ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client is receiving moderate sedation with Diazepam IV and is oversedated. Which of the following medications should the nurse anticipate administering to this client?
- A. Ketamine
- B. Naltrexone
- C. Flumazenil
- D. Fluvoxamine
Correct answer: C
Rationale: Flumazenil is a specific benzodiazepine antagonist that competitively reverses the sedative effects of benzodiazepines like Diazepam. In cases of oversedation or respiratory depression caused by benzodiazepines, administering Flumazenil can help reverse the effects and restore the client's consciousness and respiratory drive. Ketamine (Choice A) is a dissociative anesthetic and not used to reverse benzodiazepine sedation. Naltrexone (Choice B) is an opioid receptor antagonist and not indicated for benzodiazepine oversedation. Fluvoxamine (Choice D) is an antidepressant and not used to counteract benzodiazepine sedation.
2. A client with type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?
- A. I'll take this medicine with my meals.
- B. I'll take this medicine 30 minutes before I eat.
- C. I'll take this medicine just before I go to bed.
- D. I'll take this medicine as soon as I wake up in the morning.
Correct answer: B
Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. To ensure the insulin is available when food is digested, the client should take this medication 30 minutes before each meal. This timing aligns the medication with the expected postprandial rise in blood glucose levels, optimizing its effectiveness in controlling blood sugar levels. Choices A, C, and D are incorrect because taking Repaglinide with meals, just before bed, or as soon as waking up does not align with the medication's mechanism of action and timing needed for optimal effectiveness.
3. A client is starting therapy with doxorubicin. Which of the following findings should the nurse instruct the client to report?
- A. Hair loss
- B. Fatigue
- C. Sore throat
- D. Red urine
Correct answer: C
Rationale: The correct answer is 'C: Sore throat.' Doxorubicin is known to have immunosuppressive effects, which can predispose the client to infections. A sore throat can be an early sign of infection, and prompt reporting to the healthcare provider is crucial to initiate appropriate interventions and prevent complications. Choices A, B, and D are incorrect because hair loss, fatigue, and red urine are common side effects of doxorubicin and are typically expected during therapy. While these side effects should be monitored, they do not require immediate reporting unless they become severe or concerning.
4. During discharge instructions, a client with a new prescription for Phenytoin should be advised to take which of the following actions?
- A. Brush and floss your teeth regularly.
- B. Avoid drinking grapefruit juice.
- C. Take this medication on an empty stomach.
- D. Increase your intake of calcium-rich foods.
Correct answer: A
Rationale: The correct instruction for a client with a new prescription for Phenytoin is to brush and floss their teeth regularly. Phenytoin is known to cause gingival hyperplasia, a condition that affects the gums. By maintaining good oral hygiene practices such as regular brushing and flossing, the client can help minimize the risk of developing this side effect. Choices B, C, and D are incorrect. Avoiding grapefruit juice is more relevant for medications affected by grapefruit juice metabolism, taking medication on an empty stomach is not specifically indicated for Phenytoin, and increasing calcium-rich foods is not directly related to the side effects or administration of Phenytoin.
5. A client is starting therapy with Metformin. Which of the following instructions should be included by the healthcare provider?
- A. Take this medication with your first bite of food.
- B. Take this medication on an empty stomach.
- C. Take this medication before bedtime.
- D. Take this medication every other day.
Correct answer: A
Rationale: The correct answer is A: 'Take this medication with your first bite of food.' Metformin should be taken with meals to reduce gastrointestinal side effects and ensure better absorption. By taking the medication with the first bite of food, the client can help minimize potential stomach upset and improve the drug's effectiveness. Choice B is incorrect because taking Metformin on an empty stomach can increase the risk of gastrointestinal side effects. Choice C is incorrect as there is no specific recommendation to take Metformin before bedtime. Choice D is incorrect because Metformin is typically taken daily, not every other day, as prescribed by the healthcare provider.
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