ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment 2020 A
1. 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.
2. A healthcare professional is reviewing the laboratory results for a client who has a prescription for filgrastim. The healthcare professional should recognize that an increase in which of the following values indicates a therapeutic effect of this medication?
- A. Erythrocyte count
- B. Neutrophil count
- C. Lymphocyte count
- D. Thrombocyte count
Correct answer: B
Rationale: Filgrastim is a medication used to stimulate the production of neutrophils in patients with neutropenia. Neutrophils are a type of white blood cell that plays a crucial role in fighting off infections. Therefore, an increase in neutrophil count would indicate a therapeutic effect of filgrastim. The other options, such as erythrocyte count (red blood cells), lymphocyte count, and thrombocyte count (platelets), are not directly affected by filgrastim and would not indicate a therapeutic effect of this medication.
3. A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects?
- A. Hyperkalemia
- B. Hypertension
- C. Constipation
- D. Nephrotoxicity
Correct answer: D
Rationale: Correct. Amphotericin B is known for its nephrotoxicity, which can lead to kidney damage. Monitoring kidney function is crucial to detect any signs of nephrotoxicity early. Choices A, B, and C are incorrect because hyperkalemia, hypertension, and constipation are not typically associated with amphotericin B use. Therefore, the nurse should focus on monitoring for nephrotoxicity.
4. A healthcare professional is planning to administer diltiazem via IV bolus to a client who has atrial fibrillation. When assessing the client, the healthcare professional should recognize that which of the following findings is a contraindication to the administration of diltiazem?
- A. Hypotension
- B. Tachycardia
- C. Decreased level of consciousness
- D. History of diuretic use
Correct answer: A
Rationale: Diltiazem, a calcium channel blocker, can cause hypotension. Administering it to a client who already has hypotension could exacerbate this condition. Therefore, hypotension is a contraindication to the administration of diltiazem. Incorrect Choices: B) Tachycardia is not a contraindication for administering diltiazem in atrial fibrillation as it is commonly used to control the heart rate. C) Decreased level of consciousness may require evaluation but is not a direct contraindication to diltiazem administration. D) History of diuretic use is not a contraindication if the client is not currently experiencing hypotension.
5. A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects?
- A. Increases blood pressure
- B. Prevents esophageal bleeding
- C. Decreases heart rate
- D. Reduces ammonia levels
Correct answer: D
Rationale: The correct answer is D: Reduces ammonia levels. Lactulose is used to reduce blood ammonia levels in clients with hepatic encephalopathy. Options A, B, and C are incorrect because lactulose does not have the therapeutic effect of increasing blood pressure, preventing esophageal bleeding, or decreasing heart rate.
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