ATI RN
ATI RN Pharmacology 2019 Exam 6 Questions
Extract:
Question 1 of 5
A nurse is preparing to administer insulin to a client who has diabetes mellitus. The client has a prescription for regular insulin 4 units and NPH insulin 12 units subcutaneous. Identify the steps the nurse should take when mixing the two types of insulin.
Correct Answer: D,A,B,C
Rationale: The correct steps for mixing regular and NPH insulin are as follows:
D: Inject 12 units of air into the NPH insulin vial - This step prevents a vacuum from forming in the vial.
A: Inject 4 units of air into the regular insulin vial - Balances the pressure in the vial.
B: Draw up 4 units of the regular insulin into the syringe - Withdraw the regular insulin first to avoid contamination.
C: Draw up 12 units of the NPH insulin into the syringe - Finally, draw up the NPH insulin.
These steps ensure accurate dosing and prevent contamination.
Incorrect choices:
E: No step provided.
F: No step provided.
G: No step provided.
These choices are incorrect as they do not provide any guidance on the correct procedure for mixing the two types of insulin.
Question 2 of 5
A nurse recently administered filgrastim intravenously to a client who has cancer and is receiving cytotoxic chemotherapy. For which of the following data, discovered after the medication was administered, should the nurse file an incident report?
Correct Answer: B
Rationale: The correct answer is B because filgrastim should be stored and administered according to the manufacturer's guidelines, typically at refrigerated temperatures to maintain stability. Allowing the medication vial to sit at room temperature for 2 hours may compromise its efficacy and safety. This deviation from proper storage and handling procedures could potentially lead to adverse effects on the client.
Choices A, C, and D are not appropriate reasons for filing an incident report in this scenario.
Choice A indicates a normal neutrophil count before administration, which is not a direct consequence of the incorrect handling of the medication.
Choice C, the timing of the chemotherapy, is unrelated to the administration of filgrastim.
Choice D, flushing the IV line with dextrose 5% in water, is a standard practice and not a reason for filing an incident report unless there were complications directly related to the flush.
Question 3 of 5
A nurse is assessing a client who has hypermagnesemia. Which of the following medications should the nurse prepare to administer?
Correct Answer: C
Rationale: The correct answer is C: Calcium gluconate. In hypermagnesemia, there is an excess of magnesium in the blood, leading to muscle weakness, hypotension, and potentially cardiac arrest. Calcium gluconate is the antidote for magnesium toxicity as it competes with magnesium for binding sites, reversing the effects of hypermagnesemia. Flumazenil (
A) is used to reverse benzodiazepine overdose, acetylcysteine (
B) for acetaminophen overdose, and protamine sulfate (
D) for heparin overdose. In summary, only calcium gluconate directly addresses the underlying issue of hypermagnesemia by antagonizing the effects of excess magnesium.
Question 4 of 5
A nurse is reviewing the medical history of a client prior to medication administration and notes a history of an anaphylactic reaction to penicillin. The nurse should identify that which of the following medications is contraindicated for this client?
Correct Answer: D
Rationale: The correct answer is D: Ceftriaxone. Penicillin and ceftriaxone belong to the same antibiotic class (beta-lactams), which can cross-react in clients allergic to penicillin. This client's history of an anaphylactic reaction to penicillin indicates a high risk of an allergic reaction to ceftriaxone. Metronidazole (
A), clarithromycin (
B), and vancomycin (
C) are not contraindicated in clients with a penicillin allergy as they do not share a similar chemical structure or mechanism of action.
Question 5 of 5
A nurse is assessing a client who is taking an osmotic laxative. Which of the following findings should the nurse identify as an indication of fluid volume deficit?
Correct Answer: B
Rationale: The correct answer is B: Oliguria. Osmotic laxatives work by drawing water into the bowel to soften stool. If a client taking osmotic laxatives experiences oliguria (decreased urine output), it can indicate fluid volume deficit, as the body may be conserving water due to dehydration from excessive fluid loss through laxative use. Nausea (choice
A) can be a side effect of laxatives but does not directly indicate fluid volume deficit. Weight gain (choice
C) is unlikely in fluid volume deficit. Headaches (choice
D) can be a symptom of dehydration but are not specific to fluid volume deficit.