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PN ATI Capstone Proctored Comprehensive Assessment 2020 A
1. A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication?
- A. Hearing examination
- B. Glucose tolerance test
- C. Electrocardiogram
- D. Pulmonary function tests
Correct answer: C
Rationale: The correct answer is C: Electrocardiogram. Amitriptyline can cause cardiac arrhythmias, so an electrocardiogram is necessary before starting treatment. A hearing examination (choice A) is not required before initiating amitriptyline. A glucose tolerance test (choice B) is not indicated for starting this medication. Pulmonary function tests (choice D) are not necessary before initiating amitriptyline for depression.
2. A nurse is preparing to administer amoxicillin 250 mg liquid suspension PO every 8 hr to an older adult client. The amount available is amoxicillin 50 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number)
- A. 5 mL
- B. 6 mL
- C. 4 mL
- D. 7 mL
Correct answer: A
Rationale: To calculate the amount of amoxicillin in mL needed per dose, we can use the formula: 50 mg/mL = 250 mg / X mL. Cross multiply to solve for X: 50X = 250. Divide both sides by 50 to find X, which equals 5 mL per dose. Therefore, the nurse should administer 5 mL of amoxicillin per dose. Choice B, 6 mL, is incorrect as it does not match the calculated result. Choice C, 4 mL, is incorrect as it is too low based on the calculation. Choice D, 7 mL, is incorrect as it is too high based on the calculation.
3. 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.
4. A nurse is reviewing the laboratory values for a client who is receiving a continuous IV heparin infusion and has an aPTT of 90 seconds. Which of the following actions should the nurse prepare to take?
- A. Administer vitamin K
- B. Reduce the infusion rate
- C. Give the client a low-dose aspirin
- D. Request an INR
Correct answer: B
Rationale: An aPTT of 90 seconds is elevated, indicating a risk of bleeding due to excessive anticoagulation. The appropriate action is to reduce the infusion rate of heparin to prevent further complications. Administering vitamin K is not indicated for an elevated aPTT due to heparin therapy. Giving the client a low-dose aspirin can further increase the risk of bleeding when combined with heparin. Requesting an INR is not necessary for monitoring heparin therapy; aPTT is the more specific test for assessing heparin's therapeutic effect. Therefore, the correct action for the nurse to prepare to take is to reduce the infusion rate of heparin.
5. A client with a severe urinary tract infection (UTI) asks why both ciprofloxacin and phenazopyridine are needed. Which of the following responses should the nurse make?
- A. Phenazopyridine decreases adverse effects of ciprofloxacin.
- B. Combining phenazopyridine with ciprofloxacin shortens the course of therapy.
- C. The use of phenazopyridine allows for a lower dosage of ciprofloxacin.
- D. Ciprofloxacin treats the infection, and phenazopyridine treats pain.
Correct answer: D
Rationale: Ciprofloxacin is an antibiotic that treats the infection, while phenazopyridine is a urinary analgesic that relieves pain. Choice A is incorrect because phenazopyridine does not decrease adverse effects of ciprofloxacin; it primarily addresses pain. Choice B is incorrect because combining phenazopyridine with ciprofloxacin does not shorten the course of therapy; they serve different purposes. Choice C is incorrect because the use of phenazopyridine does not allow for a lower dosage of ciprofloxacin; they have independent roles in UTI management.
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