a client who has a prescription for the use of oxygen in his home. Which of the following should the nurse teach the client about using oxygen safely in his home? (Select all that apply.) A. Family members who smoke must be at least 10 ft from the client when oxygen is in use. B. Nail polish should not be used near a - assigned identification num- ber - telephone number - birth date or other per- sonal-specific identifiers. Bar code scanners may be used to identify clients - Removing items that could cause the client to trip, such as throw rugs and loose car- pets - Placing electrical cords and extension cords that against a wall behind furniture - Making sure that steps and sidewalks are in good repair - Placing grab bars near the toilet and in the tub or shower and installing a stool riser - Using a non-skid mat in the tub or shower - Placing a shower chair in the shower - Ensuring that lighting is ade- quate both inside and outside of the home B C E ATI comprehensive predictor C 47 / client who is receiving oxygen. C. A "No Smoking" sign should be placed on the front door. D. Cotton bedding and clothing should be replaced with items made from wool. E. A fire extinguisher should be readily available in the home. 106. A nurse is providing home safety instruc- tions to a group of older adult clients. Match the safety risk with the appropriate instruction. Passive smoking Carbon monoxide poisoning Food poisoning A. Have water heaters inspected on an an- nual basis. B. Cook all meat at an appropriate temper- ature. C. Avoid enclosed areas with others who may be smoking. 107. When performing nasotracheal suctioning what technique should be used? 108. A nurse educator is presenting a module on basic first aid for newly licensed home health nurses. The nurse educator evalu- ates the teaching as effective when the newly licensed nurse states the client who has heat stroke will have which of the fol- lowing? A. Hypotension B. Bradycardia C. Clammy skin D. Bradypnea ATI comprehensive predictor C 50 / suffo- cation): infant (birth-1 yr) 30 degree lateral position is recommended for clients at risk for pressure ulcers -avoid plastic bags -keep balloons out of reach -ensure crib mattress fits snugly -ensure crib slats are no more than 6 cm (2.4 in) apart -remove crib mobiles and ATI comprehensive predictor C 51 / 113. hypotension is classified with a reading be- low normal; 114. What temperature should pork be cooked at 115. What is the safest way to thaw out frozen foods 116. What are the precautions for vancomycin resistant enterococcus gyms by 4-5 months -do not use pillows in crib -place infant on back for sleep -keep toys with small parts out of reach -remove drawstrings from jackets and other clothing systolic < 90 mm Hg; can be a result of fluid depletion, heart failure, or vasodilation 160 degrees In the refrigerator Standard precautions includ- ing hand washing and gloving should be followed 117. What does a newborns poop look like If your baby is exclusively breastfed, her poop will be yellow or slightly green and have a mushy or creamy con- sistency 118. What is appropriate for an adolescent in the hospital? 119. What is the proper nutrition during preg- nancy 120. What should be avoided during pregnancy ATI comprehensive predictor C 52 / Puzzles and books - Folic acid is important for pregnancy, as it can help to prevent birth defects known as neural tube defects, in- cluding spina bifida - green leafy vegetables and brown rice ATI comprehensive predictor C 55 / teem somatic complaints persist for an extended period of time 127. Signs for meningococcemia Vomiting, febrile, petechial rash (unstable) 128. Levothyroxine effects Used to restore client's meta- bolic rate * Toxic effects = heat intol- erance, Tachycardia, Weight loss, Hypertension 129. Multiple Sclerosis Patient Mitoxantrone SE's Mitox- antrone IV every 3 months (chemo drug) * Report Sore Throat (greatest risk for client is severe infection due to myelosuppression from mi- toxantrone) *Vomiting = causes dehydra- tion * Hair Loss = emotional dis- tress * Amenorrhea = emotional distress 130. Malnourished COPD patients (1) Limit liquid intake at meal times (2)Consume foods w/ protein (like eggs) ATI comprehensive predictor C 56 / (3)Maintain an upright posi- tion (High Fowler's position) to promote ventilation (4)Use milk instead of water when making soup 131. Anger stage ATI comprehensive predictor C 57 / Which grief process is it when Client ex- hibits increased anxiety + may project anger toward self + others "I don't deserve to die, this isn't fair" 132. Which Grief Process when Client acknowl- edges the impending loss while remaining hopeful "If I could just make it through this, I'd never smoke again" 133. How should you respond when client wants to discontinue dialysis 134. What should the nurse do when one mem- ber of a support group expresses anger repeatedly? 135. What immunizations are CONTRAINDICAT- ED for pregnant women + which SHOULD be given? Bargaining Stage "What has changed to make you decide this?" = Seek clarification from client to establish mutual understanding while staying therapeutic Focus more on the group members who have a positive outlook (Speak to group member pri- vately to uncover source of anger) Contraindicated = Herpes Zoster + Varicella + MMR (measles, mumps, rubella) Should give = TDaP (Tetanus, Diphtheria, Pertus- sis) 136. Long term effects of NSAIDS (Ibuprofen) Gastric Ulcerations, perfora- ATI comprehensive predictor C 60 / 143. 143. Substance use disorder (ex- periences more rapid cy- cling), anxiety disorders, eat- ing disorders, ADHD. Electroconvulsive therapy for the patient who is suicidal or rapid cycling who HAS taken Lithium and has proven inef- fective. Used to subdue man- ic behavior. ATI comprehensive predictor C 61 / What kind of medications are indicated for abstinence maintenance of alcohol? Disulfiram (Antabuse), Nal- trexone (Vivitrol), Acam- prosate (Campral) 144. Teaching points for naltrexone (Vivitrol)? Take with meals to supress GI distress. Monthly IM injec- tions should be suggested for patients who have difficulty to adhering to the medication regimen. 145. A nurse is caring for a client who under- B went a subtotal gastrectomy. To manage dumping syndrome, the nurse should ad- vise the client to: a) restrict fluid intake to 1 qt (1,000 ml)/day. b) drink liquids only between meals. c) don't drink liquids 2 hours before meals. d) drink liquids only with meals. 146. A patient who has undergone colosto- C my surgery is experiencing constipa- tion. Which of the following interventions should a nurse consider for such a patient? a) Instruct the patient to keep a record of food intake b) Instruct the patient to avoid prune or apple juice c) Suggest fluid intake of at least 2 L per day d) Assist the patient regarding the correct diet or to minimize food intake 147. A ATI comprehensive predictor C 62 / client is admitted with a diagnosis of D acute appendicitis. When assessing the ab- domen, the nurse would expect to find re- bound tenderness at which location? a) Left lower quadrant b) Left upper quadrant ATI comprehensive predictor C 65 / a) Large intestine b) Ileum c) Stomach d) Liver 152. A nurse is caring for a client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission? a) Skim milk b) Nothing by mouth c) Regular diet d) Clear liquids 153. Bladder retraining for the treatment of urge incontinence: 154. what are normal creatinine levels? what are normal BUN levels? 155. What are total serum protein values (nor- mals) B •Use timed voidings to increase intervals between voidings/decrease voiding frequency. •Perform pelvic floor (Kegel) exercises. •Perform relaxation tech- niques. •Offer undergarments while the client is retraining. • Teach the client not to ignore the urge to void. •Provide positive reinforce- ment as client maintains con- tinence. •Eliminate or decrease caf- feine drinks. • Take diuretics in the morn- ing. 0.8-1.4 mg/dL 8-25 mg/dL ATI comprehensive predictor C 66 / 6-8 g/dL ATI comprehensive predictor C 67 / 156. Describe pre-albumin this is the best tool for evalu- ating nutrition. it has a half-life of 2 days which is much shorter than albumin so it is much more accurate. (albu- min's half-life is 2-3 weeks) 157. what is normal pre-albumin values? what are normal serum levels of magne- sium ? what is a normal potassium serum level? 17-40 mg/dL 1.5-2.5 mEq/L (less than 1.5 is considered hypomagne- semia) 3.5-5.0 mEq/L (less than 3.5 is considered hypokalemia) 158. what are good sources of folic acid? Excellent sources of fo- late include romaine lettuce, spinach, asparagus, turnip greens, mustard greens, calf's liver, parsley, collard greens, broccoli, cauliflower, beets, chicken liver and lentils. 159. Sources of potassium beans, spinach, potatoes, dried apricots, acorn squash, yogurt, salmon, avocados, mushrooms and bananas 160. what is important about the diet of some- one taking ACE inhibitors? ATI comprehensive predictor C 70 / paragus, cabbage, pickels, prunes 37-48% (male is 42-52%) 12-16 g/dL (male 13-17) 4500-11,000 / uL avoid hard-to-digest foods such as nuts, corn, popcorn, and seeds, for fear that these foods would get stuck in the diverticula and lead to inflam- mation. (Eat foods high in fiber) thyramine--it can cause el- evated BP. This is found in "aged" products such as aged cheeses (swiss), cured meats (pepper- oni/salomi), sauerkraut, soy sauce...Examples of MAOI's are: Isocarboxazid (Marplan), Phenelzine (Nardil), Sel- ogilive, Emsam, Eldepryl, Ze- lapar... at age 35 (women) 8.6-10 mg/dL calcium gluconate (be- cause hypocalcemia causes Chvostek's sign) fine hand tremors, mild GI up- set, slurred speech and mus- cle weakness ATI comprehensive predictor C 71 / 168. a nurse is obtaining a medication history from a client who is to start a new prescrip- tion for warfarin ( Coumadin) . which of the following over the counter medication should the nurse instruct the client to avoid 169. a nurse responsible for a client receiving a antihypertensive medication is to 170. a client should receive a dose of flumazenil ( romazicon) to treat symptoms of 171. a nurse is reinforcing teaching to a client who is prescribed diazepam tor anxiety of the following statement indicated the client understand the teaching 172. a nurse is reinforcing teaching to a client who is starting amitriptyline ( Elavil) for treatment of depression which of the fol- lowing should the nurse include 173. a client who is start taking lithium car- bonate month ago tell the nurse she has just begun taking multiply daily doses of ibuprofen ( motrin) for tension headache. should the client avoid ibuprofen. why or why not ? 174. a client has prescription for valproic ( De- pakote) which of the following laboratory value should the nurse anticipate monitor for the client taking this medication ATI comprehensive predictor C 72 / Aspirin teach the client to change po- sition slowly to avoid dizzi- ness or fainting benzodiazepine overdose I will tell my doctor before I stop taking the medication 1.change position slowly to minimize dizziness 2.chewing sugarless gum to prevent dry mouth what , if any is the appro- priate action for the nurse to take NSAIDS such as ibupro- fen increase the renal reab- sorption of lithium carbon- ate , possibly leading to lithi- um carbonate toxicity . there- for this client would avoid NSAIDS . the nurse should notify the provider of client headache and ibuprofen us thrombocytes, amylase count and liver function test ATI comprehensive predictor C 75 / 182. Adverse effect of Verapamil Avoid grapefruit juice 183. Interaction of diuretics and ACE inhibitors excessive reduction in blood pressure and symptomatic hypotension or hyperkalemia 184. What can prevent MI, stroke, or death in high-risk patients 185. What to monitor for when taking enoxa- parin (lovenox) 186. What are the therapeutic effects of prota- mine 187. How to prevent adverse effects of oxy- codone Ramipril Hyperkalemia Cases of headache, hemor- rhagic anemia, eosinophilia, alopecia, hepatocellular and cholestatic liver injury report- ed Antidote to severe heparin overdose + Reversal of he- parin administered during procedures can cause respiratory de- pression. What is the nursing interven- tion and/or client education ? Monitor vital signs. › Stop opioids for respiratory rate less than 12/min, and no- tify the provider. ATI comprehensive predictor C 76 / › Have naloxone and resusci- tation equipment available. › Avoid use of opioids with CNS depressant medications (barbiturates, benzodiazepines, consump- tion of alcohol). ATI comprehensive predictor C 77 / 188. opioid agonists can cause Constipation What is the nursing intervention and/or client education ? Advise the client to increase fluid/fiber intake and physical activity. › Administer a stimulant lax- ative such as bisacodyl (Dul- colax) to counteract decreased bowel motility, or a stool softener such as do- cusate sodium (Colace) to prevent constipation. 189. Adverse effects of ferrous sulfate constipation; upset stomach; black or dark-colored stools; or. temporary staining of the teeth. 190. Baclofen (Lioresal) therapeutic outcome: Decrease the frequency and severity of muscle spasms (MS). 191. What is the difference between respiratory acidosis and respiratory alkalosis? 192. Bowel elimination how to get a specimen collection 193. Identifying manifestations of transient is- chemic attacks