ATI RN
RN Pediatric Nursing 2023 ATI
1. The nurse is reviewing the prescriber�s orders and notes that omeprazole has been order for a patient admitted with acute coronary syndrome (ACS). The nurse should be concerned if this medication is combined with which medication noted on the patient�s record.
- A. Aspirin 81mg daily
- B. Clopidogrel (Plavix) 75mg daily
- C. Heparin 5000 units subQ q12hrs
- D. Metoprolol 50mg q8hrs
Correct answer: B
Rationale: For patients who lack risk factors for GI bleeding, combined use of clopidogrel with a PPI, may reduce the effects of clopidogrel without offering any real benefits and thus should be avoided.
2. For which patient diagnosis would a prescription for nifedipine be least appropriate?
- A. Angina Pectoris
- B. Essential HTN
- C. Atrial Fibrillation
- D. Vasospastic Angina
Correct answer: C
Rationale: Nifedipine primarily acts as a calcium channel blocker, exerting its effects on vascular smooth muscle. It is not effective for treating dysrhythmias like Atrial Fibrillation, which involve abnormalities in the heart's electrical system. Nifedipine is commonly prescribed for conditions such as angina pectoris, essential hypertension, and vasospastic angina due to its vasodilatory and anti-anginal properties. Choices A, B, and D are more appropriate as nifedipine can help in managing angina pectoris, hypertension, and vasospastic angina by reducing myocardial oxygen demand and dilating coronary arteries.
3. Which urinalysis result should the nurse anticipate for a child admitted with acute glomerulonephritis?
- A. Bacteriuria and increased specific gravity
- B. Hematuria and proteinuria
- C. Proteinuria and decreased specific gravity
- D. Bacteriuria and hematuria
Correct answer: B
Rationale: In acute glomerulonephritis, the glomeruli become inflamed, leading to the leakage of red blood cells (hematuria) and proteins (proteinuria) into the urine. These are hallmark findings in this condition due to the damage to the glomerular filtration barrier. Bacteriuria, the presence of bacteria in the urine, is not typically associated with acute glomerulonephritis unless there is a concurrent urinary tract infection. Specific gravity may be normal or decreased due to the loss of proteins in the urine, rather than increased. Therefore, the correct anticipated urinalysis result for a child with acute glomerulonephritis is hematuria and proteinuria.
4. A patient is receiving glucocorticoids for the treatment of rheumatoid arthritis. The patient complains of having a headache. Which ordered medication should the nurse administer?
- A. Aspirin
- B. Acetaminophen
- C. Ibuprofen
- D. Naproxen Sodium (Aleve)
Correct answer: B
Rationale: When a patient is already receiving glucocorticoids for rheumatoid arthritis and complains of a headache, it is essential to consider the potential interactions and side effects of additional medications. Aspirin and NSAIDs like ibuprofen and naproxen sodium can increase the risk of gastrointestinal irritation and ulceration when used concurrently with glucocorticoids. Acetaminophen is a safer choice in this scenario for managing the patient's headache without exacerbating the gastrointestinal issues associated with the use of glucocorticoids. Acetaminophen does not have the same gastrointestinal side effects as aspirin, ibuprofen, or naproxen sodium, making it the most appropriate option for headache relief in this case.
5. Mary is excited to work with the family of a friend with whom she has lost contact. Mary hopes the family will be able to connect her with her friend and is looking forward to hearing about her friend. At the next session, she asks the mother many questions about her friend and they spend a lot of time discussing their home town, etc. Which statement describes this scenario?
- A. It is not therapeutic: The relationship serves no purpose
- B. It is therapeutic: Therapist, child, and family have a reciprocal caring relationship
- C. It is not therapeutic: Mary is benefiting, but not the child and family
- D. It is therapeutic: Both parties are benefiting in the relationship
Correct answer: C
Rationale: In this scenario, Mary's focus on her own needs and interests by asking the mother about her lost friend and hometown indicates a lack of therapeutic benefit for the child and family. Effective therapy should prioritize the needs and goals of the child and family, not the therapist's personal desires or connections. Therefore, this interaction is not therapeutic as it fails to address the primary purpose of the therapy, which is to benefit the child and family. Choice A is incorrect because while the relationship may not be therapeutic, it does serve a purpose for Mary. Choice B is incorrect as there is no indication of a reciprocal caring relationship in this scenario. Choice D is incorrect as the focus is primarily on Mary's personal interests, rather than mutual benefit in the therapeutic relationship.
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