ATI LPN
ATI LPN Pharmacology Exam I Questions
Extract:
Question 1 of 5
In addition to the dorsogluteal and ventrogluteal muscles, which of these sites can safely be used for intramuscular injections?
Correct Answer: A
Rationale: Deltoid and vastus lateralis are large muscles with good vascularity; they safely absorb IM injections, minimizing nerve damage or tissue irritation risks. Chest and abdomen lack sufficient muscle mass for IM; these are subcutaneous or IV sites, risking poor absorption or injury if used intramuscularly. Forearm and scapula are too thin or bony; IM injections here risk nerve or bone damage, lacking the muscle bulk needed for safe drug delivery. Lower leg (e.g., calf) has small muscles and major vessels; IM use risks vascular injury or slow absorption, making it an unsafe injection site.
Question 2 of 5
The patient is admitted to the cardiac unit. Everyone admitted to the cardiac unit will have an EKG done unless otherwise ordered. This is an example of which type of order?
Correct Answer: D
Rationale: PRN is as needed; EKGs here are routine, not symptom-driven, making this inapplicable to a standard admission protocol for all patients. One-time is a single event; this order applies to all admissions ongoing, not a one-off, distinguishing it from limited-duration directives. STAT is immediate; routine EKGs aren't urgent, occurring as part of standard care, not requiring the priority of acute intervention orders. Standing orders apply automatically to all qualifying patients; this EKG protocol fits, ensuring consistent cardiac assessment unless overridden.
Question 3 of 5
The physician gives orders to infuse 1 unit (250 mL) of packed red blood cells over 4 hours. Calculate the flow rate in milliliters per hour.
Correct Answer: A
Rationale: Flow rate is volume divided by time; 250 mL over 4 hours equals 62.5 mL/hr, ensuring safe transfusion pacing to avoid fluid overload or hemolysis. 125 mL/hr assumes 250 mL over 2 hours; this doubles the ordered rate, risking circulatory overload and transfusion reactions in a standard protocol. 250 mL/hr infuses the unit in 1 hour; this rapid rate exceeds safe limits, potentially causing hypertension or pulmonary edema in vulnerable patients. 500 mL/hr is far too fast, implying 250 mL in 30 minutes; this dangerous speed could trigger severe hemolytic reactions or cardiovascular collapse.
Question 4 of 5
Why does the nurse administer lorazepam intramuscularly (IM) to the patient rather than into the subcutaneous tissue?
Correct Answer: C
Rationale: Body fat levels influence subcutaneous absorption but are not the primary reason for choosing IM over SC injection in this scenario. Needle size varies by medication and patient factors, but this is not the defining reason for selecting IM over SC injection. IM injections deliver medication directly to muscle tissue with a rich vascular supply, ensuring faster absorption and onset compared to subcutaneous administration. IM injections are not inherently safer for patients at risk of bleeding; they carry similar risks and require proper assessment before administration.
Question 5 of 5
A patient has an order for a subcutaneous injection of insulin. The nurse will prepare to give this injection into which of the following tissues?
Correct Answer: D
Rationale: Vastus lateralis is muscle; insulin given intramuscularly absorbs too fast, risking hypoglycemia, unlike the slower, safer subcutaneous route intended. Deltoid is also muscle; subcutaneous insulin isn't given here as it's not fatty enough, leading to unpredictable absorption rates versus abdominal tissue. Intravenous line is for IV drugs; insulin via IV is rare and only in emergencies, not standard subcutaneous orders, risking rapid overdose effects. Abdominal fat is ideal for subcutaneous insulin; it ensures steady absorption into capillaries, maintaining glycemic control per pharmacokinetic principles.