PHARMACOLOGY ATI RN PROCTORED EXAM
[DATE]
[COMPANY NAME]
[Company address]
, PHARMACOLOGY ATI RN PROCTORED EXAM
1. Nurse has just received a bag of packed red blood cells (RBCs) for a patient.
What is the longest time the nurse can let the blood infuse?
a. 30 minutes
b. 2 hours
c. 4 hours
d. 6 hours
ANS: C
Ideally a unit of whole blood or packed RBCs is transfused in 2 hours. This time
can be lengthened to 4 hours if the patient is at risk for extracellular volume
excess. Beyond 4 hours there is a risk for bacterial contamination of the blood.
1. patient has an acute intravascular hemolytic reaction to a blood transfusion.
After discontinuing the blood transfusion, which is the nurse’s next action?
a. Discontinue the IV catheter.
b. Return the blood to the blood bank.
c. Run normal saline through the existing tubing.
d. Start normal saline at TKO rate using new tubing.
ANS: D
The nurse should first attach new tubing and begin running in normal saline at a
rate to keep the vein open, in case any medications need to be delivered through
an IV site. The existing tubing should not be used because
that would infuse the blood in the tubing into the patient. It is necessary to
preserve the IV catheter in place for IV access to treat the patient. After the
patient has been assessed and stabilized, the blood can be returned to the blood
bank.
38.A nurse is assessing a patient who is receiving a blood transfusion and
finds that the patient is anxiously fidgeting in bed. The patient is afebrile and
dyspneic. The nurse auscultates crackles in both lung bases and sees jugular
vein distention. On which transfusion complication will the nurse focus
interventions?
1
, a. Fluid volume overload
b. Hemolytic reaction
c. Anaphylactic shock
d. Septicemia
ANS: A
The signs and symptoms are concurrent with fluid volume overload.
Anaphylactic shock would have presented with urticaria, dyspnea, and
hypotension. Septicemia would include a fever. A hemolytic reaction would
consist of flank pain, chills, and fever.
39.A nurse is preparing to start a blood transfusion. Which type of tubing will the
nurse obtain?
Two-way valves to allow the patient’s blood to mix and warm the
a. blood transfusing
b. An injection port to mix additional electrolytes into the blood
c. A filter to ensure that clots do not enter the patient
d. An air vent to let bubbles into the blood
ANS: C
When administering a transfusion you need an appropriate-size IV catheter and
blood administration tubing that has a special in-line filter. The patient’s blood
should not be mixed with the infusion blood. Air bubbles should not be allowed
to enter the blood. The only substance compatible with blood is normal saline;
no additives should be mixed with the infusing blood.
40. The nurse is caring for a patient with hyperkalemia. Which body system
assessment is the priority?
a. Gastrointestinal
b. Neurological
c. Respiratory
d. Cardiac
ANS: D
Cardiac is the priority. Hyperkalemia places the patient at risk for potentially
2
[DATE]
[COMPANY NAME]
[Company address]
, PHARMACOLOGY ATI RN PROCTORED EXAM
1. Nurse has just received a bag of packed red blood cells (RBCs) for a patient.
What is the longest time the nurse can let the blood infuse?
a. 30 minutes
b. 2 hours
c. 4 hours
d. 6 hours
ANS: C
Ideally a unit of whole blood or packed RBCs is transfused in 2 hours. This time
can be lengthened to 4 hours if the patient is at risk for extracellular volume
excess. Beyond 4 hours there is a risk for bacterial contamination of the blood.
1. patient has an acute intravascular hemolytic reaction to a blood transfusion.
After discontinuing the blood transfusion, which is the nurse’s next action?
a. Discontinue the IV catheter.
b. Return the blood to the blood bank.
c. Run normal saline through the existing tubing.
d. Start normal saline at TKO rate using new tubing.
ANS: D
The nurse should first attach new tubing and begin running in normal saline at a
rate to keep the vein open, in case any medications need to be delivered through
an IV site. The existing tubing should not be used because
that would infuse the blood in the tubing into the patient. It is necessary to
preserve the IV catheter in place for IV access to treat the patient. After the
patient has been assessed and stabilized, the blood can be returned to the blood
bank.
38.A nurse is assessing a patient who is receiving a blood transfusion and
finds that the patient is anxiously fidgeting in bed. The patient is afebrile and
dyspneic. The nurse auscultates crackles in both lung bases and sees jugular
vein distention. On which transfusion complication will the nurse focus
interventions?
1
, a. Fluid volume overload
b. Hemolytic reaction
c. Anaphylactic shock
d. Septicemia
ANS: A
The signs and symptoms are concurrent with fluid volume overload.
Anaphylactic shock would have presented with urticaria, dyspnea, and
hypotension. Septicemia would include a fever. A hemolytic reaction would
consist of flank pain, chills, and fever.
39.A nurse is preparing to start a blood transfusion. Which type of tubing will the
nurse obtain?
Two-way valves to allow the patient’s blood to mix and warm the
a. blood transfusing
b. An injection port to mix additional electrolytes into the blood
c. A filter to ensure that clots do not enter the patient
d. An air vent to let bubbles into the blood
ANS: C
When administering a transfusion you need an appropriate-size IV catheter and
blood administration tubing that has a special in-line filter. The patient’s blood
should not be mixed with the infusion blood. Air bubbles should not be allowed
to enter the blood. The only substance compatible with blood is normal saline;
no additives should be mixed with the infusing blood.
40. The nurse is caring for a patient with hyperkalemia. Which body system
assessment is the priority?
a. Gastrointestinal
b. Neurological
c. Respiratory
d. Cardiac
ANS: D
Cardiac is the priority. Hyperkalemia places the patient at risk for potentially
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