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ATI Fundamentals Proctored Exam Review 2023. Nursing Process- ATI Fundamentals Ch. 7 Assessment/ Data Collection ▪ Pt. interview ▪ Medical history ▪ Physical assessment ▪ Lab reports ▪ S/S, feelings ▪ Objective data VS Analysis ▪ ID pt. health status ▪ Recognize trends a...

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  • July 13, 2023
  • 54
  • 2022/2023
  • Exam (elaborations)
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ATI Fundamentals Proctored Exam Review 2023

❖ Nursing Process- ATI Fundamentals Ch. 7
➢ Assessment/ Data Collection

▪ Pt. interview

▪ Medical history

▪ Physical assessment

▪ Lab reports

▪ S/S, feelings

▪ Objective data VS

➢ Analysis

▪ ID pt. health status

▪ Recognize trends and patterns

➢ Planning
▪ Nurse initiated/Independent Interventions

▪ Provider-Initiated/Dependent interventions

▪ Collaborative interventions
▪ Establish priorities

➢ Implementation
▪ Base care according to data and plan of care

▪ Use problem-solving and critical thinking

▪ Minimize risks

▪ Implement nursing action based on delegation

➢ Evaluation

▪ Evaluate client responses to interventions for form clinical judgement

▪ See if goals are met

▪ Determine effectiveness of nursing care plan




Practice Question: A nurse is discussing the nursing process with a newly hired

,nurse. Which of the following statements by the newly hired nurse should the nurse
identify as appropriate for the planning step of the nursing process?
➢ A. “I will determine the most important client problems that we should address.”
➢ B. “I will review the past medical history on the client’s record to get
more information.”
➢ C. “I will go carry out the new prescriptions from the provider.”
➢ D. “I will ask the client if his nausea has resolved.”



Practice Question: By the second postoperative day, a client has not achieved
satisfactory pain relief. Based on this evaluation, which of the following actions should
the nurse take, according to the nursing process?
➢ A. Reassess the client to determine the reasons for inadequate pain relief.
➢ B. Wait to see whether the pain lessens during the next 24 hr.
➢ C. Change the plan of care to provide different pain relief interventions.

➢ D. Teach the client about the plan of care for managing his pain
➢

,❖ Medical and Surgical Sepsis- ATI Fundamentals Ch. 10
➢ Hand Hygiene PRIMARY BEHAVIOR!!!!!!
➢ 3 essential components (at least 15 seconds and up to 2 minutes if more soiled)

▪ Soap

▪ Water

▪ Friction

➢ Must perform hand hygiene with either soap and water or alcohol-based product
➢ Alcohol based amount- usually 3-5mLs (rub until completely dry)

➢ If visible soiled= soap and water (2 min)
➢ Perform hand hygiene using recommended antiseptic solutions
for immunocompromised or multi-drug resistant micro-organisms
➢ Personal Protective Equipment (PPE):

▪ Put on (or Don): Gown Mask Googles Gloves
▪ Take off (or Doff): Gloves Googles Gown Mask

➢ Physical Environment:

▪ Do not place items on the floor (even soiled laundry)

▪ Do not shake linens can spread microorganisms in the air

• Keep from touch clothing keep away from you

▪ Clean LEAST soiled areas FIRST

▪ Use plastic bags for moist, soiled items

▪ Place specimens in biohazard containers

➢ Maintaining a Sterile Field:

▪ Prolonged exposure to airborne micro-organisms can make sterile items
nonsterile.
• Avoid coughing, sneezing, and talking directly over a sterile field.

, • Ask patients to refrain from touching supplies

▪ Only sterile items may be in a sterile field.

• The outer wrappings and 1-inch edges of packaging that contains sterile
items are not sterile.

• Touch sterile materials only with sterile gloves

▪ Microbes can move by gravity from nonsterile item to a sterile item.

• Do not reach across or above a sterile field.

• Do not turn your back on a sterile field.

• Hold items to add to a sterile field at a minimum of 6 inches above the field.

▪ Any sterile, non-waterproof wrapper that encounters moisture becomes
nonsterile

• Keep all surfaces dry.

• Discard any sterile packages that are torn, punctured, or wet.

➢ Sterile Filed set up:

▪ First open flap or wrapper of packaging AWAY from you

▪ Next open SIDE flaps

▪ Last open last flap TOWARD your body



Practice Question: A nurse is wearing sterile gloves in preparation for performing a
sterile procedure. Which of the following objects can the nurse touch without breaching
sterile technique? (Select all that apply.)
➢ A. a bottle containing a sterile solution
➢ B. The edge of the sterile drape at the base of the field

➢ C. The inner wrapping of an item on the sterile field
➢ D. An irrigation syringe on the sterile field
➢ E. One gloved hand with the other gloved hand

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