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2.climb stairs with alternative legs?3.jump on one foot? 4.ride bicycle?36. Suspect newborn abuse, when mom states—“baby should sleep through night by now”37. Midline shift intercostal, extra beat in-between heart beat—mitral murmur38. Magnesium toxicity—monitor urine output39. Magnesium toxicity antidote—calcium gluconate 40. Magnesium toxicity—hyperreflexia41. Preeclampsia with 3+ deep tendon reflex—assess patient42. Glomerulonephritis, S/S—hematuria43. Schizophrenia—disorganized speech44. Hears voices, an appropriate response by the nurse—“I understand, but I don't hear them”45. Crutches—hold on side with elbow slightly bent46. Scratchy, rubbing heart sounds—pericarditisEXHIBIT 14.Hypothyroidism, taking levothyroxine and has low BP
ATI Study Guide 1.gastric bypass2.stomach resection2.dumping syndrome3.thyroid storm15.Postmenopausal, drinking alcohol hemoglobin 8, anemia taking iron, another vitamin to add—b12? or vitamin d?47. Cardiac catheter, report—pounding pulses16.Cardiac catheter—bed rest 12 hrs, or semi fowlers, or check pulse q1548. Cardiac catheter, expected finding post—warmth in skin, warmth sensation49. Potassium contraindicated—impaired renal failure50. Lasix contraindicated—renal failure51. Foley in child—apply sterile gloves before procedure52. NG tube feeding, risk for aspiration—hx of GERD53. Low blood sugar s/s SATA—sweating, confusion and tremors54. After report who to see first—patient who just received 4oz of juice b/c low blood sugar17.Consent, choose what provider must inform patient prior to signing consent—SATA3.risk4.alternative tx5.description of procedure1.expected outcome?2.WRONG55. Taking Dilantin with another med—dilantin toxicity56. Group facilitation in psych setting—modeling57. Orientation stage—introduction and setting goals, limit rules58. Nurse to delegate to AP—patient dropped pitcher of water 18.Borderline personality disorder—clinging or impulsive59. Histrionic—seductive behavior60. Heating pad tx, contraindication—peripheral neuropathy19.COPD weight loss, chest pain during eating—decreased snacking between meals or contact dietary61. Cushings—hyperglycemia62. TPN—change tubing every 24hours to prevent infection63. TPN intervene—when nurse gives meds through same port64. Alzheimer, assess for remote memories—ask about his school65. Paracentesis—urinate prior to procedure20.Monitor for A/E—contractions?66. Child in fire—look in mouth for smoke inhalation21.Referral for home visit—first action is to?1.Call family on phone2.Schedule appointment with family3.Verify source of referral6.Implement nursing process 67. Burn victim after airway—initiate IV fluids68. Blood infusion—prime with 0.9 sodium chloride69. Mother is dying, nurse needs to choose appropriate response to daughter SATA—
ATI Study Guide 1.choose these 3:1.“you seem…”, 2.“lets talk about it..”