ATI Proctored
Ultimate ATI Proctored Exam Study Guide Notes
Learning Objectives
Upon completion of study guide and videos, learners will be able to: - Identify and master the basic principles and procedures of nursing. - Integrate test-taking strategies to accumulate information into long-term memory. - Analyze comprehension of material by measuring practice test percentages daily. - Differentiate between answer choices through pattern recognition and rationalization. - Exemplify confidence and belief in self to achieve a level 3.
Fundamentals of Nursing Principles and Procedures
Critical Thinking
Evidence-based Practice
Patient-centered Care
Clinical Application
Nursing Process (A.D.P.I.E.)
Therapeutic Communication - When in doubt: RAISE THE LEVEL OF THE BED (e.g., 30 to 45 degrees). - If a patient refuses medications, assess the reason why.
Positioning Importance - One of the first actions after inspecting and assessing the patient is to conduct a thorough physical examination. - Discharge Planning should start during admission to prepare for care during and after hospital stay.
Communication and Emergency Protocols
SBAR Model (Communication Tool): - Situation: Briefly describe the issue. - Background: Provide context about the patient. - Assessment: Share your assessment of the situation. - Recommendation: State what you expect to happen next.
Fire Response (R.A.C.E.)
R: Rescue and protect patients in immediate danger by moving them to safety.
A: Alarm – Activate the fire alarm and report the details.
C: Contain – Close doors and windows, turn off oxygen sources and electrical devices.
E: Extinguish the fire if safe to do so, using the appropriate fire extinguisher.
Fire Extinguisher Usage (P.A.S.S.)
P: Pull the pin.
A: Aim at the base of the fire.
S: Squeeze the handle.
S: Sweep the extinguisher from side to side.
Classes of Fire Extinguishers
Class A: For combustibles (paper, wood, upholstery).
Class B: For flammable liquids.
Class C: For electrical fires.
Class D: For metals.
Class K: For kitchen fires involving fats and oils.
Class ABC: Multipurpose extinguisher for various types of fires.
Personal Protective Equipment (PPE) Guidelines
Donning PPE (Bottom’s Up Method): - Order: Gown, Mask, Goggles, Gloves.
Doffing PPE (Alphabetical Order Method): - Order: Gloves, Goggles, Gown, Mask.
Physical Examination Sequence
Inspection – Visual observation of the patient.
Palpation – Using touch to assess.
Percussion – Tapping body parts to assess underlying structures.
Auscultation – Listening to body sounds.
Physical Examination Order for Abdomen: Inspection → Auscultate → Percuss → Palpate.
Transmission Precautions
Airborne Precautions: - Protect against infections smaller than 5 mcg (e.g., Measles, Tuberculosis). - Use private rooms, N95 masks for healthcare workers, negative pressure airflow.
Droplet Precautions: - Protect against larger droplets (e.g., pneumonia, meningitis). - Place patients in private rooms, require surgical masks for healthcare workers and patients.
Contact Precautions: - Protect against direct contact (e.g., MRSA, Scabies). - Use gloves and gowns, private rooms recommended.
Nasogastric Intubation (NG Tube) Guidelines
Indications: - Decompression, Feeding, Lavage, Compression.
Nursing Considerations: - Position patient correctly (high Fowler’s position), assess placement, monitor output, and maintain hygiene.
Hand Hygiene Practices
Crucial Steps: - Wash hands after contact with any patient or potentially contaminated materials; even after glove removal. - Perform proper surgical handwashing techniques, ensuring hands drain correctly away from clean areas.
Safe Patient Transferring Practices
Position wheelchair at a 45-degree angle relative to the bed.
Assist the patient from their weaker side, ensuring a wide stance for balance.
Understanding Phases of Care
Preoperative: Begins with consent to have surgery, ends at the surgical suite.
Intraoperative: From transfer to surgery until admission to PACU.
Postoperative: From PACU admission until healing is complete.
Total Parenteral Nutrition (TPN) Guidelines
Monitor blood glucose every 4 hours, check weight daily, change IV tubing every 24 hours.
Patient Safety and Client Education
Cleansing Enema Procedure: Position left side, lubricate catheter, and maintain proper height for fluid entry.
Nursing Process: Assessment → Analysis → Planning → Implementation → Evaluation, focusing on patient outcomes.
Client Safety and Restraint Protocols
Use restraints only when necessary, ensuring proper fit and monitoring for circulation issues.
Document the use of restraints, assessing the patient's condition regularly and providing necessary care.
Vision Loss Types and Care
Common Types: Presbyopia, cataracts, glaucoma, diabetic retinopathy, macular degeneration.
Assess Visual Acuity: Use Snellen and Rosenbaum charts for screening.
Sputum Specimen Collection and Airway Management
Understand the indication for collection, proper techniques, and evaluation of results for patient management.
Important ABG Values
Normal ranges: - pH: 7.35-7.45 - PaCO2: 35-45 mm Hg - HCO3: 22-26 mEq/L - PaO2: 80-100 mm Hg - SaO2: 95-100%
Five Rights of Delegation
Right Task.
Right Circumstance.
Right Person.
Right Direction.
Right Supervision.
Fall Prevention Measures
Use gait belts, ensure safe environment, encourage gradual position changes.
Infection Control Practices
Proper methods for changing linens and avoiding cross-contamination.
Guidelines on handling blood and body fluid spills as per facility policy.
Closing Notes for Effective Study
Continuous practice through sample questions, reflecting on learning outcomes, and staying updated with best practices in nursing care and client education are essential.
Foster a mindset of professional growth and commitment to lifelong learning in nursing to ensure excellence in providing patient care.