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 client with congestive heart failure taking digoxin reports nausea and refuses to eat breakfast. Which action should the nurse take first?
- A. Encourage the client to eat the toast on the breakfast tray.
- B. Administer an antiemetic.
- C. Inform the client's provider.
- D. Check the client's apical pulse.
Correct answer: D
Rationale: The correct action for the nurse to take first is to check the client's apical pulse. Nausea can be a sign of digoxin toxicity, and one of the early signs of digoxin toxicity is changes in the pulse rate. By checking the client's apical pulse, the nurse can assess if the digoxin level is too high. Encouraging the client to eat or administering an antiemetic may not address the underlying issue of digoxin toxicity. While informing the provider is important, assessing the client's condition through checking the apical pulse should be the immediate priority.
3. A nurse is preparing to administer prochlorperazine 2.5 mg IV. Available is prochlorperazine injection 5 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth)
- A. 0.5 mL
- B. 0.005 mL
- C. 0.05 mL
- D. 5 mL
Correct answer: A
Rationale: To calculate the mL needed, set up a proportion: 5 mg / 1 mL = 2.5 mg / X mL. Cross multiply to find X: 5 * X = 2.5 * 1, X = 2.5 / 5 = 0.5 mL. Therefore, the nurse should administer 0.5 mL. Choice B, 0.005 mL, is incorrect as it doesn't match the calculated result. Choice C, 0.05 mL, is incorrect as it is ten times the correct value. Choice D, 5 mL, is incorrect as it represents the total volume of the entire vial, not the amount needed for the specific dose.
4. A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching?
- A. Take hydrochlorothiazide as needed for edema.
- B. Check your weight once weekly.
- C. Take the hydrochlorothiazide on an empty stomach.
- D. Take the hydrochlorothiazide in the morning.
Correct answer: D
Rationale: The correct answer is to take hydrochlorothiazide in the morning. This medication is usually advised to be taken in the morning to prevent nocturia, which is excessive urination at night. Option A is incorrect because hydrochlorothiazide should be taken daily as prescribed, not as needed for edema. Option B is incorrect as monitoring weight weekly may not be specifically related to hydrochlorothiazide therapy. Option C is incorrect as hydrochlorothiazide does not need to be taken on an empty stomach.
5. A nurse is preparing to administer an enteral tube feeding through an NG tube at 250 mL over 4 hr. The nurse should set the pump to deliver how many mL/hr? (Round the answer to the nearest whole number)
- A. 63 mL/hr
- B. 36 mL/hr
- C. 78 mL/hr
- D. 90 mL/hr
Correct answer: A
Rationale: To calculate the rate for the enteral tube feeding, divide the total volume by the total time: 250 mL / 4 hr = 62.5 ≈ 63 mL/hr. Therefore, the nurse should set the pump to deliver 63 mL/hr. Choices B, C, and D are incorrect as they do not match the correct calculation result. B is too low, C is too high, and D is also too high based on the correct calculation.
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