Ati Adult 2

Front 1

You are assessing a PT who has a new diagnosis of osteoarthritis. Which findings would you expect?

1. Crepitus with joint movement

2. Decreased range of motion of the affected joint

3. Involvement of smaller joints of the body

4. Spongy tissue over the joints

5. Joint pain that resolves with rest

Back 1

1. Crepitus with joint movement-expected b/c loosened bone and cartilage move in the diseased joint.

2. Decreased range of motion of the affected joint- expected b/c pain limits movement

3. Involvement of smaller joints of the body

4. Spongy tissue over the joints

5. Joint pain that resolves with rest- expected b/c these PTs will have increased pain with activity and decreased pain with rest

Front 2

RN is planning care for a PT following a lumbar puncture. Which of the following actions should the RN plan to include?

1. Apply a pressure dressing to the site for 12hr

2. Restrict the PTs fluid intake for 24r

3. Ensure the PT lies flat for 4-8 hr

4. Administer pain medications every 3-4 hr

Back 2

1. Apply a pressure dressing to the site for 12hr- not needed

2. Restrict the PTs fluid intake for 24r-not needed

3. Ensure the PT lies flat for 4-8 hr- this will prevent CSF leakage from the puncture site

4. Administer pain medications every 3-4 hr- not needed

Front 3

RN is caring for a PT who has advancing amyotrophic lateral sclerosis. Which of the following intervention is the RN priority?

1. Provide for frequent rest periods throughout the day

2. Medicate for pain on a regular schedule

3. Monitor pulse oximetry findings

4. Administer baclofen for spasticity

Back 3

1. Provide for frequent rest periods throughout the day- not priority

2. Medicate for pain on a regular schedule- not priority

3. Monitor pulse oximetry findings- greatest risk is paralysis of respiratory muscles. ABCs

4. Administer baclofen for spasticity- not priority but should do to limit interference with self care

Front 4

RN is assessing a PT who had a right hemispheric stroke. Which of the following neurologic deficits should the RN expect?

1. Aphasia

2. Right sided neglect

3. Impulsive behavior

4. Inability to read

Back 4

1. Aphasia- this would be Left hemispheric stroke

2. Right sided neglect-will have left side effects if there is damage to right side

3. Impulsive behavior- with right hemispheric stroke will demonstrate impulsive behavior, poor judgement, and lack of awareness of neurologic deficits

4. Inability to read- PT with left sided stroke is likely to have difficulties in reading due to the inability to discriminate different letters and words

Front 5

Rn is caring for a PT who is 72hr postoperative following an above the knee amputation and reports phantom limb pain. Which of the following actions should the RN take?

1. Remind the PT that the limb has been removed

2. Change the dressing on the PTs residual limb

3. Administer oral dose of gabapentin to the PT

4. Elevate the PTs residual limb above heart level

Back 5

1. Remind the PT that the limb has been removed- would not be therapeutic

2. Change the dressing on the PTs residual limb- would not have any affect on pain

3. Administer oral dose of gabapentin to the PT-should administer a nonopiod medication to treat the nerve pain

4. Elevate the PTs residual limb above heart level- elevating the residual limb above the heart after 48hr can cause hip or knee flexion contracture.

Front 6

RN is providing teaching regarding a new script for carbidopa-levodopa for PT with parkinson disease. Which of the following PT statements indicates an understanding?

1. I should expect a slight increase in my blood pressure while taking this medication

2. I should take my medication with a high protein food

3. I should expect my urine to be a darker color

4. I will expect it to take up to a week for this medication to work.

Back 6

1. I should expect a slight increase in my blood pressure while taking this medication- would be orthostatic hypotension

2. I should take my medication with a high protein food-High protein foods can delay the absorption and reduce the amount absorbed into the bloodstream

3. I should expect my urine to be a darker color

4. I will expect it to take up to a week for this medication to work.

Front 7

RN is caring for PT after a sudden loss of consciousness and falling in her home. Dr determines she has had an embolic stroke. Which of the following medications should the RN administer?

1. Recombinant tissue plasminogen activator

2. Recombinant factor VIII

3. Nitroglycerin

4. Lidocaine

Back 7

1. Recombinant tissue plasminogen activator- this thrombolytic is administered to dissolve the blood clot that caused the stroke

2. Recombinant factor VIII- is administered to manage symptoms of hemophilia.

3. Nitroglycerin- used for angina

4. Lidocaine- antidysrhythmic agent used to treat ventricular dysrhythmias

Front 8

Rn is caring for a PT who has a viral meningitis. Which of the following actions should the RN take?

1. Assess the PTs neurologic status every 8 hr

2. Maintain the PT on droplet precautions

3. Monitor capillary refill at least every 4 hr

4. Place the PT in a well lit environment

Back 8

1. Assess the PTs neurologic status every 8 hr- should do Q4

2. Maintain the PT on droplet precautions- this would be only for bacterial meningitis only needs standard

3. Monitor capillary refill at least every 4 hr- should perform a complete vascular assessment at least Q4 to monitor for vascular compromise.

4. Place the PT in a well lit environment - should minimize

Front 9

RN is teaching a PT who has epilepsy and is to start therapy with phenytoin. Which of the following instructions should the RN include?

1. Rinse with antiseptic mouthwash in place of using dental floss

2. Use an over the counter antihistamine if a rash develops

3. Slowly taper the medication after 6 consecutive months without seizure activity

4. Take medications at a consistent time each day to maintain therapeutic blood levels.

Back 9

1. Rinse with antiseptic mouthwash in place of using dental floss- need to have good oral hygiene due to gingival hyperplasia

2. Use an over the counter antihistamine if a rash develops- should stop and report rash

3. Slowly taper the medication after 6 consecutive months without seizure activity- would take this whether you have a seizure or not

4. Take medications at a consistent time each day to maintain therapeutic blood levels.- need a regular schedule to maintain therapeutic blood levels

Front 10

RN is caring for a PT who has multiple sclerosis. Which of the following findings should the RN expect?

1. hypoactive DTRs

2. Ascending paralysis

3. Intention tremors

4. Increased lacrimation

Back 10

1. hypoactive DTRs- would have hyperactive DTRs

2. Ascending paralysis- this would be Guillain Barre Syndrome

3. Intention tremors- Are at risk for motor dysfunction such as tremors, poor coordination, and loss of balance

4. Increased lacrimation- this would be r/t myasthenia gravis

Front 11

RN is caring for a PT who has a full arm cast and reports pain of of 8 that is unrelieved by pain medication. Which of the following actions should the RN plan to take first?

1. Administer additional pain medication

2. Check the circulation of the affected extremity

3. Document the findings

4. Reposition the affected extremity

Back 11

1. Administer additional pain medication - not 1st

2. Check the circulation of the affected extremity- greatest risk to the PT is neuromuscular injury resulting from compartment syndrome. This should be the first action.

3. Document the findings- not 1st

4. Reposition the affected extremity- not 1st

Front 12

RN is assessing a PT who has a possible head injury following a MVC the RN should recognize that which of the following findings indicate increasing ICP?

1. Restlessness

2. Dizziness

3. Hypotension

4. Fever

Back 12

1. Restlessness- sign of ICP this is an early sign

2. Dizziness- not a sign of ICP

3. Hypotension- The cushing reflex ( hypertension and a widening pulse pressure) is a late sign of ICP

4. Fever- Not a sign of ICP

Front 13

Rn is caring for a PT in balanced suspension skeletal traction who reports intermittent muscle spasms. Which of the following actions should the RN take first?

1. Reposition the PT

2. Provide distraction

3. Administer a muscle relaxant

4. Check the position of the weights and ropes

Back 13

1. Reposition the PT- not 1st action

2. Provide distraction- not 1st action

3. Administer a muscle relaxant- not 1st action

4. Check the position of the weights and ropes- checking these will limit muscle spasms.

Front 14

RN is caring for a PT who is recovering from a stroke and has right sided homonymous hemianopsia. To help the PT adapt, The RN should take which of the following actions?

1. Check the PT cheek on his affected side after eating to be sure no food remains there

2. Encourage the PT to sit upright with his head tilted slightly forward during meals.

3. Provide the PT with eating utensils that have large handles

4. Remind the PT to look consciously at both sides of his meal tray.

Back 14

1. Check the PT cheek on his affected side after eating to be sure no food remains there- does not cause this

2. Encourage the PT to sit upright with his head tilted slightly forward during meals.- does not cause dysphagia

3. Provide the PT with eating utensils that have large handles-does not impair

4. Remind the PT to look consciously at both sides of his meal tray.-PT has lost the right visual field of both eyes and might only eat the food he is able to see

Front 15

Rn is caring for a PT who was admitted for status epileptics and is on seizure precautions. Which of the following actions should the nurse plan to take?

1. Assess hourly for a pike in BP

2. Maintain the PT on bed rest

3. Keep a padded tongue blade a the bedside

4. Establish IV access

Back 15

1. Assess hourly for a pike in BP- not r/t

2. Maintain the PT on bed rest- not r/t

3. Keep a padded tongue blade a the bedside- should not place any objects in the mouth.

4. Establish IV access- will need IV anti epileptic medications via IV so should plan to have this

Front 16

RN is providing teaching for a PT who is prescribed alendronate for osteoporosis. Which of the following information should the RN include in the teaching?

1. Take this med with 240ml of milk

2. Remain upright for 30min after taking the med

3. Expect this med to increase serum Ca levels

4. Increase vit D intake to promote absorption.

Back 16

1. Take this med with 240ml of milk- should be water not milk Ca can reduce absorption

2. Remain upright for 30min after taking the med- this will prevent ulcers and esophagitis which may occur

3. Expect this med to increase serum Ca levels- should decrease the levels

4. Increase vit D intake to promote absorption.- does not aid in absorption

Front 17

RN is caring for a PT who is postoperative following a craniotomy. Which action should the RN take?

1. Suction the PT every 2 hr

2. Report wound drainage greater than 50ml/8hr

3. Position the PT flat in bed

4. Assess the PTs neurologic status every 8 hr.

Back 17

1. Suction the PT every 2 hr- will increase ICP

2. Report wound drainage greater than 50ml/8hr- greatest risk is hemorrhage and hypovolemic shock.

3. Position the PT flat in bed- will increase ICP

4. Assess the PTs neurologic status every 8 hr.- should be Q15-30min for the first 4-6 hR

Front 18

RN is assessing a PT who has rheumatoid arthritis. Which of the following assessment findings should the RN expect?

1. Unilateral joint movement

2. Ulnar deviation

3. Fractures of the spine

4. Decreased sedimentation rate.

Back 18

1. Unilateral joint movement- usually occurs bilaterally and symmetrically. osteoarthritis will occur unilaterally.

2. Ulnar deviation- the inflammation that occurs in the hand joints can make them susceptible to deformity from daily use. ulnar deviation, lateral deviation of the fingers

3. Fractures of the spine- compression Fx of the spine are more common in PTs with osteoporosis

4. Decreased sedimentation rate. -would be increased due to inflammatory response

Front 19

RN is reviewing post op instructions with a PT following cataract surgery. Which of the following PT statements indicates an understanding of instructions.

1. I should call my DR is I experience a decrease in my vision

2. I may take aspirin for eye discomfort following the surgery

3. I can blow my nose to clear out any drainage

4. I can lift objects up to 20lbs

Back 19

1. I should call my DR is I experience a decrease in my vision- not normal should be improved vision after this surgery.

2. I may take aspirin for eye discomfort following the surgery- can lead to bleeding from the eye

3. I can blow my nose to clear out any drainage-this can increase intraocular pressure

4. I can lift objects up to 20lbs- this can increase intraocular pressure

Front 20

Rn is planning care of PT who has a closed head injury from a fall and is receiving mechanical ventilation which of the following interventions is the nurse priority?

1. Maintain a PaCO2 of approximately 35 mm hg

2. Provide small doses of fentanyl via IV bolus for pain management

3. Monitor body temp every 1-2 hr

4. Reposition the PT every 2 hr

Back 20

1. Maintain a PaCO2 of approximately 35- to prevent hypercarbia and subsequent vasodilation effects as this will lead to ICP

2. Provide small doses of fentanyl via IV bolus for pain management- should do but not priority

3. Monitor body temp every 1-2 hr-should do but not priority

4. Reposition the PT every 2 hr- should do but not priority

Front 21

RN is developing a teaching plan for a PT who has menieres disease which instructions should the RN include?

1. Move head slowly to decrease vertigo

2. Apply warm packs to the affected ear during acute attacks

3. Increase intake of foods and fluids high in salt

4. Administer corticosteriods during acute attacks

Back 21

1. Move head slowly to decrease vertigo- this will prevent vertigo

2. Apply warm packs to the affected ear during acute attacks- does not relieve the manifestations

3. Increase intake of foods and fluids high in salt-should reduce salt intake as this will exacerbates meniere's disease

4. Administer corticosteriods during acute attacks- these will actually worsen manifestations

Front 22

RN is providing teaching for a PT and his family about the diagnosis and treatment of alzheimer's disease Which of the following statements by the family indicates an understanding of the teaching?

1. There is a test for Alzheimers disease that can establish a reliable diagnosis

2. The goal of medication therapy is to reverse the degenerative changes that can occur in brain tissue

3. Early manifestations of Alzheimer's disease include mild tremors and muscular rigidity.

4. Early manifestations of Alzheimers disease can help delay cognitive changes

Back 22

1. There is a test for Alzheimers disease that can establish a reliable diagnosis

2. The goal of medication therapy is to reverse the degenerative changes that can occur in brain tissue

3. Early manifestations of Alzheimer's disease include mild tremors and muscular rigidity.

4. drugs used to treat Alzheimers disease can help delay cognitive changes-

Front 23

Rn is caring for a PT who has retinal detachment. Which of the following reports about the affected eye should the RN report?

1. Photophobia

2. Complete blindness

3. Flashes of bright light

4. Pain

Back 23

1. Photophobia- should not experience this

2. Complete blindness- can have some visual field loss in the area of detachment but not total blindness

3. Flashes of bright light- can have experience flashes of bright light or floating dark spots in the affected eye as the retinal layers separate.

4. Pain- no pain fiber located in the retina

Front 24

RN is assessing a PT who reports sudden, severe eye pain with blurred vision. The provider determines the PT has primary angle-closure glaucoma. Which of the following medications should the RN administer?

1. Osmotic diuretics via IV bolus

2. Mydriatic ophthalmic drops

3. Corticosteriod ophthalmic drops

4. Epinephrine via IV bolus

Back 24

1. Osmotic diuretics via IV bolus-will reduce intraocular pressure

2. Mydriatic ophthalmic drops-will cause pupillary dilation

3. Corticosteriod ophthalmic drops- not r/t

4. Epinephrine via IV bolus- will cause pupillary dilation

Front 25

RN is caring for a PT who has a basilar fx following a fall from a ladder. Which of the following findings should the RN report?

1. GCS score 15

2. ICP reading of 15mm

3. Ecchymosis at base of skull

4. Clear drainage from skull

Back 25

1. GCS score 15- WNL

2. ICP reading of 15mm- WNL

3. Ecchymosis at base of skull- would be r/t to a contusion

4. Clear drainage from skull- indicative of a CSF leak