ATI RN Practice Quiz B

A nurse is preparing to administer 0.9% NaCl 1,500ml to infuse over 8hr to a client who is postoperative. The nurse should set the IV pump to deliver how many mL/hr?

188ml/hr

A nurse is caring for a client who is receiving haloperidol. The nurse should identify which of the following as an adverse effect of the medication?

Akathisia Rationale: an adverse effect associated with haloperidol is the development of extrapyramidal manifestations such as dystonia, pseudoparkinsonism, and akathisia.

A nurse is administering baclofen for a client who has a spinal cord injury. Which of the following findings should the nurse document as a therapeutic outcome?

Decrease in flexor and extensor spasticity

A nurse is teaching about zolpidem to a client who has insomnia. The nurse should identify that which of the following client statements indicates an understanding of the teaching?

I should use this for a short period of time

A nurse is teaching a client who is starting to take diltiazem. Which of the following statements should the nurse identify as an indication that the client understands the teaching?

I will check my heart rate before I take the medication.

A nurse is teaching about self-administration of transdermal medication with a male client who has a new prescription for nitroglycerin. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching?

I will remove the patch after 14 hours.

A nurse is providing discharge instructions to a client who is to self-administer insulin at home. Which of the following client statements should indicate to the nurse that the teaching is effective?

I will store my unopened bottles of insulin in the refridgerator.

A nurse is assessing a client who is receiving epoetin alfa to treat anemia. Which of the following findings should the nurse monitor?

Increased blood pressure Rationale: the therapeutic effect of epoetin alfa is an increase in hematocrit levels, which can result in an increase in a client's blood pressure. If the client's hematocrit level rises too rapidly, hypertension and seizures can result. The nurse should monitor the client's blood pressure and ensure hypertension is controlled prior to administering the medication.

A nurse is caring for a client who is refusing to take their scheduled morning furosemide. Which of the following statements should the nurse make?

"By not taking your furosemide, you might retain fluid and develop swelling"

A nurse is teaching a client who is to start taking ranitidine for peptic ulcer disease. Which of the following client statements should the nurse identify as understanding of the teaching?

"I know that smoking makes ranitidine less effective"

A nurse is providing teaching for a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include?

--Blood glucose levels will need to be monitored --Avoid contact with persons who have known infections --Grapefruit juice can increase the blood levels of the medication

A nurse is caring for a client who has sickle cell anemia and is taking hydroxyurea. Which of the following findings should the nurse report to the provider?

--Hemoglobin 7.0 g/dl --Platelets 75,000 --Potassium 5.2

A nurse is providing discharge teaching to a client who has a new prescription for furosemide twice daily. The nurse should include which of the following instructions in the teaching? Select all.

--Increase intake of potassium-rich foods --monitor for muscle weakness --dangle your legs from the side of the bed before standing

A nurse is preparing to administer 0.9% NaCl 1,000ml over 8 hr to a client. The drop factor of the manual IV tubing is 15 gtt/ml. The nurse should set the manual IV infusion to deliver how many gtt/min? (round to nearest whole number)

31 gtt/min

A nurse is completing an incident report for a medication error. Which of the following should the nurse include in the report?

Administered propanolol 80 mg PO at 1800 to the client who did not have a prescription for the medication.

A nurse is precepting a newly licensed nurse who is caring for clients. The nurse should complete an incident report for which of the following actions by the newly licensed nurse?

Administers isosorbide mononitrate to a client who has BP 82/60 Rationale: I.M. is a nitrate used for clients with angina. Taking it leads to vasodilation, which can result in hypotension. The nurse should withold the medication and notify the provider if the client's systolic blood pressure is below the expected reference range of 120/80.

A nurse is reviewing the medical record of a client who has hypertension. The nurse should identify which of the following findings as a contraindication for receiving propranolol?

Asthma Rationale: asthma is contraindicated for receiving propranolol. Propranolol is an adrenergic antagonist which blocks the beta2 receptors in the lungs, causing bronchoconstriction and leading to serious airway resistance and possible resp arrest.

A nurse is caring for a client who is recovering from DVT and is to start taking warfarin. For which of the following findings should the nurse monitor as an adverse effect of warfarin?

Bleeding gums

A nurse is assessing a client who has received atropine eye drops during an eye examination. Which of the following findings should the nurse expect as an effect of the medication?

Blurred vision Rationale: blurred vision is an expected finding following the administration of atropine eye drops. This is due to the cycloplegic effects of the medication, which cause near objects to appear blurry to the client

A nurse is caring for a client who has a magnesium level of 13.1 mEq/L. The nurse should expect to administer which of the following medications?

Calcium gluconate Rationale: the nurse should expect to administer IV calcium gluconate to the client and prepare to provide ventilatory support. The client is at risk for respiratory depression and cardiac dysrhythmias because a mag level of 3.1 is above the ref range of 1.3 to 2.1.

A nurse is preparing to teach a client who is to start a new prescription for extended release verapamil. Which of the following instructions should should the nurse plan to include?

Change positions slowly Rationale: risk of orthostatic hypotension with verapamil (a diuretic). The nurse should also instruct the client that verapamil can cause palpitations, which should be reported to the provider. The client should never discontinue the med abruptly because the client might experience chest pain.

A nurse is providing teaching to a client who is to start taking sumatriptan. Which of the following adverse effects should the nurse instruct the client to monitor for and report to the provider?

Chest pressure Rationale: sumatriptan is an antimigraine agent which can cause coronary vasospasms, resulting in angina. The client should report chest pressure or heavy arms to the provider.

A nurse is administering cefotetan via intermittent IV bolus to a client who suddenly dyspnea and widespread hives. Which of the following actions should the nurse take first?

Discontinue the medication IV infusion.

A nurse is caring for a client who is taking atorvastatin for hyperlipidemia. Which of the following client laboratory values should the nurse monitor?

Creatine kinase

A nurse is reviewing lab results for a client who is to receive a dose of ceftazidime via intermittent IV bolus. Which of the following laboratory findings is the priority for the nurse to report to the provider before administering the medication?

Creatinine 2.6 mg/dL Normal creatinine levels are 0.8 to 1.2 mg/dL

A nurse is planning to teach about inhalant medications to a client who has a new diagnosis of exercise-induced asthma. Which of the following medications should the nurse plan to instruct the client to use prior to physical activity?

Cromolyn Rationale: Cromolyn sodium stabilizes mast cells, which inhibit the release of histamine and other inflammatory mediators. The client should use cromolyn 10 to 15 min before planning to exercise to prevent bronchospasms.

A nurse is caring for a client who has developed hypomagnesemia due to long-term therapy with lansoprazole. The nurse should monitor the client for which of the following manifestations?

Disorientation The nurse should monitor for disorientation and confusion as manifestations of hypomagnesemia; and for positive Chvostek's and Trousseau's signs.

A nurse is assessing a client who is taking amitriptyline for depression. Which of the following findings should the nurse identify as an adverse effect of the medication?

Dry mouth Rationale: the nurse should expect the client to have a dry mouth due to the blocking of acetylcholine receptors that cause anticholinergic responses

A nurse is teaching a client who has a new prescription for ducosate sodium about the medication's mechanism of action. Which of the following information should the nurse include in the teaching?

Ducosate sodium reduces the surface tension of the stools to change their consistency. Rationale: Ducosate sodium is a surfactant that softens stool by reducing surface tension, allowing water to penetrate more easily into the stool.

A nurse is caring for a client who has heart failure and a prescription for enalapril. The nurse should monitor the client for which of the following findings as an adverse effect of the medication?

Enalapril improves cardiac functioning in clients who have heart failure and can cause hyperkalemia due to potassium retention by the kidneys.

A nurse contacts a client's provider on the telephone to obtain a prescription for pain medication. Which of the following actions should the nurse take?

Have the provider spell out the unfamiliar medication names.

A nurse in a provider's office is assessing a client who has been taking aspirin daily for the past year. For which of the following findings should the nurse notify the provider immediately?

Hyperventilation. Rationale: This may occur due to acute salicylate poisoning, which causes respiratory alkalosis in the early stages.

A nurse is providing teaching to a client who has depression and a new prescription for fluoxetine. Which of the following statements by the client indicates an understanding of the teaching?

I should take acetaminophen instead of ibuprofen for my headache while taking this medication. Rationale: Fluoxetine suppresses platelet aggregation, which increases the risk of bleeding when used concurrently with NSAIDS and anticoagulants.

A nurse is caring for a client who has heart failure and is receiving an IV infusion of dopamine. Which of the following findings indicates that the medication is effective?

Increased cardiac output. Rationale: dopamine is an adrenergic that causes a receptor specificity effect, which increases cardiac output and improves perfusion.

A nurse is assessing a client who is taking tamoxifen to treat breast cancer. Which of the following findings is the priority for the nurse report to the provider?

Leg tenderness Rationale: the greatest risk to this client is the development of a thromboembolism, which is an adverse effect of tamoxifen. The nurse should also monitor the client for other manifestations of a thromboembolism, including leg tenderness, redness, swelling, and shortness of breath.

A nurse is caring for a client who is to receive treatment for opioid use disorder. Which of the following medications should the nurse expect to administer?

Methadone Rationale: expect to administer methadone for treatment of opioid use disorder. Methadone can be administered for withdrawal and to assist with maintenance and suppressive therapy.

A nurse administered digoxin immune Fab to a client who received the incorrect dose of digoxin over a period of 3 days. The nurse should identify that which of the following findings indicates the antidote was effective?

Normal sinus rhythm. Rationale: Dysrhythmias are a life-threatening adverse effect of digoxin toxicity. The return of the heart to normal sinus rhythm indicates a therapeutic response to the antidote. Digoxin immune Fab is administered to a client who is experiencing severe digoxin toxicity. It binds with digoxin and works to reduce the clients blood digoxin level.

A nurse is caring for a client who reports lethargy and myalgia after taking clozapine for 9 months. Which of the following actions should the nurse plan to take?

Obtain WBC with absolute neutrophil count. Rationale: the client who takes clozapine can develop lethargy and myalgia caused by the adverse effect of agranulocytosis. Therefore, monitoring the WBC with absolute neutrophil count weekly for the first 6 months of treatment is recommended. After 6 months, monitoring can occur every 2 weeks up to 1 year.

A circulating nurse is planning care for a client who is scheduled for surgery and has a latex allergy. Which of the following actions should the nurse include in the plan of care?

Place monitoring cords and tubes in a stockinet.

A nurse is preparing to mix and administer dantrolene via IV bolus to a client who has developed malignant hyperthermia during surgery. Which of the following actions should the nurse take?

Reconstitute the initial dose with 60ml of sterile water without a bacteriostatic agent. Rationale: the nurse should dilute the medication with 60ml of sterile water without a bacteriostatic agent and inject rapidly. Store the reconstituted med at room temperature, protect it from light until use, and use within 6hr.

A nurse is planning discharge teaching for a client who has a prescription for furosemide. The nurse should plan to include which of the following statements in teaching?

Take a glass of milk with each dose of medication. Rationale: the client should take furosemide with food or milk to reduce gastric irritation.

A nurse is caring for a client who is receiving end-of-life care and has a prescription for fentanyl patches. Which of the following information regarding the adverse effects of fentanyl should the nurse plan to give to the client and family?

Take a stool softener on a daily basis. Rationale: constipation is an adverse effect of opioid use. --Naloxone is only for use in the acute care setting. --Urinary retention is an adverse effect of opioids, including fentanyl.

A nurse is preparing to administer hydrochlorothiazide to a client. Which of the following actions should the nurse take prior to administering the medication?

Take the client's BP. Rationale: HCTZ is a thiazide diuretic administered to promote urine output and reduce blood pressure and edema.

A nurse administers ceftazidime to a client who has a severe penicillin allergy. The nurse should identify which of the client findings as an indication that she should complete an incident report?

The client reports shortness of breath Rationale: a severe penicillin allergy is a contraindication for taking ceftazidime, a cephalosporin antibiotic, due to the potential for cross-sensitivity. SOB can indicate the client is developing anaphylaxis.

A nurse in a clinic is caring for a client who is taking aspirin for the treatment of arthritis. The nurse should identify which of the following findings as an indication that the client is beginning to exhibit salicylism?

Tinnitus Rationale: Tinnitus is a manifestation of aspirin toxicity, also called salicylism. Other manifestations include sweating, headache, and dizziness.

A nurse is reviewing the medical record of a client who has schizophrenia and a prescription for clozapine. Which of the following laboratory tests should the nurse review before administering the medication?

Total cholesterol Rationale: the nurse should review the client's total cholesterol before administering clozapine, because this medication can cause hyperlipidemia.

A nurse is teaching a client who is stating to take amitriptyline. Which of the following findings should the nurse include in the teaching as an adverse effect of the medication?

Urinary retention Rationale: amitriptyline is an antidepressant, and the nurse should instruct the client that amitriptyline causes the anticholinergic effect of urinary retention.

A nurse is reviewing the laboratory results of a client who is taking carbamazepine for a seizure disorder. Which of the following findings should the nurse report to the provider?

WBC 3,500 Rationale: WBC reference range is 5,000 to 10,000

A nurse is preparing to administer a new prescription of amoxicillin/clavulanic to a client. The client tells the nurse that they are allergic to penicillin. Which of the following actions should the nurse take first?

Withhold the medication.

A nurse is caring for a client who has diabetes mellitus and is taking glyburide. The client reports feeling confused and anxious. Which of the following actions should the nurse take first?

Perform a capillary blood glucose test.

A nurse is providing teaching to a client about the use of ethinyl estradiol/norelgestromin. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching?

"I will fold the sticky sides of the old patch together before disposing it" Rationale: the client should fold the sticky sides of the old patch together and then place it in a childproof container to ensure safe disposal of the patch.

A nurse is caring for a client who has hypocalcemia and is receiving calcium citrate. The nurse should identify that which of the following findings indicates a therapeutic response to the medication?

Client report of decreased paresthesia. Rationale: paresthesia (tingling/numbness) is a manifestation of hypocalcemia. The nurse should also monitor for a decrease in other manifestations of hypocalcemia including muscle twitching and cardiac dysrhythmias.

A nurse is providing teaching to a client who is to start therapy with digoxin. For which of the following adverse effects should the nurse instruct the client to monitor and report to the provider? A- Dry cough B- Pedal edema C- Bruising D- Yellow-tinged vision

D- Yellow-tinged vision Rationale: this is a sign of digoxin toxicity. Other manifestations of digoxin toxicity include nausea, vomiting, loss of appetite, and fatigue.

A nurse is caring for a client who has pneumonia. The client tells the nurse she is pregnant and that she has not told her provider yet. The nurse should identify that pregnancy is a contraindication for receiving which of the following medications?

Doxycycline Rationale: doxycycline is a tetracycline antibiotic. The nurse should identify that doxycycline can cause teratogenic effects.

A nurse is teaching a client who is taking allopurinol for the treatment of gout. Which of the following information should the nurse include in the teaching?

Drink 2L of water daily. The nurse should instruct the client to drink at least 2L of water each day to prevent renal stone formation and kidney injury, because allopurinol is eliminated through the kidneys

A nurse is providing teaching to a client who has a prescription for trimethoprim/sulfamethoxazole. Which of the following instructions should the nurse include in the teaching?

Drink 8 to 10 glasses of water daily. A nurse should instruct the client to increase water intake to 1,920 to 2,400ml a day to decrease the chance of kidney damage from crystallization.

A nurse is administering diazepam to a client who is having a colonoscopy. Which of the following actions should the nurse take?

Ensure flumazenil is available to administer for toxicity management. Rationale: the nurse should monitor for manifestations of diazepam toxicity, such as respiratory depression and hypotension. The nurse should be prepared to administer flumazenil to reverse the effects of diazepam. *the nurse should measure the capnography level every 15 to 30 mins until the client is awake and oriented and vital signs have returned to baseline.

A nurse is teaching about a new prescription for ciprofloxacin to a client who has a UTI. The nurse should identify which of the following statements as an indication that the client understands the teaching?

I will report any signs of tendon pain or swelling. Rationale: Ciprofloxacin, a fluoroquinolone, is associated with a risk of tendon rupture. This risk is increased in older adult clients, so the client should notify the provider at the onset of tendon pain or swelling.

A nurse is providing teaching to a client who has a new prescription for ferrous sulfate. The nurse should instruct the client to take the medication with which of the following to promote absorption?

Orange juice Rationale: the absorption of ferrous sulfate is enhanced by a vitamin C source, such as orange juice.

A nurse is monitoring for adverse effects of hydrochlorothiazide after administering the medication to an older adult client who has heart failure. Which of the following findings should the nurse identify as an adverse effect of the medication?

Orthostatic hypotension