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PN ATI Capstone Proctored Comprehensive Assessment A
1. A nurse on a medical unit is preparing to administer alendronate 40 mg PO for an older adult client who has Paget's disease of the bone. Which of the following actions should be the nurse's priority?
- A. Administer the medication to the client before breakfast in the morning.
- B. Assist the client to a chair before administering the medication.
- C. Give the medication to the client with water rather than milk.
- D. Educate the client on how to take the medication at home.
Correct answer: A
Rationale: The correct answer is to administer the medication to the client before breakfast in the morning. Alendronate should be taken on an empty stomach before breakfast to ensure optimal absorption. Choice B is incorrect because assisting the client to a chair is not directly related to the administration of alendronate. Choice C is incorrect as there is no specific requirement to avoid taking alendronate with milk. Choice D is also incorrect as the priority at this moment is the correct administration of the medication in the hospital setting.
2. A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should include that a severe allergy to which of the following medications is a contraindication to ceftriaxone?
- A. Gentamicin
- B. Clindamycin
- C. Piperacillin
- D. Sulfamethoxazole-trimethoprim
Correct answer: C
Rationale: The correct answer is C. Ceftriaxone, a cephalosporin antibiotic, has a cross-sensitivity with penicillin antibiotics like piperacillin. Therefore, a severe allergy to penicillin or penicillin-related antibiotics would be a contraindication to ceftriaxone. Choices A, B, and D are incorrect because they are not associated with a known cross-sensitivity with ceftriaxone.
3. A nurse is preparing to administer furosemide 4 mg/kg/day PO divided into 2 equal doses daily to a toddler who weighs 22 lb. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number)
- A. 20 mg
- B. 15 mg
- C. 10 mg
- D. 30 mg
Correct answer: A
Rationale: To calculate the dosage per dose, first, convert the toddler's weight from pounds to kilograms: 22 lb / 2.2 = 10 kg. Then, multiply the weight by the dosage: 4 mg × 10 kg = 40 mg/day. Since this total daily dose is divided into 2 equal doses, the nurse should administer 20 mg per dose. Therefore, the correct answer is 20 mg. Choice B (15 mg) is incorrect because it does not account for the correct weight conversion and dosage calculation. Choice C (10 mg) is incorrect as it only considers the weight conversion but doesn't multiply it by the dosage. Choice D (30 mg) is incorrect as it miscalculates the dosage by not dividing the total daily dose into 2 equal parts.
4. A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse should anticipate a prescription for which of the following medications?
- A. Methimazole
- B. Somatropin
- C. Levothyroxine
- D. Propylthiouracil
Correct answer: C
Rationale: Levothyroxine is the correct answer. In this scenario, the client's elevated TSH and decreased T3 and T4 levels indicate hypothyroidism, a condition where the thyroid gland does not produce enough hormones. Levothyroxine is a synthetic form of thyroid hormone that is used to replace or supplement the body's naturally produced thyroid hormones. Methimazole and Propylthiouracil are used to treat hyperthyroidism by reducing the production of thyroid hormones. Somatropin is a growth hormone used to treat growth hormone deficiency and other conditions unrelated to thyroid disorders.
5. A nurse is preparing a discharge teaching plan for a client who is to begin long-term oral prednisone for asthma. Which of the following instructions should the nurse include in the plan?
- A. Stop taking the medication if a rash occurs.
- B. Take the medication on an empty stomach to enhance absorption.
- C. Schedule the medication on alternate days to decrease adverse effects.
- D. Treat shortness of breath with an extra dose of the medication.
Correct answer: C
Rationale: When initiating long-term oral prednisone therapy for asthma, it is essential to schedule the medication on alternate days. This approach helps reduce the risk of adverse effects commonly associated with corticosteroid use. Choice A is incorrect because abrupt discontinuation of prednisone can lead to adrenal insufficiency. Choice B is incorrect as prednisone should be taken with food to minimize gastrointestinal side effects. Choice D is incorrect because using an extra dose of prednisone to treat shortness of breath is not appropriate and can lead to overdosing.
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