NUR 2513Exam #2
Practice ATI Answer Key
2022.
1.A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client
refused breakfast and is complaining of nausea and weakness. Which of the following actions
should the nurse take first?
A. Check the client's vital signs.
Rationale: It is possible that the client's nausea is secondary to digoxin toxicity. By obtaining
vital signs, the nurse can assess for bradycardia, which is a symptom of digoxin
toxicity. The nurse should withhold the medication and call the provider if the
client's heart rate is less than 60 bpm.
B. Request a dietitian consult.
Rationale: While the dietitian might be able to assist the client with making appropriate food
choices, this is not the first action the nurse should take.
C. Suggest that the client rests before eating the meal.
Rationale: While this intervention might be appropriate, this is not the first action the nurse
should take.
D. Request an order for an antiemetic.
Rationale: While this intervention might relieve the client's nausea, this is not the first action
the nurse should take.
2.A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV
infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which
of the following responses should the nurse give?
A. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level."
Rationale: The effects of heparin begin within minutes. This response does not accurately
answer the client's question.
B. "A pharmacist is the person to answer that question."
Rationale: Contacting the pharmacist is not the appropriate answer for the nurse to give.
C. "Heparin does not dissolve clots. It stops new clots from forming."
Rationale: This statement accurately answers the client's question.
D. "The oral medication you will take after this IV will dissolve the clot."
Rationale: This is not a correct response. Warfarin, a PO medication that is often started after
the client has been on heparin, does not dissolve clots.
3.A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous
infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The
client asks the nurse why both anticoagulants are necessary. Which of the following statements
should the nurse make?
Page 1
,NUR 2513Exam #2
Practice ATI Answer Key
2022.
A. "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches
a therapeutic level."
Rationale: Heparin and warfarin are both anticoagulants that decrease the clotting ability of
the blood and help prevent thrombosis formation in the blood vessels. However,
these medications work in different ways to achieve therapeutic coagulation and
must be given together until therapeutic levels of anticoagulation can be achieved
by warfarin alone, which is usually within 1 to 5 days. When the client's PT and INR
are within therapeutic range, the heparin can be discontinued.
B. "I will call the provider to get a prescription for discontinuing the IV heparin today."
Rationale: Discontinuing the IV heparin is not indicated at this time.
C. "Both heparin and warfarin work together to dissolve the clots."
Rationale: Neither medication dissolves clots that have already formed.
D. "The IV heparin increases the effects of the warfarin and decreases the length of your hospital
stay."
Rationale: Neither medication increases the effects of the other.
4.A nurse caring for a client who has hypertension and asks the nurse about a prescription for
propranolol. The nurse should inform the client that this medication is contraindicated in clients who
have a history of which of the following conditions?
A. Asthma
Rationale: Propranolol, a beta-blocker, is contraindicated in clients who have asthma because it can
cause bronchospasms. Propranolol blocks the sympathetic stimulation, which
prevents smooth muscle relaxation.
B. Glaucoma
Rationale: Beta-blockers are contraindicated in clients who have cardiogenic shock,
but are not contraindicated in a client who has glaucoma.
C. Depression
Rationale: Beta-blockers are contraindicated in clients who have AV heart block,
but are not contraindicated in clients who have depression.
D. Migraines
Rationale: Beta-blockers are used for prophylactic treatment of migraine headaches.
5.A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac
dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this
medication?
A. Hyperthermia
Rationale: Temperature is not affected by verapamil.
Page 2
,NUR 2513Exam #2
Practice ATI Answer Key
2022.
B. Hypotension
Rationale: Verapamil, a calcium channel blocker, can be used to control supraventricular
tachyarrhythmias.
It also decreases blood pressure and acts as a coronary vasodilator and
antianginal agent. A major adverse effect of verapamil is hypotension; therefore,
blood pressure and pulse must be monitored before and during parenteral
administration.
C. Ototoxicity
Rationale: Verapamil is not toxic to the ear.
D. Muscle pain
Rationale: Verapamil does not cause muscle pain.
6.A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a
therapeutic effect of the medication?
A. Decreased blood pressure
Rationale: Lisinopril, an ACE inhibitor, may be used alone or in combination with other
antihypertensives in the management of hypertension and congestive heart failure.
A therapeutic effect of the medication is a decrease in blood pressure.
B. Increase of HDL cholesterol
Rationale: This is not an intended effect of lisinopril.
C. Prevention of bipolar manic episodes
Rationale: This is not an intended effect of lisinopril.
D. Improved sexual function
Rationale: This is not an intended effect of lisinopril. Lisinopril may in fact cause sexual
dysfunction and impotence.
7.A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the
following statements by the client indicates an adverse effect of the medication?
A. "I can walk a mile a day."
Rationale: Improving the client's cardiac output, which in turn will improve the client's exercise
tolerance, is a therapeutic response to digoxin.
B. "I've had a backache for several days."
Rationale: Backaches are not an adverse effect of digoxin.
C. "I am urinating more frequently."
Rationale:
Page 3
, NUR 2513Exam #2
Practice ATI Answer Key
2022.
Improving the client's cardiac output, which in turn will increase blood flow to the
kidneys and urination, is a therapeutic response to digoxin.
D. "I feel nauseated and have no appetite."
Rationale: Anorexia, nausea, vomiting, and abdominal discomfort are early signs of digoxin
toxicity.
8.A nurse is caring for a client who has a new prescription for ferrous sulfate tablets twice daily for
iron-deficiency anemia. The client asks the nurse why the provider instructed that she take the
ferrous sulfate between meals. Which of the following responses should the nurse make?
A. "Taking the medication between meals will help you avoid becoming constipated."
Rationale: Taking the medication with food can reduce the GI symptoms associated with
it. However, taking the medication between meals maximizes absorption.
B. "Taking the medication with food increases the risk of esophagitis."
Rationale: Reclining immediately after taking ferrous sulfate may lead to esophageal
corrosion. Clients should remain upright for 15-30 min following administering.
C. "Taking the medication between meals will help you absorb the medication more efficiently."
Rationale: Ferrous sulfate provides the iron needed by the body to produce red blood cells.
Taking iron supplements between meals helps to increase the bioavailability of the
iron.
D. "The medication can cause nausea if taken with food."
Rationale: Taking ferrous sulfate with food can reduce the GI symptoms associated with it.
However, taking the medication between meals maximizes absorption.
9.A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin
alfa. Which of the following laboratory results should the nurse review for an indication of a
therapeutic effect of the medication?
A. The leukocyte count
Rationale: Epoetin alfa does not affect the leukocyte, or WBC, count.
B. The platelet count
Rationale: An increase in platelets is not the therapeutic or desired effect of epoetin alfa.
C. The hematocrit (Hct)
Rationale: Epoetin alfa is an antianemic medication that is indicated in the treatment of clients
who have anemia due to reduced production of endogenous erythropoietin, which
may occur in clients who have end-stage renal disease or myelosuppression from
chemotherapy. The therapeutic effect of epoetin alfa is enhanced red blood cell
production, which is reflected in an increased RBC, Hgb, and Hct.
D. The erythrocyte sedimentation rate (ESR)
Page 4
Practice ATI Answer Key
2022.
1.A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client
refused breakfast and is complaining of nausea and weakness. Which of the following actions
should the nurse take first?
A. Check the client's vital signs.
Rationale: It is possible that the client's nausea is secondary to digoxin toxicity. By obtaining
vital signs, the nurse can assess for bradycardia, which is a symptom of digoxin
toxicity. The nurse should withhold the medication and call the provider if the
client's heart rate is less than 60 bpm.
B. Request a dietitian consult.
Rationale: While the dietitian might be able to assist the client with making appropriate food
choices, this is not the first action the nurse should take.
C. Suggest that the client rests before eating the meal.
Rationale: While this intervention might be appropriate, this is not the first action the nurse
should take.
D. Request an order for an antiemetic.
Rationale: While this intervention might relieve the client's nausea, this is not the first action
the nurse should take.
2.A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV
infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which
of the following responses should the nurse give?
A. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level."
Rationale: The effects of heparin begin within minutes. This response does not accurately
answer the client's question.
B. "A pharmacist is the person to answer that question."
Rationale: Contacting the pharmacist is not the appropriate answer for the nurse to give.
C. "Heparin does not dissolve clots. It stops new clots from forming."
Rationale: This statement accurately answers the client's question.
D. "The oral medication you will take after this IV will dissolve the clot."
Rationale: This is not a correct response. Warfarin, a PO medication that is often started after
the client has been on heparin, does not dissolve clots.
3.A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous
infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The
client asks the nurse why both anticoagulants are necessary. Which of the following statements
should the nurse make?
Page 1
,NUR 2513Exam #2
Practice ATI Answer Key
2022.
A. "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches
a therapeutic level."
Rationale: Heparin and warfarin are both anticoagulants that decrease the clotting ability of
the blood and help prevent thrombosis formation in the blood vessels. However,
these medications work in different ways to achieve therapeutic coagulation and
must be given together until therapeutic levels of anticoagulation can be achieved
by warfarin alone, which is usually within 1 to 5 days. When the client's PT and INR
are within therapeutic range, the heparin can be discontinued.
B. "I will call the provider to get a prescription for discontinuing the IV heparin today."
Rationale: Discontinuing the IV heparin is not indicated at this time.
C. "Both heparin and warfarin work together to dissolve the clots."
Rationale: Neither medication dissolves clots that have already formed.
D. "The IV heparin increases the effects of the warfarin and decreases the length of your hospital
stay."
Rationale: Neither medication increases the effects of the other.
4.A nurse caring for a client who has hypertension and asks the nurse about a prescription for
propranolol. The nurse should inform the client that this medication is contraindicated in clients who
have a history of which of the following conditions?
A. Asthma
Rationale: Propranolol, a beta-blocker, is contraindicated in clients who have asthma because it can
cause bronchospasms. Propranolol blocks the sympathetic stimulation, which
prevents smooth muscle relaxation.
B. Glaucoma
Rationale: Beta-blockers are contraindicated in clients who have cardiogenic shock,
but are not contraindicated in a client who has glaucoma.
C. Depression
Rationale: Beta-blockers are contraindicated in clients who have AV heart block,
but are not contraindicated in clients who have depression.
D. Migraines
Rationale: Beta-blockers are used for prophylactic treatment of migraine headaches.
5.A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac
dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this
medication?
A. Hyperthermia
Rationale: Temperature is not affected by verapamil.
Page 2
,NUR 2513Exam #2
Practice ATI Answer Key
2022.
B. Hypotension
Rationale: Verapamil, a calcium channel blocker, can be used to control supraventricular
tachyarrhythmias.
It also decreases blood pressure and acts as a coronary vasodilator and
antianginal agent. A major adverse effect of verapamil is hypotension; therefore,
blood pressure and pulse must be monitored before and during parenteral
administration.
C. Ototoxicity
Rationale: Verapamil is not toxic to the ear.
D. Muscle pain
Rationale: Verapamil does not cause muscle pain.
6.A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a
therapeutic effect of the medication?
A. Decreased blood pressure
Rationale: Lisinopril, an ACE inhibitor, may be used alone or in combination with other
antihypertensives in the management of hypertension and congestive heart failure.
A therapeutic effect of the medication is a decrease in blood pressure.
B. Increase of HDL cholesterol
Rationale: This is not an intended effect of lisinopril.
C. Prevention of bipolar manic episodes
Rationale: This is not an intended effect of lisinopril.
D. Improved sexual function
Rationale: This is not an intended effect of lisinopril. Lisinopril may in fact cause sexual
dysfunction and impotence.
7.A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the
following statements by the client indicates an adverse effect of the medication?
A. "I can walk a mile a day."
Rationale: Improving the client's cardiac output, which in turn will improve the client's exercise
tolerance, is a therapeutic response to digoxin.
B. "I've had a backache for several days."
Rationale: Backaches are not an adverse effect of digoxin.
C. "I am urinating more frequently."
Rationale:
Page 3
, NUR 2513Exam #2
Practice ATI Answer Key
2022.
Improving the client's cardiac output, which in turn will increase blood flow to the
kidneys and urination, is a therapeutic response to digoxin.
D. "I feel nauseated and have no appetite."
Rationale: Anorexia, nausea, vomiting, and abdominal discomfort are early signs of digoxin
toxicity.
8.A nurse is caring for a client who has a new prescription for ferrous sulfate tablets twice daily for
iron-deficiency anemia. The client asks the nurse why the provider instructed that she take the
ferrous sulfate between meals. Which of the following responses should the nurse make?
A. "Taking the medication between meals will help you avoid becoming constipated."
Rationale: Taking the medication with food can reduce the GI symptoms associated with
it. However, taking the medication between meals maximizes absorption.
B. "Taking the medication with food increases the risk of esophagitis."
Rationale: Reclining immediately after taking ferrous sulfate may lead to esophageal
corrosion. Clients should remain upright for 15-30 min following administering.
C. "Taking the medication between meals will help you absorb the medication more efficiently."
Rationale: Ferrous sulfate provides the iron needed by the body to produce red blood cells.
Taking iron supplements between meals helps to increase the bioavailability of the
iron.
D. "The medication can cause nausea if taken with food."
Rationale: Taking ferrous sulfate with food can reduce the GI symptoms associated with it.
However, taking the medication between meals maximizes absorption.
9.A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin
alfa. Which of the following laboratory results should the nurse review for an indication of a
therapeutic effect of the medication?
A. The leukocyte count
Rationale: Epoetin alfa does not affect the leukocyte, or WBC, count.
B. The platelet count
Rationale: An increase in platelets is not the therapeutic or desired effect of epoetin alfa.
C. The hematocrit (Hct)
Rationale: Epoetin alfa is an antianemic medication that is indicated in the treatment of clients
who have anemia due to reduced production of endogenous erythropoietin, which
may occur in clients who have end-stage renal disease or myelosuppression from
chemotherapy. The therapeutic effect of epoetin alfa is enhanced red blood cell
production, which is reflected in an increased RBC, Hgb, and Hct.
D. The erythrocyte sedimentation rate (ESR)
Page 4
