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MED SURGE GI ACTUAL EXAM WITH 101
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MED SURGE GI ACTUAL EXAM WITH 101
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MED SURGE GI ACTUAL EXAM WITH 100+ QUESTIONS AND CORRECT ANSWERS WITH RATIONALES (100% CORRECT ANSWERS) ACTUAL ATI MED SURGE GI (GASTROINTESTINAL) EXAM GRADED A+(MOST RECENT!!)A nurse is caring for a client who reports recent unintended weight loss, feeling lethargic, and increased thirst. The client has frequent urination, which interferes with
their daily activities. Which of the following alterations in endocrine function should the nurse suspect?
Hypothyroidism
Hypoglycemia
Hyperthyroidism
Hyperglycemia - ANSWER Hyperglycemia
Common manifestations of hyperglycemia include increased thirst, increased urine output, unintentional weight loss, and fatigue .
Nursing Practice Act (NPA) - ANSWER defines the scope of nursing practice within
the state
The physician has ordered a smaller dose than your prefilled syringe contains. You need to expel some medication. The correct way to hold the syringe to expel the medication is which of the following? - ANSWER The syringe should be held needle down.
owen urine vid 2
https://www.youtube.com/watch?v=5BnC3gjvCnw - ANSWER A patient with an epidural catheter precludes the patient from receiving Lovenox.
Question 2Select one:TrueFalse - ANSWER true
The person performing the Lovenox injection must expel the air bubble in the prefilled syringe prior to administering the medication.
Question 3Select one:TrueFalse - ANSWER false
The alcohol should be dry on the skin prior to injecting the Lovenox.
Question 4Select one:TrueFalse - ANSWER true
The injection site is located on the abdomen; at least Blank 1 Question 5 1 inch3 inches2 inches4 inches distance from the umbilicus? - ANSWER 2 inches away in lovehandles, pinched skin 90 degrees SC. alternating sides each time Ketorolac (Toradol) - ANSWER *class*: nonsteroidal anti-inflammatory agents, nonopioid analgesics
*Indication* pain
*Action*: Pain relief due to prostaglandin inhibition
*Nursing Considerations*:
-may cause GI bleeding, Stevens-Johnson Syndrome, anaphylaxis, drowsiness
- should not exceed 5 days of therapy
- bleeding risk increased with garlic, ginger, and ginkgo
- may decrease effectiveness of hypertensive medications and diuretics
How fast will you infuse the ketorolac?*
1) 60mg per minute
2) 30 seconds per mg
3) 1-2 minutes is preferred
4) Each 15mg must be equally distributed over 5 minutes - ANSWER 3) 1-2 minutes is preferred
Is Ketorolac compatible with D5NS?* - ANSWER sure is
What if your client had D5 0.45 NS infusing? Is ketorolac compatible?* - ANSWER no
Your client has NS infusing and a heparin drip has been Y'd into the NS. The physician has entered an order for ondansetron 4mg IV x 1. Is ondansetron compatible with the heparin and NS?*
1) Yes, both heparin and NS are listed as compatible under ondansetron.
2) No, Heparin is not listed as compatible.
3) No, NS is not listed as compatible.
4) I don't know how to find the compatibility. - ANSWER yes NS and heparin are compatible w zofran
Ondansetron (Zofran) - ANSWER Antiemetic. Side effects: headache, EPSs. Nursing interventions: administer tablets 30 min prior to chemotherapy and 1-2 hr before radiation.
If the ondansetron is compatible with heparin and NS, how fast will you administer the ondansetron?*
1) 2-5 minutes is preferred
2) 1 minute is preferred
3) 4mg over 15 seconds
4) Each 1mg over 2 minutes - ANSWER Not many clinicians are aware that ondansetron 4 to 8 mg iv should be administered over 2 to 5 min[6] and certainly not as a bolus or in less than 30 s.
Your client's Heparin and NS has been discontinued, and has new orders for LR at 100ml/hr and hydromorphone 1mg IV x 1. Is hydromorphone compatible with LR?*
1) Yes, they are compatible together.
2) No, they are not compatible together. - ANSWER yes Your hydromorphone vial is 5mg/ml. How many ml will you draw up to administer 1mg?*
1) 0.4ml
2) 1ml
3) 0.2ml
4) 0.3ml - ANSWER 0.2ml
What is the rate of administration for hydromorphone IV push?*
1) A single dose over a maximum of 1 minute.
2) A single dose over a maximum of 30 seconds.
3) A single dose over a minimum of 2 - 3 minutes.
4) A single dose slammed because the client requested it. - ANSWER 3) A single dose over a minimum of 2 - 3 minutes.
Your client has LR infusing and has received a single dose of hydromorphone. You have new orders to start a diltiazem drip at 10mg/hour. Is diltiazem and LR compatible together?*
1) No, LR is not listed.
2) Yes, LR is listed. - ANSWER Diltiazem (Cardizem) - ANSWER *class*: Ca Channel Blocker (Bezothiazepine), antianginals, antiarrhythmics, antihypertensive
*Indication*: hypertension, angina, SVT, a-fib, aflutter
*Action*: inhibits calcium transport resulting in inhibition of excitation and contraction,
leads to depression of AV and SA node leading to decreased HR, leads to vasodilatation and decreased blood pressure.
*Nursing Considerations*:
- contraindicated in 2nd and 3rd AV block
- may cause arrhythmias, CHF, bradycardia, peripheral edema, gingival hyperplasia
- increases digoxin levels
- don't drink *grapefruit juice*
- assess for signs of CHF
- monitor EKG continuously
- tell patient to change positions slowly
- monitor serum potassium
- instruct pt on how to take blood pressure
bladder irrigation https://www.youtube.com/watch?v=9wGZ7YjuaFA - ANSWER 3 channels; infusion of sterile solution to prevent clot, drainage of fluid to bag (middle hub for portable bag; clean w alc swab prior to changing), inflate balloon to hold cath base rate on color; darker= faster, lighter=slower bc bleeding less
drainage should equal or slightly more than infusion intake (if not assess kinks or suspect clot that might need manual irrigation)
owen cath vid 1 https://www.youtube.com/watch?v=OEvHLYvzs8s - ANSWER types of caths: - red robin/ straight cath/ in and out; without pigtail - indwelling cath; yellow w pigtail for 10ml of sterile slaine (sizes/ 16 french, 18 french
on hub)
- three way cath; CBI DO NOT test balloon for infaltion prior to insertion green cath holder sticks to leg strict I and O's always good practice !
film cath/speciment cath: short cath w firm tube collector good for females-young children and older adults
unisex intermitted cath; longer specimen gathers in bag urometer; typically in ICU/CCU to measure ml per hour, empty into back bag ON the HOUR each hour; home discharge w foley; portable leg bag- do not sleep in, loose clothing, changing bags; gloves, empty bag if needed, towel under, trashcan near, kink tub and alc swab hub, plug in wihtout touching inside or around hub, psuch twist firmly. record amount color smell times educate
specimen sample from small child
-wee/u bag; boys/girls, not for sterile specimen, for urine analysis, adhesion placed
owens vid 2 urine https://www.youtube.com/watch?v=5BnC3gjvCnw - ANSWER 24 hour collections
- without foley void; discard first mornings void, doc times, lab chooses container, get
pt to tell each void time, no flushing or leaving out. put in contain in basin of ice. can send to lab for testing if no interruptions - indwelling cath; new drainage bag in basin on ice w container. maintain ice for 24 hrs.
owens vid 3 urine station https://www.youtube.com/watch?v=LBbUxhH3_4s - ANSWER sterile specimen -indwelling cath; clamp, clean gloves, cleanse port w alc swab, side port/specimen collection port connect sterile laurel lock 10ml syringe (NOT TO BULB HUB), pull back to collect, unclamp, empty wihout touching cup and ready w lid faced up, label bag and send lab. ( new inserted cath can be collected from bag) straining urine (white funnel w filter)
- instruct pt to inform when voiding, measure in grad cylinder, keep stones or findings
in a cup for testing
owens vid 4 urien station
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