ATI QUESTIONS MIDTERM
A nurse is caring for a client who takes Ginkgo biloba daily at home. Which of the following effects should the nurse expect from the use of this herbal supplement? A. Decreased platelet aggregation B. Prevention of migraine headaches C. Increased risk of deep-vein thrombosis D. Lowered cholesterol and triglyceride levels
A. Decreased platelet aggregation
A nurse is teaching a client who has a new diagnosis of angina and has a prescription for isosorbide mononitrate 10 mg PO twice daily. Which of the following client statements indicates an understanding of the teaching? A. "I can take my second dose of medication no later than 9:00 PM." B. "I should change positions slowly when getting out of bed." C. "If I miss a dose, I should double the next dose." D. "I should notify my provider if I experience a headache while taking this medication."
B. "I should change positions slowly when getting out of bed."
A nurse is teaching about taking donepezil with a client who was recently diagnosed with early Alzheimer's disease. Which of the following instructions should the nurse include in the teaching? A. "You should chew the medication thoroughly prior to swallowing." B. "You should take this medication late in the evening." C. "You should take this medication with food." D. "If you miss taking a dose for a day, take 2 doses the following day."
B. "You should take this medication late in the evening."
A nurse is providing discharge teaching for a client who has a new prescription for metoprolol. Which of the following instructions should the nurse include? (Select all that apply.) A. "Do not stop taking this medication abruptly." B. "Take the medication right before bedtime." C. "Avoid exposure to sunlight." D. "Count your radial pulse daily." E. "Change positions slowly."
A. "Do not stop taking this medication abruptly." D. "Count your radial pulse daily." E. "Change positions slowly."
A nurse is preparing to administer heparin 8,000 units subcutaneously every 8 hr. Heparin 10,000 units/1 mL is available. How many mL should the nurse administer per dose? (Fill in the blank with the numeric value only, round the answer to the nearest tenth, and use a leading zero if applicable. Do not use a trailing zero.)
0.8
A nurse is preparing to administer heparin 500 units/hr to a client who has a deep-vein thrombosis. Heparin is available at 25,000 units in 500 mL of 5% dextrose in water. The nurse should set the IV pump to deliver how many mL/hr? (Fill in the blank with the numeric value only, round to the nearest whole number, use a leading zero if applicable. Do not use a trailing zero.)
10
A nurse is caring for a client who takes warfarin to treat chronic atrial fibrillation and has early manifestations of Alzheimer's disease. The client's partner asks the nurse if the client would benefit from taking ginkgo biloba. Which of the following responses should the nurse make? A. "Ginkgo biloba will likely interfere with the effectiveness of his other medications." B. "You should ask his provider if ginkgo biloba is safe." C. "Ginkgo biloba is most effective in the later stages of Alzheimer's disease." D. "People who have Alzheimer's disease should adhere to the medication regimen their provider prescribes."
A. "Ginkgo biloba will likely interfere with the effectiveness of his other medications.
A nurse in a provider's office is assessing a client who has been taking feverfew. Which of the following statements by the client indicates a therapeutic effect of the supplement? A. "I am having fewer migraine headaches since I started taking feverfew." B. "My memory seems to be getting better since I started taking feverfew." C. "I have fewer infections when I take feverfew." D. "I have not had another urinary tract infection since starting feverfew."
A. "I am having fewer migraine headaches since I started taking feverfew."
A nurse is administering subcutaneous heparin to a client who is at risk for deep vein thrombosis. Which of the following actions should the nurse take? A. Administer the medication into the client's abdomen B. Inject the medication into a muscle C. Massage the site after administering the medication D. Use a 22-gauge needle to administer the medication
A. Administer the medication into the client's abdomen
A nurse is preparing to administer an epinephrine IV bolus to a client. Which of the following should the nurse verify before initiating the IV medication? A. Concentration of the formulation B. Reversibility of the medication C. Potential barriers to absorption D. Gastric emptying time
A. Concentration of the formulation
A nurse is administering brimonidine eye drops to a client who has glaucoma. Which of the following ocular effects should the nurse expect? A. Decreased intraocular pressure B. Blocked growth of new blood vessels C. Paralysis of accommodation D. Mydriasis
A. Decreased intraocular pressure
A nurse is teaching a client who has chemotherapy-induced anemia and a prescription for epoetin alfa. The nurse should instruct the client to report which of the following findings as an adverse effect of epoetin alpha? A. Hypertension B. Leukocytosis C. Bone pain D. Neutropenia
A. Hypertension
A nurse is planning care for a client with thrombophlebitis who has a prescription to receive heparin via continuous IV infusion. Which of the following actions should the nurse include in the plan of care? A. Infuse the heparin using an electronic IV pump B. Administer vitamin K if the client has indications of hemorrhage C. Adjust the dosage of heparin based on the client's PT levels D. Inform the client that the heparin will dissolve the thrombus
A. Infuse the heparin using an electronic IV pump
A nurse is caring for a client who developed hypoglycemia following an insulin injection. The client is conscious and responds appropriately to verbal stimuli. Which of the following medications should the nurse plan to administer first? A. Oral glucose tablet B. 50% dextrose intravenously C. Glucagon intramuscularly D. Epinephrine intravenously
A. Oral glucose tablet
A nurse is caring for a client with asthma who has been taking an inhaled glucocorticoid and long-acting beta2-agonist combination dry-powdered inhaler (DPI) for maintenance therapy. The nurse should identify that which of the following is a disadvantage of this medication? A. Restricted dosage flexibility B. Complicated delivery device C. Serious systemic effects D. Limited efficacy over time
A. Restricted dosage flexibility
A nurse is providing teaching to a group of new parents about medications. The nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects? A. Reye's syndrome B. Visual disturbances C. Diabetes mellitus D. Wilms' tumor
A. Reye's syndrome
A nurse is caring for a client who has a prescription for subdermal etonogestrel. The nurse should alert the provider about which of the following findings in the client's medical history? A. Takes St. John's wort B. Breastfeeds a 6-month-old infant C. Has a parent with hypertension D. Has a positive human papillomavirus (HPV) test result
A. Takes St. John's wort
A nurse is assessing a client who reports using several herbal and vitamin supplements daily, including saw palmetto. The nurse should recognize that saw palmetto is a supplement used by clients to elicit which of the following therapeutic effects? A. Urinary health promotion B. Immune system stimulation C. Decreased leg pain from arterial disease D. Prevention of nausea caused by motion sickness
A. Urinary health promotion
A nurse is teaching a client with chronic asthma who has a new prescription for cromolyn. Which of the following instructions should the nurse include in the teaching? A. "Use the inhaler just before exercise." B. "The medication's therapeutic effects can take up to several weeks to develop." C. "You will shake the medication container for 3 seconds." D. "You will need to exhale slowly after you inhale."
B. "The medication's therapeutic effects can take up to several weeks to develop."
A nurse is performing an admission assessment for a client who has asthma and reports several food allergies. Which of the following actions should the nurse take first? A. Document the client's food allergies in the medical record B. Ask the client to identify the specific food allergies C. Monitor the client for indications of anaphylaxis D. Have epinephrine available for administration
B. Ask the client to identify the specific food allergies
A nurse is assisting with a client's laceration repair in which the provider will use both lidocaine and epinephrine. The nurse should inform the client that the epinephrine will perform which of the following actions? A. Act as a catalyst for the anesthetic properties of lidocaine B. Delay systemic absorption of the anesthetic properties of lidocaine C. Open the blood vessels for rapid anesthesia from the lidocaine D. Prevent medication toxicity during the procedure
B. Delay systemic absorption of the anesthetic properties of lidocaine
A nurse is monitoring a client who has asthma, takes albuterol, and recently started taking propranolol to treat a cardiovascular disorder. The client reports that the albuterol has been less effective. Which of the following factors should the nurse identify as a possible explanation for this change? A. Potentiative interaction B. Detrimental inhibitory interaction C. Increased adverse reaction D. Toxicity-reducing inhibitory interaction
B. Detrimental inhibitory interaction
A nurse is admitting a client who has atrial fibrillation with a heart rate of 155/min. The nurse should anticipate a prescription from the provider for which of the following medications? A. Atropine B. Diltiazem C. Epinephrine D. Vasopressin
B. Diltiazem
A nurse is reviewing the medication administration record of a client who has impaired swallowing. The nurse should crush the medication when administering which of the following prescriptions? A. Aspirin EC 80 mg PO daily B. Levothyroxine 75 mcg PO q AM before breakfast C. Metformin XR 500 mg PO daily D. Nitroglycerin 0.3 mg SL PRN chest pain, may repeat q 5 min for 2 additional doses
B. Levothyroxine 75 mcg PO q AM before breakfast
A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions? A. Raynaud's phenomenon B. Migraine headaches C. Ulcerative colitis D. Anemia
B. Migraine headaches
A nurse is admitting a client who has unstable angina. Which of the following medications should the nurse anticipate administering to the client? A. Epinephrine B. Nitroglycerin C. Lidocaine D. Atropine
B. Nitroglycerin
A nurse is caring for a client who has unstable angina. The nurse should anticipate a prescription from the provider for which of the following medications? A. Epinephrine B. Nitroglycerin C. Lidocaine D. Atropine
B. Nitroglycerin
A nurse is caring for a client who has asthma and is prescribed a short-acting beta2-agonist. Which of the following should the nurse identify as the expected outcome of this medication? A. Reduces the frequency of attacks B. Reverses bronchospasm C. Prevents inflammation D. Decreases chronic manifestations
B. Reverses bronchospasm
A nurse is providing teaching to a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse give the client? A. Take the medication and herbal supplement together. B. Stop taking the herbal supplement while taking the medication. C. Take the herbal supplement and the medication at least 2 hr apart. D. Take an antacid with both the herbal supplement and the medication.
B. Stop taking the herbal supplement while taking the medication.
A nurse is preparing a 24-hr urine specimen for a client who is suspected to have pheochromocytoma. Which of the following laboratory tests from the 24-hr urine specimen should the nurse use to determine the client's condition? A. Creatinine clearance B. Vanillylmandelic acid (VMA) C. 17-hydroxycorticosteroids (17-OHCS) D. Protein
B. Vanillylmandelic acid
A nurse is caring for a client who reports using several herbal medicines. Which of the following actions should the nurse take? A. Discourage the use of unregulated medications and supplements B. Verify the herbal supplements do not interact with medications the provider has prescribed C. Tell the client to limit the number of herbal supplements to no more than 2 D. Describe the dangers of taking plant-derived medications and supplements
B. Verify the herbal supplements do not interact with medications the provider has prescribed
A nurse is caring for a client with multiple sclerosis and neurogenic bladder who is receiving bethanechol. The nurse should identify that which of the following client statements indicates a therapeutic action of the medication? A. "My mouth seems very dry lately." B. "I've noticed my heart beating faster." C. "I am able to urinate more freely." D. "I've noticed I can take a deep breath more easily."
C. "I am able to urinate more freely
A nurse is preparing to administer timolol eye drops to a client who has primary open-angle glaucoma (POAG). Prior to administering the medication, the nurse should recognize that which of the following conditions in the client's medical history is a contraindication to receiving this medication? A. Hypertension B. Peripheral vision loss C. Asthma D. Increased intraocular pressure
C. Asthma
A nurse in a provider's office is assessing a client who reports taking a dietary supplement to reduce hot flashes related to menopause. Which of the following supplements should the nurse expect the client to report taking? A. Flaxseed B. Ginkgo biloba C. Black cohosh D. St. John's wort
C. Black cohosh
A nurse is caring for a client who is experiencing cycloplegia following the administration of atropine eye drops during an eye examination. Which of the following findings should the nurse expect as a result of cycloplegia? A. Inability to tolerate bright lights B. Pinpoint pupils C. Blurred vision D. Inability to perform an upward gaze
C. Blurred vision
A nurse is teaching a group of nurses about the effects of a client receiving spinal anesthesia. Which of the following pieces of information should the nurse include in the teaching? A. Lidocaine toxicity will cause the client to develop tachycardia. B. Most clients develop a headache from spinal anesthesia. C. Hypotension is an adverse effect of spinal anesthesia. D. Urinary urgency occurs when the client has spinal anesthesia.
C. Hypotension is an adverse effect of spinal anesthesia
A nurse administered an antibiotic 10 min ago to a client who is now reporting wheezing and swelling of the eyelids. Which of the following actions should the nurse perform first? A. Give oral corticosteroids B. Administer dopamine C. Give diphenhydramine IV D. Administer epinephrine subcutaneously
D. Administer epinephrine subcutaneously
A nurse is caring for a client who is taking an agonist medication. The nurse should expect which of the following actions from this type of medication? A. Acts with a partial agonist molecule to block receptors fully B. Temporarily occupies receptors instead of other competitive molecules C. Blocks receptors and prevents them from activating with a regulatory molecule D. Binds to receptors and mimics regulatory molecules
D. Binds to receptors and mimics regulatory molecules
A nurse is caring for a client who is 12 hours postoperative following a total hip arthroplasty. Which of following medications should the nurse anticipate administering to this client to prevent deep vein thrombosis (DVT)? A. Aspirin B. Warfarin C. Ticagrelor D. Enoxaparin
D. Enoxaparin
A nurse is caring for a client with benign prostatic hyperplasia who has a new prescription for doxazosin. Which of the following manifestations should the nurse monitor for as an adverse effect of doxazosin? A. Seizures B. Tachycardia C. Bronchodilation D. Hypotension
D. Hypotension
A nurse is caring for a client who is taking warfarin. Which of the following laboratory values should the nurse recognize as an effective response to the medication? A. Hct 45% B. Hgb 15 g/dL C. aPTT 35 seconds D. INR 3.0
D. INR 3.0
A nurse is providing teaching to a client with asthma who has a new prescription for a short-acting beta-2 agonist (SABA) bronchodilator. Which of the following pieces of information should the nurse share? A. The SABA will provide prolonged control of asthma attacks. B. SABAs are also available in an oral form. C. The SABA will have to be taken with an inhaled glucocorticoid. D. Notify the provider if the SABA is needed more than twice per week.
D. Notify the provider if the SABA is needed more than twice per week.
A nurse in the PACU is assessing a newly admitted client and observes intercostal retractions and a high-pitched inspiratory sound. The nurse should identify these findings as manifestations of which of the following complications? A. Pulmonary edema B. Tension pneumothorax C. Flail chest D. Respiratory obstruction
D. Respiratory obstruction
A nurse is caring for a client who is receiving IV ampicillin and develops urticaria and dyspnea. Which of the following actions should the nurse take first? A. Elevate the client's feet and legs B. Administer epinephrine C. Infuse 0.9% sodium chloride D. Stop the medication infusion
D. Stop the medication infusion
A nurse is providing teaching to a client with hypertension and type 1 diabetes mellitus who has a new prescription for metoprolol. Which of the following statements by the client indicates an understanding of the teaching? A. "I might have difficulty recognizing when my blood sugar is low." B. "I will have a lower risk of developing an infection while I take this medication." C. "I should be concerned about losing excess weight while I take this medication." D. "I could have more problems with high blood sugar while taking this medication."
A. "I might have difficulty recognizing when my blood sugar is low."
A nurse is caring for a client who has asthma and requires long-term treatment. The nurse should identify that which of the following medications used for long-term treatment places the client at an increased risk of asthma-related death? A. Salmeterol B. Fluticasone C. Budesonide D. Theophylline
A. Salmeterol
A nurse is caring for a client who is experiencing acute alcohol withdrawal. The nurse should expect to administer which of the following medications? A. Disulfiram B. Chlordiazepoxide C. Methadone D. Varenicline
B. Chlordiazepoxide
A nurse is caring for a client who is receiving continuous cardiac monitoring. Which of the following medications should the nurse anticipate administering to treat atrial fibrillation? A. Atropine B. Diltiazem C. Epinephrine D. Phenytoin
B. Diltiazem
A nurse is teaching a client who has a new prescription for warfarin. Which of the following statements should the nurse identify as an indication that the client understands the instructions? A. "I'll use a safety razor to shave each day." B. "I'll be sure to eat lots of spinach." C. "I'll avoid contact sports like football." D. "I'll take ibuprofen if I get a headache."
C. "I'll avoid contact sports like football."
A nurse is preparing to administer warfarin to a client who has a new onset of atrial fibrillation. The client asks the nurse, "What should this medication do?" Which of the following responses should the nurse make? A. "It helps your heart return to a normal rhythm." B. "It dissolves blood clots." C. "It can reduce your risk of having a stroke." D. "It helps to prevent bleeding in atrial fibrillation."
C. "It can reduce your risk of having a stroke.
A nurse is teaching the parents of a toddler who had an anaphylactic reaction to peanut butter about administering injectable epinephrine. Which of the following instructions should the nurse include? A. "Common sites for an injection of epinephrine are the fatty tissue found in the upper arm and in the lower abdomen." B. "Administer epinephrine prior to giving your child peanut products in the future." C. "No further treatment is needed after injecting the epinephrine." D. "You will need to increase the dosage as your child gains weight."
D. "You will need to increase the dosage as your child gains weight."
A nurse is planning care for a client who is scheduled to undergo electroconvulsive treatment (ECT). Which of the following interventions should the nurse include? A. Maintain a clear liquid diet for 6 to 8 hr prior to ECT B. Allow the client to sleep for 3 to 4 hr following ECT C. Administer IM epinephrine to the client prior to ECT D. Reorient the client to the environment after ECT
D. Reorient the client to the environment after ECT
A nurse is assessing a client who is experiencing chest pain. Which of the following medications should the nurse expect to administer to suppress the aggregation of platelets? A. Nitroglycerin B. Aspirin C. Morphine D. Metoprolol
B. Aspirin
A nurse is caring for a child who received penicillin IM 15 minutes ago. The child is now irritable and restless. Which of the following actions should the nurse take first? A. Administer diphenhydramine B. Assess for laryngeal edema C. Initiate hourly urine output monitoring D. Give epinephrine IV push
B. Assess for laryngeal edema
A nurse is providing discharge teaching to a client who has venous thrombosis and a prescription for warfarin. Which of the following instructions should the nurse include in the teaching? A. Take ibuprofen as needed for headaches or other minor pains B. Carry a medical alert ID card C. Report to the laboratory weekly to have blood drawn for aPTT D. Increase intake of dark green vegetables
B. Carry a medical alert ID card
A nurse is caring for a client who is taking acarbose to treat type 2 diabetes mellitus. For which of the following adverse effects of this medication should the nurse monitor the client? A. Insomnia B. Diarrhea C. Joint pain D. Polycythemia
B. Diarrhea
A nurse is performing a preoperative assessment of a client who is about to undergo an aneurysm clipping. The nurse should identify a risk for increased bleeding when the client reports taking which of the following dietary supplements? A. Soy B. Garlic C. Black cohosh D. Green tea
B. Garlic
A nurse is reviewing the laboratory values of a client who is receiving a continuous IV heparin infusion and has an aPTT of 90 sec. Which of the following actions should the nurse prepare to take? A. Administer vitamin K B. Reduce the infusion rate C. Give the client a low-dose aspirin D. Request an INR
B. Reduce the infusion rate
A nurse is preparing to administer an IM injection for a client. Which of the following factors should the nurse identify as a potential contraindication to administering the medication via the IM route? A. The medication is a depot preparation. B. The client is taking an anticoagulant. C. The medication is a particulate suspension. D. The client has been vomiting.
B. The client is taking an anticoagulant.
A nurse is monitoring a client with pneumonia who has received penicillin G intramuscularly (IM). Which of the following findings should the nurse plan to evaluate first? A. Pain at the injection site B. Prolonged motor dysfunction C. Laryngeal edema D. Temperature 37.6°C (99.7°F)
C. Laryngeal edema
A nurse is reviewing the medication administration record of a client who is receiving an opioid medication for pain. Which of the following prescriptions should the nurse clarify with the provider? A. Metoprolol B. Ondansetron C. Lorazepam D. Naloxone
C. Lorazepam
A nurse is caring for a client who takes warfarin 2.5 mg PO daily and has an INR of 6.2. The nurse should anticipate a prescription from the provider for which of the following medications? A. Protamine sulfate B. Fondaparinux C. Vitamin K D. Bivalirudin
C. Vitamin K
A nurse is caring for a client who is pregnant and inquiring about alternative, non-pharmacological therapies for nausea and vomiting of pregnancy (NVP). Which of the following options should the nurse recommend? A. "Be sure to eat at least 3 large meals each day." B. "If you're experiencing nausea when you wake up, wait to eat until lunchtime." C. "You may need to take additional supplements to alleviate nausea." D. "Ginger is effective in the treatment of nausea and vomiting."
D. "Ginger is effective in the treatment of nausea and vomiting."
A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to administer? A. Ibuprofen B. Naproxen C. Aspirin D. Acetaminophen
D. Acetaminophen
A nurse is caring for a client who is taking warfarin. Which of the following laboratory values should the nurse recognize as an effective response to the medication?A. Hct 45% B. Hgb 15 g/dL C. aPTT 35 seconds D. INR 3.0
D. INR 3.0
A nurse is reviewing the laboratory reports of a client who has been taking warfarin for atrial fibrillation. Which of the following results should the nurse report to the provider immediately? A. PT 18 seconds B. Platelet count 160,000/mm^3 C. Hct 43% D. INR 5.5
D. INR 5.5
A nurse is caring for a client who is experiencing an acute asthma exacerbation. Which of the following medications should the nurse identify as being contraindicated for this client? A. Dextromethorphan B. Montelukast C. Ciprofloxacin D. Propranolol
D. Propranolol
A nurse is administering subcutaneous epinephrine for a client who is experiencing anaphylaxis. The nurse should monitor the client for which of the following adverse effects? A. Hypotension B. Hyperthermia C. Hypoglycemia D. Tachycardia
D. Tachycardia
