ATI RN
ATI Pharmacology Proctored Exam
1. A client with migraine headaches is starting prophylaxis therapy with Propranolol. Which finding in the client's history should the nurse report to the provider?
- A. The client had a prior myocardial infarction.
- B. The client takes warfarin for atrial fibrillation.
- C. The client takes an SSRI for depression.
- D. An ECG indicates a first-degree heart block.
Correct answer: D
Rationale: Propranolol is contraindicated in clients with first-degree heart block due to its negative inotropic and chronotropic effects. The nurse should report this finding to the provider to consider an alternative therapy to prevent potential worsening of cardiac conduction abnormalities. Choices A, B, and C are not directly contraindications to Propranolol therapy for migraine headaches and do not pose immediate risks that would require reporting to the provider.
2. A patient is being discharged with a new prescription for Hydrochlorothiazide. Which of the following instructions should the nurse include?
- A. Take the medication before bedtime.
- B. Monitor for increased blood pressure.
- C. Take the medication with food.
- D. Monitor for leg cramps.
Correct answer: D
Rationale: The correct instruction the nurse should include is to monitor for leg cramps. Leg cramps can be a sign of hypokalemia, which is a potential adverse effect of Hydrochlorothiazide. By monitoring for leg cramps, the patient can detect signs of low potassium levels and report them to the healthcare provider promptly. This proactive approach helps prevent complications associated with hypokalemia. The other options are incorrect because taking Hydrochlorothiazide before bedtime or with food is not specific to the medication's adverse effects. Monitoring for increased blood pressure is not typically a common adverse effect of this medication.
3. A client is withdrawing from alcohol and has a new prescription for Propranolol. Which of the following information should be included in the teaching?
- A. Increases the risk for seizure activity.
- B. Provides a form of aversion therapy.
- C. Decreases cravings.
- D. Results in mild hypertension.
Correct answer: C
Rationale: The correct answer is C: 'Decreases cravings.' Propranolol is commonly used as an adjunct medication during alcohol withdrawal to help reduce cravings for alcohol. It does not increase the risk for seizure activity, provide aversion therapy, or result in mild hypertension. By decreasing cravings, Propranolol can support the client in managing alcohol withdrawal symptoms and promoting abstinence. Therefore, it is important to educate the client on how Propranolol can help them cope with alcohol cravings effectively.
4. A client with brain cancer and headaches is prescribed dexamethasone. What is the purpose of this adjuvant medication?
- A. To decrease inflammation and swelling
- B. To improve concentration
- C. To induce sedation
- D. To treat depression
Correct answer: A
Rationale: Dexamethasone, a glucocorticoid, is indicated for clients with brain cancer to decrease inflammation and swelling. It helps reduce cerebral edema and relieve pressure caused by the tumor, ultimately alleviating headaches. The purpose of prescribing dexamethasone in this case is not to improve concentration (choice B), induce sedation (choice C), or treat depression (choice D). Methylphenidate, a stimulant, is used for conditions like ADHD, not for brain cancer. Hydroxyzine, an antihistamine, is primarily used for anxiety and itching, not for brain cancer. Amitriptyline, a tricyclic antidepressant, is used for conditions like depression and neuropathic pain, not specifically for brain cancer-related headaches.
5. A healthcare provider is reviewing a client's medical history and notes that the client has a prescription for Digoxin. Which of the following findings is a manifestation of Digoxin toxicity?
- A. Elevated blood pressure
- B. Bradycardia
- C. Yellow-tinged vision
- D. Ringing in the ears
Correct answer: C
Rationale: Yellow-tinged vision, along with nausea, vomiting, and confusion, are common manifestations of Digoxin toxicity. Visual disturbances are important to recognize as they can indicate the need for immediate medical attention and potential adjustment of Digoxin therapy to prevent serious complications. Elevated blood pressure is not typically associated with Digoxin toxicity; instead, hypotension may occur. Bradycardia is a common therapeutic effect of Digoxin rather than a sign of toxicity. Ringing in the ears, or tinnitus, is also a potential side effect of Digoxin but is less specific to toxicity compared to yellow-tinged vision.
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