ATI practice exam B
Nurse in provider's office is assessing pt who has been taking aspirin daily for past year. For which of following findings should nurse notify provider immediately?
Hyperventilation
Circulating nurse is planning care for pt who is schedule for surgery and has latex allergy. Which of following actions should nurse include in plan of care?
Place monitoring cords and tubes in a stockinet.
Nurse is providing teaching for pt who has MS and new prescription for methylprenisolone. Which of following instructions should nurse include? (select all that apply)
"Blood glucose levels will be monitored during therapy" : The nurse should instruct the client that their blood glucose levels will be monitored during therapy because corticosteroids, such as methylprednisolone, can raise blood glucose levels."Avoid contact with persons who have known infections": The nurse should instruct the client to avoid contact with persons who have known infections because corticosteroids, such as methylprednisolone, suppress the immune response and mask manifestations of infection."Grapefruit juice can increase the blood levels of the medication": The nurse should instruct the client that grapefruit juice increases the absorption of the medication, which can lead to toxicity and adrenal suppression.
Nurse is caring for pt who is refusing to take their scheduled morning furosemide. Which of following statements should nurse make?
"By not taking your furosemide, you might retain fluid and develop swelling."
Nurse is planning discharge teaching for pt who has prescription for furosemide. Nurse should plan to include which of following statements in teaching?
"Drink a glass of milk with each dose of medication."
Nurse is teaching pt who is taking ranitidine for PUD. Which of following pt statements should nurse identify as understanding of teaching?
"I know smoking makes ranitidine less effective."
Nurse is providing teaching to pt who has depression and new prescription for fluoxetine. Which of following statements by pt indicates understanding of teaching?
"I should take acetaminophen instead of ibuprofen for my headaches while taking this medication."
Nurse is teaching pt who is starting to take diltiazem. Which of following statements should nurse identify as indication that pt understands teaching?
"I will check my heart rate before I take the medication."
Nurse is providing teaching to pt about to use ethinyl estradiol/norelgestromin. Nurse should identify that which of following statements by pt indicates understanding of teaching?
"I will fold the sticky sides of the old patch together before disposing it."
Nurse is teaching about self-administration of transdermal medication w/ male pt who has new prescription for nitroglycerin. Nurse should identify that which of following statements by pt indicates understanding of teaching?
"I will remove the patch after 14 hours."
Nurse is teaching about new prescription to pt who has new UTI. Nurse should identify which of following statements as an indication that pt understands teaching?
"I will report any signs of tendon pain or swelling."
Nurse is providing discharge instructions to pt who is to self-administer insulin at home. Which of following client statements should indicated to nurse that teaching is effective?
"I will store my unopened bottles of insulin in the refrigerator."
Nurse is teaching about zolpidem to pt who has insomnia. Nurse should identify that which of following pt statements indicates an understanding of teaching?
"I will use this medication for a short period of time."
Nurse is providing discharge teaching to pt who has new prescription for furosemide BID. Nurse should include which of following instructions in teaching? (select all that apply)
"Increase intake of potassium-rich foods": Loop diuretics, such as furosemide, act at the loop of Henle by blocking the resorption of sodium, water, and potassium. An adverse effect of the medication is the development of electrolyte imbalances such as hyponatremia, hypochloremia, and hypokalemia. To prevent hypokalemia, the client should increase intake of potassium-rich foods, such as potatoes, spinach, dried fruit, and nuts." Monitor for muscle weakness": Furosemide, a loop diuretic, causes a loss of potassium, which can result in manifestations of hypokalemia such as difficulty concentrating, shallow respirations, hyporeflexia, and muscle weakness. The nurse should instruct the client to monitor for these manifestations and report them to the provider. "Dangle your legs from the side of the bed before standing": Loop diuretics, such as furosemide, reduce vascular tone and increase fluid excretion. These effects decrease blood return to the heart and can manifest as dizziness and lightheadedness when going from a lying to a standing position. The client should change positions slowly to minimize orthostatic hypotension.
Nurse is preparing to administer NS 1500ml over 8hr to pt who is postop. Nurse should set IV pump to deliver how many ml/hr?
188 ml/hr
Nurse is preparing to administer NS 1L over 8 hr to pt. Drop factor of manual IV tubing is 15 gtt/mL. Nurse should set manual IV infusion to deliver how many gtt/min?
31 gtt/min
Nurse is completing incident report for med error. Which of following information should nurse include in report?
Administered propranolol 80 mg PO at 1800 to the client who did not have a prescription for the medication.
Nurse is caring for pt who is receiving haloperidol. Nurse should identify which of following findings as adverse effect of med?
Akathisia
Nurse is reviewing medical record of pt who has HTN. Nurse should identify which of following findings as contraindication for receiving propranolol?
Asthma
Nurse is caring for pt who is recovering from DVT and is to start taking warfarin. For which of following findings should nurse monitor as an adverse effect of warfarin?
Bleeding gums
Nurse is assessing pt who has received atropine eye drops during eye examination. Which of following findings should nurse expect as adverse effect of med?
Blurred vision
Nurse is caring for pt who has Mg 3.1 mEq/L. Nurse should expect to administer which of following meds?
Calcium gluconate
Nurse is caring for a pt who has hypocalcemia and is receiving calcium citrate. Nurse should identify that which of following findings indicates therapeutic response to med?
Client report of decreased paresthesia
Nurse is assessing pt who is taking tamoxifen to treat breast cancer. Which of following findings is priority for nurse to report to provider?
Leg tenderness
Nurse is reviewing lab results for pt who is to receive dose of ceftazidime via intermittent IV bolus. Which of following lab findings is priority for nurse to report to Dr before administering med?
Creatinine 2.6 mg/dL
Nurse is caring for pt who is taking atorvastatin for hyperlipidemia. Which of following client lab values should nurse monitor?
Creatinine kinase
Nurse is planning to teach about inhalant meds to pt who has new Dx of exercise-indused asthma. Which of following weds should nurse plan to instruct pt to use prior to physical activity?
Cromolyn
Nurse is administering baclofen for pt who has spinal cord injury. Which of following findings should nurse document as therapeutic outcome?
Decrease in flexor and extensor spasticity
Nurse is administering cefotetan via intermitten IV bolus to pt who suddenly develop dyspnea and widespread hives. Which of following actions should nurse take 1st?
Discontinue the medication IV infusion.
Nurse is caring for pt who has developed hypomagnesmia due to long-term therapy w/ lansoprazole. Nurse should monitor pt for which of following manifestations?
Disorientation
Nurse is teaching pt who has new prescription for docusate sodium about med's MOA. Which of folliwng information should nurse include in teaching?
Docusate sodium reduces the surface tension of the stools to change their consistency.
Nurse is caring for pt who has pneumonia. Pt tells nurse she is pregnant and that she hasn't told provider yet. Nurse should identify that pregnancy is contraindicated for receiving which of following meds?
Doxycycline
Nurse is teaching pt who is taking allopurinol for Tx of gout. Which of following information should nurse include teaching?
Drink 2 L of water daily.
Nurse is providing teaching to pt who has prescription for trimethoprim/sulfamethoxazole. Which of following instructions should nurse include in teaching?
Drink 8 to 10 glasses of water daily.
Nurse is assessing pt who is taking amitriptyline for depression. Which of following findings should nurse identify as adverse effect of med?
Dry mouth
Nurse is administering diazepam to pt who is having colonoscopy. Which of following actions should nurse take?
Ensure flumazenil is available to administer for toxicity management.
Nurse contacts a pt's provider on telephone to obtain prescription for pain med. Which of following actions should nurse take?
Have the provider spell out unfamiliar names
Nurse is caring for pt who has sickle cell anemia and is taking hydroxyurea. Which of following findings should nurse report to provider? (select all that apply)
Hemoglobin 7.0 g/dL: A hemoglobin level of 7.0 g/dL indicates hydroxyurea toxicity. This hemoglobin level is below the expected reference range of 14 to 19 g/dL for a male client and 12 to 16 g/dL for a female client. Therefore, the nurse should report this finding to the provider. Platelets 75,000/mm3: A platelet level of 75,000/mm3 indicates hydroxyurea toxicity. This platelet level is below the expected reference range of 150,00 to 400,000/mm3. Therefore, the nurse should report this finding to the provider. Potassium 5.2 mEq/L: A potassium level of 5.2 mEq/L indicates tumor lysis syndrome. This potassium level is above the expected reference range of 3.5 to 5 mEq/L. Therefore, the nurse should report this finding to the provider.
Nurse is assessing pt who is receiving epoetin alfa to Tx anemia. Which of following findings should nurse monitor?
Increased blood pressure
Nurse is caring for pt who has HF and is receiving IV infusion of dopamine. Which of following findings indicates that med is effective?
Increased cardiac output
Nurse is caring for pt who is receiving Tx for opioid use disorder. Which of following medications should nurse expect to administer?
Methadone
Nurse administer digoxin immune Fab to pt who received incorrect dose of digoxin over a period of 3 days. Nurse should identify that which of following findings indicates the antidote was effective?
Normal sinus rhythm
Nurse is caring for pt who reports lethargy and myalgia after taking clozapine for months. Which of following actions should nurse plan to take?
Obtain WBC with absolute neutrophil count.
Nurse is preparing to administer hydrochlorothiazide to pt. Which of following actions should nurse take prior to administering the med?
Obtain the client's blood pressure.
Nurse is providing teaching to pt who has new prescription for ferrous sulfate. Nurse should instruct pt to take med w/ which of following to promote absorption?
Orange juice
Nurse is monitoring for adverse effects of hydrochlorothiazide after administering med to older adult pt who has HF. Which of following findings should nurse identify as adverse effect of med?
Orthostatic hypotension
Nurse is caring for pt who has DM and is taking glyburide. Pt reports feeling confused and anxious. Which of following actions should nurse take 1st?
Perform a capillary blood glucose test.
Nurse is preparing to mix and administer dantrolene via IV bolus to pt who had developed MH during surgery. Which of following actions should nurse take?
Reconstitute the initial dose with 60 mL of sterile water without a bacteriostatic agent.
Nurse is caring for pt who is receiving end-of-life care and has prescription for fentanyl patches. Which of following information regarding adverse effects of fentanyl should nurse plan to give to pt and family?
Take a stool softener on a daily basis.
Nurse administers ceftazidime to pt who has severe penicillin allergy. Nurse should identify which of following pt findings as indication that she should complete incident report?
The client reports shortness of breath.
Nurse is reviewing medical record of pt who has schizophrenia and prescription for chlozapine. Which of following lab tests should nurse review before administering med?
Total cholesterol
Nurse is teaching pt who is starting to take amitriptyline. Which of following findings should nurse include in teaching as adverse effect of med?
Urinary retention
Nurse is reviewing lab results of pt who is taking carbamazepine for seizure disorder. Which of following findings should nurse report to provider?
WBC 3,500/mm3
Nurse is providing teaching to pt who is to start therapy w/ digoxin. For which of following adverse effects should nurse instruct pt to monitor and report to provider?
Yellow-tinged vision
Nurse is preparing to administer new prescription of amoxicillin/clavulanic to pt. Pt tells nurse that they're allergic to penicillin. Which of following actions should nurse take 1st?
withhold the medication
Nurse is preparing to teach pt who is to start new prescription for extended release verapamil. Which of following instructions should nurse plan to include?
Change positions slowly.
Nurse in clinic is caring for a pt who is taking aspirin for Tx of arthritis. Nurse should identify which of following findings as indication that pt is beginning to exhibit salicylism?
tinnitus
Nurse is preparing newly licensed nurse who is caring for 4 pts. Nurse should complete incident report for which of following actions by newly licensed nurse?
Administers isosorbide mononitrate to a client who has BP 82/60 mm Hg
Nurse is providing teaching to pt who is to start taking sumatriptan. Which of following adverse effects should nurse instruct pt to monitor for and report to Dr?
Chest pressure
Nurse is caring for pt who has HF and prescription for enalapril. Nurse should monitor pt for which of following as adverse effect of med?
Hyperkalemia
