ATI Practice A Flashcards
If a patient is on Heparin and has a DVT what is a nursing intervention?
Elevate the legs
Does walking increase the risk of a PE if the patient has a DVT?
no
What is a good intervention for patients with cancer to reduce the risk of pulmonary stasis?
The patient will walk for short distances Throughout the day.
How often should a patient that is immunocompromised wash their toothbrush in the dishwasher?
Once a week, not every month
How often should a patient in mechanical restraints be assessed?
Every 15-30 minutes
What is a nurse’s responsibility during the disaster response stage?
Performing a rapid needs assessment
What is a nurse’s role during the preparedness stage of a disaster?
Identifying the roles of disaster workers
What foods should someone eat if they need a uric acid-based diet for urinary calculi formation?
Citrus fruits and avoid foods that contain purine
What is an adverse effect that should be told to the provider if a patient is taking estradiol?
Headaches- it can be an indication of thromboembolic strokes
If a patient is taking lorazepam and their RR is 6 and BP 90/44 what medication should the nurse give?
Flumazenil (benzodiazepine receptor antagonist)
What is the antidote for cholinesterase inhibitors?
Atropmin
Why is a reddened and tender heel on a patient with a fiberglass cylinder cast concerning?
It is a sign of a pressure injury
What is a nursing intervention for cranial nerve II deficit?
Clear objects from the client’s walking area because this causes damage to the optic nerve which leads to falls
What is a concerning sign of a hemolytic transfusion reaction?
Low back pain
What should a patient report to the provider if they are taking Warfarin?
A change in color in their stools
When should a patient get lab draws after starting warfarin?
Within the first 5 days of taking the medication
How can a nurse establish trust in the orientation phase with a client whose partner recently died?
Establish the termination date of therapy
What is an example of doing root cause analysis for falls?
Investigate environmental factors that might be contributing to client injury during these hours
What substance can be used to clean surfaces to protect from Hepatitis A?
Hydrogen peroxide
What is Nystagmus?
Involuntary eye movements and muscle spasticity
What is an early manifestation of lithium toxicity
Confusion
If a client has a K+ level of 3.4 what are some manifestations?
Muscle weakness and decreased DTR
What are some manifestations of abruptio placentae?
Persistent uterine contractions, board-like abdomen, and dark red vaginal bleeding
What is sublimination?
Displayed when a client substitutes socially unacceptable behavior for acceptable behavior
