ATI LPN
PN ATI Capstone Proctored Comprehensive Assessment A
1. A nurse is preparing to administer ampicillin 500 mg in 50 ml of dextrose 5% in water (D5W) to infuse over 15 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the nurse set the manual IV infusion to deliver? (Round to the nearest whole number)
- A. 33 gtt/min
- B. 66 gtt/min
- C. 10 gtt/min
- D. 14 gtt/min
Correct answer: A
Rationale: To calculate the IV flow rate, you multiply the drop factor (10 gtt/mL) by the volume to be infused per minute (50 mL / 15 min). This gives you 10 gtt/mL × 50 mL / 15 min = 33.33. Rounding to the nearest whole number, the nurse should set the manual IV infusion to deliver 33 gtt/min. Choice B (66 gtt/min) is incorrect as it is the result of doubling the correct answer. Choice C (10 gtt/min) is incorrect as it only considers the drop factor without accounting for the volume to be infused. Choice D (14 gtt/min) is incorrect as it miscalculates the infusion rate based on the given information.
2. 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.
3. When administering subcutaneous epinephrine for a client experiencing anaphylaxis, what adverse effect should the nurse monitor for?
- A. Hypotension
- B. Hyperthermia
- C. Hypoglycemia
- D. Tachycardia
Correct answer: D
Rationale: The correct adverse effect to monitor for when administering subcutaneous epinephrine for anaphylaxis is tachycardia. Epinephrine stimulates adrenergic receptors, leading to an increased heart rate (tachycardia). Hypotension (Choice A) is less likely due to the vasoconstrictive effects of epinephrine. Hyperthermia (Choice B) and hypoglycemia (Choice C) are not commonly associated with epinephrine administration for anaphylaxis.
4. A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask-like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering?
- A. Amantadine
- B. Bupropion
- C. Phenelzine
- D. Hydroxyzine
Correct answer: A
Rationale: The correct answer is Amantadine. Amantadine is used to treat extrapyramidal symptoms, such as mask-like facial expressions, involuntary movements, and tremors, which are common side effects of antipsychotic medications like chlorpromazine. Bupropion is an antidepressant and not indicated for treating these symptoms. Phenelzine is a monoamine oxidase inhibitor used for depression and anxiety disorders, not for extrapyramidal symptoms. Hydroxyzine is an antihistamine used for anxiety and allergic conditions, not for the side effects described in the client.
5. 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.
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