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ATI RN ADV MEDSURG PROCTORED EXAM
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lOMoAR cPSD| 40923183ATI RN ADV MEDSURG PROCTORED EXAM
Nur Med Surg (Galen College of Nursing)
Med-Surg ATI Practice Exam Concepts
, lOMoAR cPSD| 4092
Med-Surg ATI Practice Exam Concepts
o Crutches
Place body weight on crutches
Advance unaffected leg onto the stair
Shift weight from crutches to unaffected leg
Bring crutches and affected leg up to the stair o Closed-suction drain nursing
interventions
Negative-pressure device
Doesn’t require wall suction
*Compress the drain reservoir after emptying (creates negative pressure)
Do not need to put below bed (doesn’t use gravity) o External fixation device
Surgeon applies the external fixation device directly to the client’s bone to form a
rigid structure around the affected extremity
Casts, boots, or splints are applied directly to the leg for internal fixation
Client should wear external fixation device continuously for a period of 4-6 weeks
Nurse should teach the client to perform care of the wound and pin sites at
home
Use crutches with rubber tips
Prevents the client from slipping and decreases fall risks
Only the provider should adjust the client’s external fixation device in order to
maintain bone alignment
o Long-term mechanical ventilation complications
Decreased cardiac output and hypotension, related to positive pressure from
mechanical ventilation inhibiting blood return to the heart
Fluid retention related to decreased cardiac output
Stress ulcers, related to elevated levels of HCl in the stomach
Increase risk for systemic infection and require pharmacological treatment
Hyponatremia, secondary to fluid retention o Postoperative nursing interventions
following mastectomy
Instruct client that the drain will remain in place for 1-3 weeks after surgery and will
be removed when there is 25 mL of output or less in a 24-hour period
Instruct client to start exercising the arm on side of surgery 24 hours after surgery
Elevate arm on surgical side on a pillow to promote lymphatic fluid return
Nurse should elevate the head of the client’s bed to at least 30 degrees to promote
drainage from the surgical site and facilitate breathing
o Patient teaching for active tuberculosis
Sputum specimens are necessary every 2-4 weeks until there are three negative
cultures
After 3 negative cultures, the client is no longer considered infectious
, lOMoAR cPSD| 409
Client’s infection is usually no longer contagious after taking TB medications for 2-3
weeks
Family members do not need to follow airborne precautions because they have
already been exposed to TB
A follow-up evaluation of the client’s TB should be performed using a chest x-ray
because the TB skin test is no longer considered accurate after a person has tested
positive
o Nursing interventions following total hip arthroplasty
Assist client to maintain legs in abduction
Client should not flex hip greater than 90 degrees to prevent hip dislocation Nurse
should place a pillow between client’s legs to prevent hip dislocation
Nurse should not keep client’s hip internally rotated, as this can lead to hip
dislocation
o Patient teaching on kidney organ donation
Client who is recipient of organ donation will require lifelong immunosuppressive
therapy to protect against transplant rejection
A healthy donor who has one kidney can manage the body’s urinary excretion
requirements
Client’s nonfunctioning kidney remains in the body until transplant surgery, unless
the client has chronic kidney infection or pain
A client who receives a kidney from live donor has a lower rate of transplant
rejection
Client who receives a kidney from a live donor has a lower rate of transplant
rejection because the donor is often more medically compatible than a donor
who is deceased
o Patient teaching about prevention of atherosclerosis
Smoking cessation
Maintain an appropriate weight
Eat a low-fat diet o MRSA precautions for health care professionals
Client should wear an isolation gown and wash hands before being transported from
the room to prevent spread of micro-organisms
Nurse should bathe client using warm water and a chlorhexidine solution to prevent
the spread of micro-organisms
Use dedicated assessment equipment when assessing the client and leave in room to
prevent cross-contamination with other clients
Mode of transmission = contact o Nephrostomy expected findings
Red-tinged urine during the first 12-24 hours
Normal BUN
Increased urine output (notify provider for decreased UO)
NOTIFY PROVIDER FOR BACK PAIN
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