Exam (elaborations)
ATI Capstone NCLEX Review A & B/ ATI Comprehensive 2024|2025 A & B
- Course
- ATI Capstone NCLEX
- Institution
- Rasmussen College
ATI Capstone NCLEX Review A & B/ ATI Comprehensive 2024|2025 A & B
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ATI Capstone NCLEX Review2024 A & B/ ATIComprehensive 2024 A & B
4 steps of Critical Thinking * ANSWER 1. identify and analyze the problem; 2. recall info you need to
resolve the problem; 3. evaluate each option; 4. select the correct or priority option
5*HT3 receptor antagonists (serotonin antagonists) * ANSWER Dolasetron (Anzemet)
Granisetron (Kytril, Sancuso)
OndANSWER etron (Zofran)
Tropisetron (Navoban)
It's 'Tron' to the rescue!
a 45*year*old client is taking methylprednisolone. What pharmacological action should the nurse expect
with this therapy? * ANSWER corticosteroids, such as methylprednisolone, will suppress airway mucus
production; therapy should promote responsiveness of beta2 receptors. Adverse effects of this
medication include bone loss and formation of candidiasis
a 52*year*old client with a Hx of angina has been prescribed trANSWER dermal nitroglycerin. Which of
the following adverse effects is not seen with this therapy? * ANSWER productive cough; nitroglycerin
therapy does not directly have an effect lung function. Physiologically, vasodilation should effect capillary
perfusion and decrease lung secretions.
a client has been prescribed lisinopril. What medication interaction should the nurse instruct this client
about? * ANSWER Potassium supplements and potassium*sparing diuretics increase the risk of
hyperkalemia in clients taking ACE inhibitors such as lisinopril. Clients should only take potassium
supplements if prescribed by the provider. Clients should also avoid salt substitutes that contain
potassium.
a client is prescribed propranolol. What client history findings would require the nurse to clarify this
prescription? * ANSWER asthma; clients with asthma should avoid Beta2 Blockade agents such as
propranolol. Bronchoconstriction can occur. Clients with asthma should be administered a beta1selective
agent.
1
,A client is taking disulfiram daily for abstinence maintenance. What is an adverse effect of disulfiram? *
ANSWER hepatotoxicity
a nurse is caring for a client with prescribed digoxin. What should alert the nurse to possible digitalis
toxicity? * ANSWER Anorexia, fatigue and weakness are signs of potential digitalis toxicity. GI effects of
digitalis toxicity include anorexia, nausea, vomiting and abdominal pain. CNS effects include fatigue,
weakness, vision changes (diplopia, blurred vision, yellow*green or white halos around objects).
Bradycardia is also commonly noted in digitalis toxicity.
a nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client. What
is the correct order the nurse should follow? * ANSWER inspect the vials for contaminants, roll NPH vial
between palms of hands, inject air into NPH insulin vial, inject air onto regular Insulin vial, withdraw
short*acting insulin into syringe
add intermediate insulin to syringe; when the prescription requires the administration of two types of
insulin, it is preferable to mix the solutions into one syringe if they are compatible to prevent the client
from receiving two injections. The mixture is stable for 28 days.
a nurse is preparing to administer bisacodyl suppository to a client. What actions should the nurse take?
* ANSWER Don clean gloves, lubricate index finger with sterile water*soluble lubricating jelly, position the
client on the left lateral side, gently retract the buttocks with the nondominant hand, insert the
suppository gently through the anus, past the internal sphincter, and against the rectal wall. Following the
administration of the medication, the nurse should apply gentle pressure to hold the buttocks together
momentarily if needed to keep medication in place.
activated partial thromboplastin time (aPTT) * ANSWER 20*36; to maintain a therapeutic level of
anticoagulation while on heparin, the aPTT should be 1.5 to 2 times the normal value (60 to 80 seconds).
adolescents's risks for injury can stem from * ANSWER increased desire to make independent decisions
and relying on peers for guidance rather than family
AFTER THE CLOT HAS LEFT THE BUILDING (Thrombolytics) * ANSWER Administer beta blockers to decrease
myocardial oxygen consumption and reduce the incidence and severity of reperfusion arrhythmias.
Analysis/data collection requires nurses to look at the data and: * ANSWER recognize patterns or trends;
compare the data with expected standards or reference ranges, and arrive to conclusions to guide
nursing care
Antianemics * ANSWER Instruct clients to take iron on an empty stomach such as 1 hr before meals to
maximize absorption. Stomach acid increases absorption. Instruct clients to space doses at
2
,approximately equal intervals throughout day to most efficiently increase red blood cell production.
Instruct clients to increase water and fiber intake (unless contraindicated), and to maintain an exercise
program to counter the constipation effects. Encourage concurrent intake of appropriate quantities of
foods high in iron (liver, egg yolks, muscle meats, yeast).
Anticoagulant common meds * ANSWER heparin, coumadin
Anticoagulants * ANSWER Anticoagulants prevent the formation of blood clots by interfering with the
clotting cascade, thereby preventing coagulation. The use of this class of medications is contraindicated
with active bleeding, such as with bleeding disorders, ulcers, or hemorrhagic brain injuries.
Antiemetics * ANSWER used in the treatment and/or prevention of nausea and vomiting.
Antihistamines (H1 histamine receptor antagonists) * ANSWER Diphenhydramine (Benadryl)
Dimenhydrinate (Gravol, Dramamine)
Meclizine (Bonine, Antivert)
Antiplatelet Nursing Interventions * ANSWER WATCH FOR BLEEDING. These medications should be taken
with food; these medications should be used cautiously in clients with peptic ulcer disease and in clients
with severe renal/hepatic disorders.
Antiplatelets * ANSWER Antiplatelets prevent platelets from clumping together by inhibiting enzymes and
factors that normally cause arterial clotting; used to prevent myocardial infarction and stroke. Low dose
therapy (81 mg) is effective for prevention of strokes and MI.
Assessment/Data collection * ANSWER the systemic collection of information about clients' present
health statuses to identify needs and additional data to collect based on findings
before administering blood products, which action should be taken? * ANSWER assess the client's
temperature; assess the client's vital signs, obtain consent for the procedure and ensure compatibility.
Prime the IV tubing with 0.9% sodium chloride. The nurse would not document client response or
administer epinephrine prior to starting the trANSWER fusion.
Black Cohosh * ANSWER Acts on the female reproductive system as an estrogen substitute. May be used
instead of estrogen therapy during menopause. Increases the effects of antihypertensive medications and
may increase effect of estrogen medications. Increases hypoglycemia in clients who are taking insulin or
other medications for diabetes.
3
, clients with diabetes mellitus should eat what when their blood glucose is low? * ANSWER they should eat
a snack of 10*15 grams of carbohydrates, such as 120 mL or 4 oz of fruit juice
collaborative interventions * ANSWER interventions nurses carry out in collaboration with other health
care team professionals (ensuring that a client receives and eats their evening snack)
Common antiplatelets * ANSWER Aspirin (Ecotrin)
Clopidogrel (Plavix)
Pentoxifylline (Trental)
common classes of antiemetics * ANSWER 5*HT3 receptor antagonists (serotonin antagonists);
Dopamine antagonists; Antihistamines (H1 histamine receptor antagonists)
common Erectile Dysfunction meds * ANSWER Sildenafil (Viagra)
Vardenafil (Levitra)
Tadalafil (Cialis)
Notice these end in 'fil'. 'Fil' helps the nitric oxide to 'fil' the penis.
Common herbal supplements * ANSWER echinacea, ginger root, ginkgo biloba, valerian, black cohosh
Common PPIs * ANSWER Omeprazole (brand names: Prilosec, Zegerid, Omepral, Omez)
LANSWER oprazole (brand names: Prevacid, Zoton, Inhibitol)
DexlANSWER oprazole (brand name: Kapidex, Dexilant)
Esomeprazole (brand names: Nexium, Esotrex)
Pantoprazole (brand names: Protonix, Somac, Pantozol, Zentro)
COUMADIN * ANSWER C*oumadin (generic name Warfarin sodium) interferes with coagulation factors by
antagonizing vitamin K.
O*ral administration is typically used. Clients may need continued heparin infusion via IV until therapeutic
effect of Coumadin is experienced (may take 3*5 days).
U*se is contraindicated in clients with low platelet counts or uncontrolled bleeding.
M*ephyton (trade name vitamin K) is the antidote for Coumadin.
A*dvise clients to avoid foods that are high in vitamin K, and avoid the use of acetaminophen,
glucocorticoids, and aspirin. Clients should wear a medical alert bracelet indicating warfarin use.
D*oses are typically taken once daily.
I*NR and PT are monitored for clients who are taking Coumadin. Depending on intent of therapy, PT should
be 1.5 to 2 times control and INR should be 2*3. Target INR is 3 to 4.5 for clients with a mechanical heart
valve.
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