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PN ATI Capstone Proctored Comprehensive Assessment 2020 A
1. A client with a seizure disorder has a new prescription for valproic acid. Which of the following laboratory values should the nurse plan to monitor? (Select all that apply)
- A. PTT
- B. Aspartate aminotransferase (AST)
- C. Alanine aminotransferase (ALT)
- D. All of the Above
Correct answer: D
Rationale: The correct answer is D, 'All of the Above.' Valproic acid can impact liver function and coagulation. Monitoring the Prothrombin Time (PTT), Aspartate Aminotransferase (AST), and Alanine Aminotransferase (ALT) is crucial. PTT is monitored to assess coagulation status, while AST and ALT are liver enzymes that indicate liver function. Monitoring these values helps detect any potential adverse effects of valproic acid on the liver and blood clotting. Choices A, B, and C are incorrect because each of these laboratory values plays a critical role in evaluating the client's response to valproic acid therapy and detecting associated complications.
2. A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn sodium metered dose inhaler. Which of the following statements by the parent indicates the need for further teaching?
- A. I will give my child a dose as soon as wheezing starts.
- B. My child should rinse out his mouth after using the inhaler.
- C. My child should exhale completely before placing the inhaler in his mouth.
- D. If my child has difficulty breathing in the dose, a spacer can be used.
Correct answer: A
Rationale: The correct answer is A. Cromolyn sodium is a preventive medication and should not be used as a rescue inhaler when wheezing starts. This indicates a need for further teaching as the parent should understand that cromolyn sodium is not meant for immediate relief of symptoms. Choice B is correct as rinsing the mouth after using the inhaler helps reduce the risk of oral thrush, a common side effect. Choice C is correct as exhaling completely before using the inhaler helps ensure proper inhalation of the medication. Choice D is correct as a spacer can be used if the child has difficulty coordinating breathing with the inhaler, improving medication delivery.
3. A nurse is planning to administer chlorothiazide 20 mg/kg/day PO divided equally and administered twice daily for a toddler who weighs 28.6 lb. The amount available is chlorothiazide oral suspension 250 mg/5 mL. How many mL should the nurse administer per dose? (Round to the nearest tenth)
- A. 2.6 mL
- B. 2.63 mL
- C. 2.7 mL
- D. 2.2 mL
Correct answer: A
Rationale: To find the dose per administration, first convert the toddler's weight to kg: 28.6 lb ÷ 2.2 = 13 kg. Then calculate the total daily dose: 20 mg/kg × 13 kg = 260 mg/day. Since it is divided into two doses, each dose is 130 mg. The concentration of the oral suspension is 250 mg/5 mL = 50 mg/mL. Therefore, to find the volume needed per dose, divide the dose by the concentration: 130 mg ÷ 50 mg/mL = 2.6 mL per dose. Hence, the nurse should administer 2.6 mL per dose. Choices B, C, and D are incorrect as they do not accurately calculate the dosage of chlorothiazide needed per dose based on the toddler's weight and the concentration of the oral suspension.
4. 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.
Correct answer: A
Rationale: Heparin is best absorbed and less likely to cause hematomas when administered into subcutaneous tissue, specifically the abdomen, which is a common site for subcutaneous injections. Injecting heparin into a muscle (Choice B) is incorrect as it should be administered subcutaneously. Massaging the site after administering the medication (Choice C) is contraindicated as it can cause tissue damage or bruising. Using a 22-gauge needle (Choice D) is not recommended for subcutaneous injections of heparin; a smaller needle size such as 25-26 gauge is preferred for subcutaneous administration.
5. 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
Correct answer: B
Rationale: Ergotamine is used to treat migraine headaches by constricting blood vessels in the brain. Therefore, the correct answer is B. Choice A, Raynaud's phenomenon, is incorrect as ergotamine is not indicated for this condition. Choice C, Ulcerative colitis, is incorrect as ergotamine is not used to treat this gastrointestinal disorder. Choice D, Anemia, is incorrect as ergotamine is not prescribed for anemia.
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