ATI RN
ATI Pediatric Proctored Exam
1. What is the most appropriate nursing consideration for a patient who is prescribed verapamil and digoxin?
- A. Restrict intake of oral fluids and high-fiber foods
- B. Take an apical pulse for 30 seconds before administration
- C. Notify the healthcare provider of nausea, vomiting, and visual changes
- D. Hold the medications if the heart rate is greater than 110 bpm
Correct answer: C
Rationale: When a patient is prescribed verapamil and digoxin, it is crucial to monitor for signs of digoxin toxicity due to the potential interaction between these medications. Verapamil can elevate digoxin blood serum levels, increasing the risk of toxicity. Symptoms of digoxin toxicity include nausea, vomiting, and visual changes. Therefore, the most appropriate nursing consideration is to notify the healthcare provider of these symptoms. Restricting intake of oral fluids and high-fiber foods is not a specific consideration related to this medication combination. Before administering digoxin, it is essential to take an apical pulse for a full minute, not just 30 seconds, to ensure accuracy. Additionally, holding the medications if the heart rate exceeds 110 bpm is not a typical response to the combination of verapamil and digoxin, which can cause bradycardia rather than tachycardia.
2. The caregiver is teaching a parent of a young child with a newly diagnosed seizure disorder. The child is prescribed valproic acid (Depakote) for control of seizures. Which parental statement indicates the need for further education?
- A. I will not use carbonated beverages to dilute his medication.
- B. I will give his medication with food to minimize gastrointestinal upset.
- C. I will not let him chew his tablet.
- D. I will bring him to the physician's office for regular blood work to check his blood levels.
Correct answer: B
Rationale: The correct answer is B. Valproic acid should be administered with food to reduce the risk of gastrointestinal upset. Giving it on an empty stomach may increase the likelihood of adverse effects. The other statements are correct: A - Carbonated beverages should not be used to dilute the medication, C - The tablet should not be chewed, and D - Regular blood work is necessary to monitor valproic acid levels and potential side effects.
3. When teaching a parent of a child with hemophilia, which of the following instructions should the nurse include?
- A. Administer aspirin for pain.
- B. Avoid administering NSAIDs.
- C. Restrict physical activities.
- D. Apply heat to joints.
Correct answer: B
Rationale: The correct answer is B: 'Avoid administering NSAIDs.' Hemophilia is a condition where blood does not clot properly. NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) can increase the risk of bleeding in individuals with hemophilia. Therefore, it is crucial for the parent to avoid giving their child NSAIDs for pain management to prevent exacerbating bleeding tendencies. Choice A is incorrect because aspirin, like NSAIDs, can also increase the risk of bleeding. Choice C is incorrect because physical activities should not be restricted but rather managed to prevent injuries that could lead to bleeding. Choice D is incorrect because applying heat to joints can worsen bleeding in individuals with hemophilia.
4. A nurse administers naloxone (Narcan) to a post-op patient experiencing respiratory sedation. What undesirable effect would the nurse anticipate after giving this medication?
- A. Drowsiness
- B. Tics and tremors
- C. Increased Pain
- D. Nausea and vomiting
Correct answer: C
Rationale: Naloxone reverses the effects of narcotics. Although the patient�s respiratory status will improve after administration of naloxone, the pain will be more acute.
5. What is the last step in interpersonal reasoning?
- A. Choose a response or mode sequence
- B. Gather Feedback
- C. Anticipate
- D. Determine if a mode shift is required
Correct answer: B
Rationale: The last step in interpersonal reasoning involves gathering feedback. Once you have gone through the process of anticipating, choosing a response or mode sequence, and determining if a mode shift is required, the final step is to gather feedback to assess the effectiveness of your interaction and make any necessary adjustments.
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