ATI RN
ATI RN Pharmacology Proctored Exam Questions
Extract:
Provider Prescriptions 1230:
0.9% sodium chloride 500 mL bolus then 100 mL/hr.
Type and cross match for 2 units of packed RBCs.
Repeat WBC, hemoglobin, hematocrit STAT.
Delay endoscopy.
2L/min O, via nasal cannula,
1330:
2 units packed RBCs IV over 4 hr.
Repeat WBC, hemoglobin, hematocrit at transfusion completion
Question 1 of 5
The nurse is ready to begin the blood transfusion. For each potential nursing action, click to specify if the action is indicated or not indicated for the client.
| Nursing Action | Indicated | Not Indicated |
|---|---|---|
| Document the blood product transfusion in the client's medical record. | ||
| Stay with the client for the first 15 min of the transfusion. | ||
| Titrate the rate of infusion to maintain the client's blood pressure at least 90/60 mm Hg. | ||
| Obtain the first unit of packed RBCs from the blood bank. | ||
| Start an IV bolus of lactated Ringer's solution. |
Correct Answer: B
Rationale:
Step 1: Stay with the client for the first 15 min of the transfusion : This action is crucial to monitor the client for any immediate adverse reactions during the initial phase of the transfusion.
Step 2: Document the blood product transfusion in the client's medical record (Not Indicated): While documentation is important, it is not the immediate priority compared to staying with the client for monitoring.
Step 3: Titrate the rate of infusion to maintain the client's blood pressure at least 90/60 mm Hg (Not Indicated): Although monitoring blood pressure is important, titrating the rate is not the initial action needed during the first 15 min.
Step 4: Obtain the first unit of packed RBCs from the blood bank (Not Indicated): This is a necessary step before starting the transfusion but is not related to the immediate monitoring of the client.
In summary, staying with the client for the first 15 min of the transf
Extract:
Question 2 of 5
A nurse is assessing a client's IV infusion site and notes that the site is cool and edematous. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct action is to apply a warm, moist compress (
Choice
D) because it can help improve circulation to the IV site, reduce edema, and potentially prevent complications like phlebitis. By applying warmth, blood vessels dilate, increasing blood flow and promoting healing. Slowing the IV solution rate (
Choice
A) won't address the underlying issue of decreased circulation. Initiating a new IV distal to the initial site (
Choice
B) may not be necessary if the issue can be resolved with a warm compress. Maintaining the extremity below the level of the heart (
Choice
C) may not improve circulation sufficiently.
Question 3 of 5
A nurse is teaching a client who has angina a new prescription for sublingual nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching?
Correct Answer: C
Rationale:
Correct Answer: C
Rationale:
1. Keeping the tablets at room temperature helps maintain their effectiveness.
2. Nitroglycerin is sensitive to light and moisture, so storing it in the original glass bottle helps protect it.
3. Extreme temperatures can affect the potency of the medication.
4. Discarding unused tablets every 6 months helps ensure efficacy.
5. Taking one tablet each morning is not recommended as nitroglycerin is usually taken as needed for angina attacks.
6. Placing the tablet between cheek and gum is not the correct administration route for sublingual nitroglycerin.
Question 4 of 5
A nurse accidentally administers the medication metformin instead of metoprolol to a client. Which of the following actions should the nurse take?
Correct Answer: D
Rationale: The correct answer is D: Check the client's glucose level. Metformin is a medication used to treat diabetes, so administering it instead of metoprolol, a beta-blocker, can lead to hypoglycemia (low blood sugar). Checking the client's glucose level is crucial to assess if the client is experiencing hypoglycemia and to take appropriate action. Monitoring thyroid function levels (
A), collecting uric acid levels (
B), and obtaining HDL levels (
C) are not relevant in this situation and would not provide immediate information on the client's condition. Checking the glucose level is the priority to address the potential adverse effects of administering the wrong medication.
Question 5 of 5
A nurse is monitoring laboratory values for a client who has chronic heart failure and is receiving digoxin. Which of the following values should the nurse report to the provider?
Correct Answer: D
Rationale: The correct answer is D: Potassium 2.9 mEq/L. Low potassium levels can increase the risk of digoxin toxicity, as digoxin competes with potassium for binding sites on cardiac cells. Hypokalemia can potentiate the effects of digoxin, leading to adverse cardiac effects.
Therefore, the nurse should report this low potassium level to the provider for potential adjustment of digoxin dosage or potassium supplementation.
Incorrect
Choices:
A: Sodium 1.38 mEq/dL - Low sodium levels can be concerning but are not directly related to digoxin toxicity.
B: Magnesium 1.5 mEq/L - Low magnesium levels can also increase the risk of digoxin toxicity but potassium is a more critical electrolyte to monitor in this case.
C: BUN level 10 mg/dL - BUN level within normal range and not directly related to digoxin therapy.