ATI RN
ATI Proctored Pharmacology 2023
1. When a nurse assesses a client's IV catheter insertion site and notes a hematoma, which of the following actions should the nurse take? (Select all that apply.)
- A. Stop the infusion.
- B. Apply alcohol to the insertion site.
- C. Apply warm compresses to the insertion site.
- D. Elevate the client's arm.
Correct answer: C
Rationale: When a nurse detects a hematoma at the IV catheter insertion site, applying warm compresses is beneficial as it can promote healing by enhancing circulation and reducing swelling. Elevating the client's arm helps in reducing edema, which can relieve pressure, pain, and further bleeding in the hematoma area. Stopping the infusion may be necessary in certain situations, but it is not a standard action for all hematoma cases. Applying alcohol to the insertion site is discouraged as it can cause irritation and may not aid in resolving the hematoma.
2. The nurse is providing information regarding safety and accidental poisoning to a grandparent who will be taking custody of a 1-year-old grandchild. Which comment by the grandparent will cause the nurse to intervene?
- A. I should call 911 if my grandchild loses consciousness.
- B. Never induce vomiting if my grandchild drinks bleach.
- C. If my grandchild eats a plant, I should provide syrup of ipecac.
- D. The number for poison control is 800-222-1222.
Correct answer: C
Rationale: The correct answer is C. Administering syrup of ipecac is no longer recommended in cases of poisoning. This is because it can lead to complications and is not considered safe. The grandparent should be informed that syrup of ipecac should not be given to a child who has ingested a toxic substance. Choices A, B, and D provide accurate information regarding actions to take in case of poisoning, such as calling 911 if the child loses consciousness, not inducing vomiting if the child drinks bleach, and having the poison control number readily available.
3. A client is receiving heparin therapy. Which laboratory value should be monitored by the nurse to evaluate the effectiveness of the therapy?
- A. PT
- B. aPTT
- C. INR
- D. Platelet count
Correct answer: B
Rationale: The activated partial thromboplastin time (aPTT) is specifically used to monitor the effectiveness of heparin therapy. It should be maintained at 1.5 to 2 times the normal level. Monitoring aPTT helps ensure that the therapeutic range of heparin is achieved to prevent clot formation while minimizing the risk of bleeding complications. Choice A (PT) is incorrect as it is used to monitor warfarin therapy, not heparin. Choice C (INR) is also incorrect as it is primarily used to monitor warfarin therapy. Choice D (Platelet count) is not directly related to monitoring the effectiveness of heparin therapy.
4. When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?
- A. Communicate the blood glucose level and insulin dose to the circulating nurse in surgery.
- B. Discuss the reason for the use of insulin therapy during the immediate postoperative period.
- C. Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
- D. Plan strategies to minimize the risk for hypoglycemia or hyperglycemia during the postoperative period.
Correct answer: C
Rationale: The correct answer is C because the administration of prescribed lispro (Humalog) insulin before transporting the patient to surgery is a task that can be safely delegated to a licensed practical/vocational nurse (LPN/LVN). This action is within the scope of practice of an LPN/LVN and does not require independent nursing judgment. Choices A and B involve communicating and discussing important medical information, which are higher-level nursing actions typically performed by registered nurses. Choice D involves planning strategies to manage blood glucose levels postoperatively, which requires critical thinking and assessment skills usually performed by a registered nurse.
5. How should bleeding in a patient on warfarin be monitored?
- A. Monitor INR levels
- B. Monitor hemoglobin levels
- C. Monitor potassium levels
- D. Monitor platelet count
Correct answer: A
Rationale: The correct answer is to monitor INR levels. INR levels are the most critical indicator for monitoring bleeding risk in patients on warfarin. INR stands for International Normalized Ratio and specifically measures the clotting tendency of the blood. Monitoring hemoglobin levels, potassium levels, or platelet count are not as directly relevant to assessing bleeding risk in patients on warfarin.
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