ATI RN
ATI RN Pharmacology 2023 retake 1 Questions
Extract:
Question 1 of 5
A nurse is caring for a client who is receiving total parenteral nutrition (TPN). The nurse identifies that the client has developed confusion pitting edema. After slowing the infusion rate, which of the following findings should the nurse assess next?
Correct Answer: A
Rationale: The correct answer is A: Urinary output. When a client on TPN develops confusion and pitting edema, it could indicate fluid overload. Slowing the infusion rate is the initial intervention to prevent further fluid accumulation. Assessing urinary output next is crucial to determine if the kidneys are functioning properly and excreting excess fluids. A decrease in urinary output would suggest renal impairment and the need for further intervention. Blood glucose level (
B) may be important but is not the priority in this case. Weight (
C) is a lagging indicator of fluid status. Heart rate (
D) may be affected by fluid overload, but urinary output is more directly related.
Question 2 of 5
A nurse is providing teaching to a client about how to self-administer subcutaneous injections of enoxaparin. Which of the following instructions should the nurse include?
Correct Answer: B
Rationale:
Correct
Answer: B. Ensure that the air bubble remains in the syringe.
Rationale: The presence of an air bubble in the syringe prevents medication leakage and ensures accurate dosing. It acts as a cushion, preventing the medication from leaking out before administration. Removing the air bubble may lead to medication wastage or incorrect dosing, impacting the effectiveness of the treatment.
Summary of other choices:
A: Injecting into the lateral thigh is not appropriate for enoxaparin, as it is typically injected into the abdomen.
C: Releasing the skin fold before injecting ensures proper insertion and absorption of the medication.
D: Rubbing the site after injection can cause bruising and discomfort, which is not recommended.
Question 3 of 5
A nurse is preparing to administer filgrastim 5 mcg/kg/day subcutaneous to a client who weighs 143 lb. How many mcg should the nurse administer per day?
Correct Answer: A
Rationale:
To calculate the dose of filgrastim for the client weighing 143 lb, first convert the weight to kg (143 lb ÷ 2.2 = 65 kg).
Then, multiply the weight in kg by the dose (5 mcg/kg/day) to get the total dose per day (65 kg x 5 mcg/kg/day = 325 mcg/day).
Therefore, the nurse should administer 325 mcg per day. The correct answer is A (324) as it is the closest value to the calculated dose of 325 mcg/day. Other choices are incorrect as they do not align with the correct calculation.
Question 4 of 5
A nurse is caring for a client who is receiving high-dose metalopramide. The nurse should monitor the client for which of the following adverse effects?
Correct Answer: D
Rationale: The correct answer is D: Tardive dyskinesia. Metoclopramide is associated with the development of tardive dyskinesia, a serious movement disorder characterized by involuntary repetitive movements of the face and limbs. This adverse effect is more common with long-term use or high doses of metoclopramide. Monitoring for signs such as facial grimacing, tongue protrusion, and repetitive chewing movements is crucial.
A: Black stools are associated with gastrointestinal bleeding, not typically caused by metoclopramide.
B: Dry cough is not a common adverse effect of metoclopramide.
C: Oral candidiasis is a fungal infection in the mouth, not directly linked to metoclopramide use.
Summarily, the correct answer, D, is related to a known adverse effect of metoclopramide, while the other options are not commonly associated with this medication.
Question 5 of 5
A nurse is assessing a client who has septic shock and is receiving dopamine by continuous IV infusion. Which of the following findings indicates that the nurse should increase the rate of infusion?
Correct Answer: B
Rationale: The correct answer is B: Hypotension. In septic shock, patients often experience severe hypotension due to systemic vasodilation. Dopamine, a vasopressor, is used to increase blood pressure by constricting blood vessels.
Therefore, if the patient's blood pressure remains low despite receiving dopamine, it indicates that the current infusion rate is not sufficient. Extravasation (
A) is a potential complication of IV therapy but does not directly indicate the need to increase the infusion rate. Headache (
C) and chest pain (
D) are common symptoms in septic shock but are not specific indicators for adjusting dopamine infusion rate.