ATI Medsurg Proctored Exam (Version 1)( Questions & Answers with rationale )(Latest updated,
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ATI Medsurg
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ATI Medsurg
ATI Medsurg Proctored Exam (Version 1)( Questions & Answers with rationale )(Latest updated,
Normal levels for: Aspartate aminotransferase (AST) & Alanine aminotransferase (ALT); What diagnosis can be made if these levels are elevated? - Answer -Below 40 for both; cirrhosis of the liver and ...
ATI Medsurg Proctored Exam (Version 1)(
Questions & Answers with rationale )(Latest
updated,
Normal levels for: Aspartate aminotransferase (AST) & Alanine aminotransferase (ALT);
What diagnosis can be made if these levels are elevated? - Answer -Below 40 for both;
cirrhosis of the liver and hepatitis
Normal levels for: Amylase and Lipase? What are these levels used for? - Answer -
Below 200; They will be elevated with pancreatitis
Normal levels for: Bilirubin? What is the level looked at for? - Answer -Below 1;
Elevation indicates altered liver function; bile duct obstruction or other hepatobiliary
dysfunction
Normal level for: Albumin? What is the level looked at for? - Answer -3.5-5; Produced in
the liver so it can indicate hepatic disease. Also indicates malnourishment
Normal level for: Ammonia? What is the level looked at for? - Answer -15-45; elevated
in liver disease
A positive fecal occult blood test is indicative of what? - Answer -GI bleeding
How many times does a FOBT (fecal occult blood test) need to be repeated to confirm
GI bleeding? - Answer -3 times
What is the positioning for a colonoscopy? - Answer -Left side lying knees to chest
Prep for Sigmoidoscopy - Answer -Bowel prep; Clear liquid 24 hr before; NPO after
midnight; no anesthesia
What procedure has the patient drink barium? - Answer -Upper GI series
What increases peristalsis? - Answer -Smoking and chewing gum
How long will stools be white after a barium swallow/upper GI series? - Answer -24-72
hrs
How often do you check residual for a patient receiving enteral feedings? - Answer -
Every 4-6 hours
What residual volume level would require the slowing or stopping of enteral feedings for
a short period of time? - Answer -100-200ml
,How is TPN administered? Who would receive it? - Answer -central line/PICC line;
those who haven't been able to eat for more than 5 days, malabsorption problem;
hypermetabolic state
Can TPN be abruptly stopped? - Answer -No, can alter BG levels significantly
How often is TPN tubing and bag changed? - Answer -Every 24 hrs even if there is TPN
left in the bag
What needs to be at the bedside if someone is receiving TPN? - Answer -Dextrose
10%; if the replacement TPN is not available yet use this until the bag is ready
What is added to TPN tubing to help collect particles? - Answer -a filter
If you suspect an air embolism while a pt is receiving TPN, what do you do? - Answer -
position them on their left side in Trendelenburg and administer oxygen
What is a big worry with TPN? - Answer -Infection because the concentrated glucose is
a great medium for bacteria growth
Can the line used for TPN be used for fluids and medications? - Answer -No, can only
strictly be used for TPN
What is paracentesis? - Answer -Needle inserted into the abdomen to remove fluid
usually caused by ascites
Before paracentesis, what does the patient need to do? - Answer -Sign consent, empty
their bladder, weigh before procedure, and measure abdominal girth, sedation as
prescribed
After paracentesis, what do you do? - Answer -Weight/VS/Measure abdominal girth
again and compare values to preprocedure values
What does ascites contain a lot of? And what complication could this lead to after a
paracentesis? - Answer -Protein; albumin levels can drop dangerously low causing
hypovolemia so you may have to administer albumin
Nursing interventions for post bariatric surgery? - Answer -Fluid limited to 30ml, 6 small
meals a day (need to be nutrient dense), closely monitor for s/s dumping syndrome
(Cramping, diarrhea, tachycardia, dizziness and fatigue)
Signs of NG displacement? - Answer -Sudden decrease in tube drainage, n/v,
abdominal distention
Stool characteristics for a colostomy? - Answer -Firmer and less liquid
Stool characteristics for a ileostomy? - Answer -liquid stool bc it hasn't entered the colon
yet
How often do ostomy bags need to be emptied? - Answer -1/4-1/2 full
Thin, fragile blood vessels in the esophagus - Answer -esophageal varices
What causes esophageal varices? - Answer -portal hypertension caused by cirrhosis of
the liver
What causes peptic ulcer disease? - Answer -H pylori, chronic NSAID use, severe
stress
pain 30-60 min after a meal; occurs during the day; pain worsened by eating - Answer -
gastric ulcer
pain occurs 1.5-3 hrs after a meal; occurs during the night; pain relieved by eating food;
- Answer -duodenal ulcer
Treatment for h pylori medication - Answer -antibiotics - amoxicillin, tetracycline and
clarithromycin - need to complete full course of antibiotics
H2 receptor antagonists - decrease secretion of acid in stomach
PPI - pantoprazole
Antacids - aluminum carbonate
mucosal protectant - Sucralfate (kerafate)
When should antacids be given? - Answer -1-2 hours apart from other medication, 1-2
hours after meals
nursing intervention for dumping syndrome? - Answer -do not give fluid with meals for 1
hr prior to and following a meal; food needs to be high protein and high fat and low fiber
low carbohydrate diet.
What can chronic gastritis cause? - Answer -Damage to parietal cells (Creates intrinsic
factor-needed for absorption of b12)
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