ATI Capstone NCLEX Review2024 A & B/ ATI Comprehensive 2024 A &
B
4 steps of Critical Thinking - ans1. 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) - ansDolasetron (Anzemet)
Granisetron (Kytril, Sancuso)
Ondansetron (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? - anscorticosteroids, 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 transdermal nitroglycerin.
Which of the following adverse effects is not seen with this therapy? - ansproductive
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? - ansPotassium 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? - ansasthma; clients with asthma should avoid Beta2 Blockade
agents such as propranolol. Bronchoconstriction can occur. Clients with asthma should
be administered a beta1selective agent.
A client is taking disulfiram daily for abstinence maintenance. What is an adverse effect
of disulfiram? - anshepatotoxicity
a nurse is caring for a client with prescribed digoxin. What should alert the nurse to
possible digitalis toxicity? - ansAnorexia, 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? - ansinspect the vials for
,ATI Capstone NCLEX Review2024 A & B/ ATI Comprehensive 2024 A &
B
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? - ansDon 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) - ans20-36; 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 - ansincreased desire to make independent
decisions and relying on peers for guidance rather than family
AFTER THE CLOT HAS LEFT THE BUILDING (Thrombolytics) - ansAdminister 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: - ansrecognize patterns
or trends; compare the data with expected standards or reference ranges, and arrive to
conclusions to guide nursing care
Antianemics - ansInstruct 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 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 - ansheparin, coumadin
Anticoagulants - ansAnticoagulants 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.
,ATI Capstone NCLEX Review2024 A & B/ ATI Comprehensive 2024 A &
B
Antiemetics - ansused in the treatment and/or prevention of nausea and vomiting.
Antihistamines (H1 histamine receptor antagonists) - ansDiphenhydramine (Benadryl)
Dimenhydrinate (Gravol, Dramamine)
Meclizine (Bonine, Antivert)
Antiplatelet Nursing Interventions - ansWATCH 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 - ansAntiplatelets 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 - ansthe 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? - ansassess 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 transfusion.
Black Cohosh - ansActs 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.
clients with diabetes mellitus should eat what when their blood glucose is low? - ansthey
should eat a snack of 10-15 grams of carbohydrates, such as 120 mL or 4 oz of fruit
juice
collaborative interventions - ansinterventions nurses carry out in collaboration with other
health care team professionals (ensuring that a client receives and eats their evening
snack)
Common antiplatelets - ansAspirin (Ecotrin)
Clopidogrel (Plavix)
Pentoxifylline (Trental)
common classes of antiemetics - ans5-HT3 receptor antagonists (serotonin
antagonists); Dopamine antagonists; Antihistamines (H1 histamine receptor
antagonists)
, ATI Capstone NCLEX Review2024 A & B/ ATI Comprehensive 2024 A &
B
common Erectile Dysfunction meds - ansSildenafil (Viagra)
Vardenafil (Levitra)
Tadalafil (Cialis)
Notice these end in 'fil'. 'Fil' helps the nitric oxide to 'fil' the penis.
Common herbal supplements - ansechinacea, ginger root, ginkgo biloba, valerian, black
cohosh
Common PPIs - ansOmeprazole (brand names: Prilosec, Zegerid, Omepral, Omez)
Lansoprazole (brand names: Prevacid, Zoton, Inhibitol)
Dexlansoprazole (brand name: Kapidex, Dexilant)
Esomeprazole (brand names: Nexium, Esotrex)
Pantoprazole (brand names: Protonix, Somac, Pantozol, Zentro)
COUMADIN - ansC-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.
N-o Coumadin for pregnant women! Oral anticoagulants fall into Pregnancy Risk
Category X. Heparin may be safely used in pregnancy.
Discharge planning - ansa process of anticipating and planning for client's needs after
discharge. To be effective, discharge planning must begin during admission
Dopamine antagonists - ansPromethazine (Phenergan)
Prochlorperazine (Compazine)
Metoclopramide (Reglan): different in generic name because it can have extra-
pyramidal side effects
drug administration interactions with iron - ansantacids or tetracycline's reduces
absorption of iron. Separate use by at least 2 hr.
Echinacea - ansUsed to treat the common cold; with chronic use, echinacea can
decrease positive effects of medications for TB, HIV, or cancer.
B
4 steps of Critical Thinking - ans1. 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) - ansDolasetron (Anzemet)
Granisetron (Kytril, Sancuso)
Ondansetron (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? - anscorticosteroids, 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 transdermal nitroglycerin.
Which of the following adverse effects is not seen with this therapy? - ansproductive
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? - ansPotassium 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? - ansasthma; clients with asthma should avoid Beta2 Blockade
agents such as propranolol. Bronchoconstriction can occur. Clients with asthma should
be administered a beta1selective agent.
A client is taking disulfiram daily for abstinence maintenance. What is an adverse effect
of disulfiram? - anshepatotoxicity
a nurse is caring for a client with prescribed digoxin. What should alert the nurse to
possible digitalis toxicity? - ansAnorexia, 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? - ansinspect the vials for
,ATI Capstone NCLEX Review2024 A & B/ ATI Comprehensive 2024 A &
B
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? - ansDon 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) - ans20-36; 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 - ansincreased desire to make independent
decisions and relying on peers for guidance rather than family
AFTER THE CLOT HAS LEFT THE BUILDING (Thrombolytics) - ansAdminister 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: - ansrecognize patterns
or trends; compare the data with expected standards or reference ranges, and arrive to
conclusions to guide nursing care
Antianemics - ansInstruct 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 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 - ansheparin, coumadin
Anticoagulants - ansAnticoagulants 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.
,ATI Capstone NCLEX Review2024 A & B/ ATI Comprehensive 2024 A &
B
Antiemetics - ansused in the treatment and/or prevention of nausea and vomiting.
Antihistamines (H1 histamine receptor antagonists) - ansDiphenhydramine (Benadryl)
Dimenhydrinate (Gravol, Dramamine)
Meclizine (Bonine, Antivert)
Antiplatelet Nursing Interventions - ansWATCH 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 - ansAntiplatelets 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 - ansthe 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? - ansassess 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 transfusion.
Black Cohosh - ansActs 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.
clients with diabetes mellitus should eat what when their blood glucose is low? - ansthey
should eat a snack of 10-15 grams of carbohydrates, such as 120 mL or 4 oz of fruit
juice
collaborative interventions - ansinterventions nurses carry out in collaboration with other
health care team professionals (ensuring that a client receives and eats their evening
snack)
Common antiplatelets - ansAspirin (Ecotrin)
Clopidogrel (Plavix)
Pentoxifylline (Trental)
common classes of antiemetics - ans5-HT3 receptor antagonists (serotonin
antagonists); Dopamine antagonists; Antihistamines (H1 histamine receptor
antagonists)
, ATI Capstone NCLEX Review2024 A & B/ ATI Comprehensive 2024 A &
B
common Erectile Dysfunction meds - ansSildenafil (Viagra)
Vardenafil (Levitra)
Tadalafil (Cialis)
Notice these end in 'fil'. 'Fil' helps the nitric oxide to 'fil' the penis.
Common herbal supplements - ansechinacea, ginger root, ginkgo biloba, valerian, black
cohosh
Common PPIs - ansOmeprazole (brand names: Prilosec, Zegerid, Omepral, Omez)
Lansoprazole (brand names: Prevacid, Zoton, Inhibitol)
Dexlansoprazole (brand name: Kapidex, Dexilant)
Esomeprazole (brand names: Nexium, Esotrex)
Pantoprazole (brand names: Protonix, Somac, Pantozol, Zentro)
COUMADIN - ansC-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.
N-o Coumadin for pregnant women! Oral anticoagulants fall into Pregnancy Risk
Category X. Heparin may be safely used in pregnancy.
Discharge planning - ansa process of anticipating and planning for client's needs after
discharge. To be effective, discharge planning must begin during admission
Dopamine antagonists - ansPromethazine (Phenergan)
Prochlorperazine (Compazine)
Metoclopramide (Reglan): different in generic name because it can have extra-
pyramidal side effects
drug administration interactions with iron - ansantacids or tetracycline's reduces
absorption of iron. Separate use by at least 2 hr.
Echinacea - ansUsed to treat the common cold; with chronic use, echinacea can
decrease positive effects of medications for TB, HIV, or cancer.
