ATI TEAS Study Guide

1. Coordinated Care (18–24%)

The largest content area. Focus on LPN scope of practice, delegation rules, and client advocacy.

Key rule: LPNs can delegate tasks to UAPs but NOT assessments, teaching, or nursing judgment tasks. RNs delegate to LPNs.

LPN scope: stable clients, routine care, data collection, medication administration
RN scope: initial assessments, care planning, complex client teaching, unstable clients
UAP scope: ADLs, vital signs on stable clients, non-invasive procedures
Advance directives must be honored — always advocate for the client's stated wishes
Informed consent is the physician's responsibility; LPN can witness the signature

2. Safety & Infection Control (10–16%)

Isolation types: Airborne (TB, measles, chickenpox) = N95 + negative pressure room. Droplet (flu, pertussis) = surgical mask. Contact (MRSA, C. diff) = gown + gloves.

Precaution	PPE	Examples
Standard	Gloves, gown PRN	All clients
Airborne	N95, negative-pressure room	TB, measles, varicella
Droplet	Surgical mask, private room	Influenza, pertussis, meningitis
Contact	Gown + gloves	MRSA, VRE, C. diff, scabies

Five medication rights: Right client · Right drug · Right dose · Right route · Right time

3. Health Promotion (6–12%)

Focus on client education, health screenings, and lifestyle modifications.

Initial teaching is an RN role; LPN can reinforce and clarify established teaching
Mammogram: annual starting age 40 (or 45 per some guidelines)
Colonoscopy: every 10 years starting age 45
Immunizations: annual flu vaccine, pneumococcal for 65+, Tdap every 10 years

4. Psychosocial Integrity (9–15%)

Therapeutic communication: Use open-ended questions, reflection, and silence. Avoid: false reassurance, advice-giving, changing the subject.

Kübler-Ross stages: Denial → Anger → Bargaining → Depression → Acceptance
Defense mechanisms: denial, repression, rationalization, projection, displacement
Crisis intervention: ensure safety first, then support coping
Suicide risk: direct, specific plan + means = HIGH risk — report immediately

5. Basic Care & Comfort (7–13%)

Topic	Key Facts
Pain (OPQRST)	Onset, Provocation, Quality, Radiation, Severity, Timing
Positioning	Semi-Fowler's for dyspnea; left lateral (Sims) for enemas; prone contraindicated post-hip replacement
Nutrition	Clear liquid → Full liquid → Soft → Regular (post-op progression)
Urinary catheter	Insert 2–3" in females, 6–9" in males; use sterile technique
Restraints	Last resort; MD order required; check q2h; document rationale

6. Pharmacological Therapies (10–16%)

High-alert medications: Anticoagulants (heparin, warfarin), insulin, opioids, concentrated electrolytes — always double-check dose.

Drug Class	Key Side Effects / Nursing Actions
Digoxin	Check HR <60 → hold; toxicity = nausea, yellow-green halos; therapeutic 0.5–2.0 ng/mL
Warfarin	Monitor PT/INR (therapeutic 2–3); antidote = Vitamin K
Heparin	Monitor aPTT (therapeutic 1.5–2.5× normal); antidote = protamine sulfate
Lithium	Therapeutic 0.6–1.2 mEq/L; toxicity signs: tremor, N/V, ataxia; maintain adequate Na+ intake
ACE Inhibitors (-pril)	Monitor for dry cough, hyperkalemia, angioedema; hold if SBP <100
Diuretics (furosemide)	Monitor K+, daily weights; replace potassium; ototoxicity with high doses

7. Reduction of Risk Potential (9–15%)

Critical lab values to memorize: Na+ 135–145 | K+ 3.5–5.0 | Ca2+ 8.5–10.5 | Glucose 70–110 | pH 7.35–7.45

Pre-op checklist: NPO status, consent signed, allergies documented, ID band confirmed
Post-op: airway first, then breathing, then circulation; HOB elevated 30° unless contraindicated
Nasogastric tube placement: check with pH (≤5 = gastric); confirm with X-ray before feeding
Pulse oximetry: SaO2 <92% = notify RN; <88% = emergency

8. Physiological Adaptation (7–13%)

ABG interpretation (ROME): Respiratory Opposite (pH↑/CO2↓ = alkalosis) | Metabolic Equal (pH↑/HCO3↑ = alkalosis)

Imbalance	pH	CO2 / HCO3	Common Cause
Resp. Acidosis	↓	CO2 ↑	COPD, hypoventilation
Resp. Alkalosis	↑	CO2 ↓	Hyperventilation, anxiety
Met. Acidosis	↓	HCO3 ↓	DKA, renal failure, diarrhea
Met. Alkalosis	↑	HCO3 ↑	Vomiting, NG suction, antacids