ATI LPN
ATI LPN Pharmacology Exam I Questions
Extract:
Question 1 of 5
The physician orders vancomycin 500 mg in 250 mL of D5W IVPB daily to infuse over 2 hours. Tubing drop factor is 15 gtts/mL. Calculate the flow rate in drops per minute.
Correct Answer: B
Rationale: 31 gtts/min assumes 250 mL over 4 hours with 15 gtts/mL; this halves the rate, underdelivering vancomycin, risking subtherapeutic levels and ineffective bacterial killing over the prescribed 2-hour infusion time. 62 gtts/min is correct; 250 mL over 2 hours is 125 mL/hr, times 15 gtts/mL equals 1875 gtts total, divided by 120 minutes yields 62 gtts/min, ensuring proper antibiotic delivery. 125 gtts/min doubles the rate; 250 mL in 1 hour with 15 gtts/mL is too fast, risking vancomycin toxicity, including renal damage, and exceeding safe infusion guidelines for IVPB. 250 gtts/min assumes 250 mL in 30 minutes; this dangerously rapid rate could cause vancomycin-induced red man syndrome or cardiovascular overload, far beyond the ordered 2-hour infusion duration.
Question 2 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 3 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 4 of 5
A patient who is to receive a daily medication by the oral route has had nausea and vomiting for the last 24 hours. The best action to ensure that the patient receives the scheduled dose is to:
Correct Answer: D
Rationale: Withholding delays treatment; nausea may persist, risking vomiting of the dose if given later, reducing bioavailability and therapeutic effect over time. Sips of water won't prevent vomiting; with ongoing nausea, the oral dose is likely expelled, decreasing absorption and failing to deliver the medication effectively. Crackers may worsen nausea or fail to retain the dose; vomiting risks remain high, compromising oral administration's reliability in this acute condition. Rectal or parenteral routes bypass the stomach, ensuring delivery despite vomiting; this maintains therapeutic levels, critical for efficacy in a nauseated patient.
Question 5 of 5
A patient is scheduled to have biofeedback therapy for migraine headaches. On arrival to the clinic, the patient appears anxious and fearful and tells the nurse that she does not want electric shocks. The most reassuring response by the nurse is:
Correct Answer: C
Rationale: Rescheduling dismisses the patient's fear; it delays therapy without addressing misconceptions, missing a chance to educate and proceed with migraine relief. Questioning prior explanation may shame the patient; it doesn't clarify biofeedback's non-invasive nature, failing to reduce anxiety about shocks. Explaining no shocks and describing biofeedback as monitoring reassures scientifically; it corrects fears, aligning with its role in stress-related migraine management. Vague reassurance lacks specificity; without addressing shocks, it's less effective, as patients need clear, factual dispelling of their expressed concern.