ATI RN Pharmacology Final

Free preview · Original latest version

Sample questions from ATI RN Pharmacology Final

This material has 60 questions with answers and rationales. Here are the first 5.

1. 1.A provider prescribes gentamicin 5 mg/kg IV every 24 hr for a child who weighs 18 kg. The available solution contains 40 mg/mL. How many milliliters should the nurse administer per dose?

   • A.22.5 mL
   • B.2.25 mL
   • C.4.5 mL
   • D.0.45 mL

   Rationale: The prescribed dose is 5 mg/kg x 18 kg = 90 mg, and 90 mg divided by 40 mg/mL equals 2.25 mL; however, this calculation identifies a discrepancy with the keyed volume. The correct volume is 2.25 mL, so the nurse should administer that amount. A volume of 0.45 mL or 22.5 mL reflects decimal or conversion errors, and 4.5 mL would deliver 180 mg. Always calculate the dose in milligrams before converting to milliliters.

2. 2.Refer to the client's chart. Which actions should the nurse take in response to the current findings? Select all that apply.

   • A.Hold the next warfarin dose and contact the prescribing provider.
   • B.Administer the prescribed dose because the client has no visible bleeding.
   • C.Instruct the client to take an extra dose of warfarin to prevent a clot.
   • D.Assess for bleeding, including a focused assessment of urine, stool, gums, and skin.
   • E.Review the new antibiotic and other medications for potential interactions.
   • F.Give an intramuscular vitamin K dose before obtaining a prescription.

   Rationale: The INR has risen from 2.6 to 5.1 after a new antibiotic was started, so the nurse should hold the next dose, notify the provider, and assess for occult as well as visible bleeding. Reviewing the antibiotic is important because medications can alter warfarin metabolism and increase anticoagulant effect. Giving the dose because bleeding is not visible ignores the elevated INR, while vitamin K requires an appropriate prescription and an intramuscular route can cause hematoma. An extra warfarin dose would further increase bleeding risk.

3. 3.During a home visit, a client with chronic pain reports that a newly applied transdermal fentanyl patch is not relieving pain. The previous patch is still in place on the upper back. Which action should the nurse take first?

   • A.Cut the new patch in half and reapply it to reduce adverse effects.
   • B.Apply a heating pad over the new patch to increase medication absorption.
   • C.Apply a second patch to a different site to provide the prescribed dose.
   • D.Remove the old patch and assess the client's respiratory rate and level of sedation.

   Rationale: The old patch must be removed to prevent unintended dose stacking, and respiratory status and sedation require prompt assessment because fentanyl can cause respiratory depression. Applying another patch could deliver an excessive dose, especially while the first patch is still releasing medication. Heat can increase transdermal absorption and cause toxicity, and patches should not be cut because this can alter drug delivery. Confirm patch instructions and removal timing during medication teaching.

4. 4.At change of shift, a nurse reviews laboratory results for four clients receiving medications. Which result requires the most immediate follow-up before the next dose is administered?

   • A.A client receiving metformin with a fasting glucose of 142 mg/dL (reference range 70 to 99 mg/dL)
   • B.A client receiving gentamicin with a trough level of 3.2 mcg/mL when the prescribed target is less than 2 mcg/mL
   • C.A client receiving levothyroxine with a TSH of 6.1 mIU/L (reference range 0.4 to 4.0 mIU/L)
   • D.A client receiving oral iron with a hemoglobin of 10.8 g/dL (reference range 12 to 16 g/dL)

   Answer and rationale are in the full material.

5. 5.A parent of a 3-month-old infant says, "The medicine spills out when I use the spoon, so I mix it into a full bottle." Which response by the nurse is best?

   • A.Use an oral syringe to measure and slowly place the medicine inside the infant's cheek.
   • B.Mix the medicine into a small amount of formula and give it before the rest of the bottle.
   • C.Place the measured dose at the back of the infant's throat to prevent spitting.
   • D.Add the medicine to the full bottle and increase the amount if the infant does not finish it.

   Answer and rationale are in the full material.