ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client has a new prescription for methotrexate to treat Rheumatoid Arthritis. The nurse should expect to monitor the client for which of the following adverse effects?
- A. Insomnia
- B. Hypertension
- C. Bone marrow suppression
- D. Constipation
Correct answer: C
Rationale: The correct answer is bone marrow suppression. Methotrexate can lead to bone marrow suppression, resulting in anemia, leukopenia, and thrombocytopenia. Monitoring for signs of decreased blood cell counts is crucial to prevent complications. Insomnia (choice A), hypertension (choice B), and constipation (choice D) are not typically associated with methotrexate use for Rheumatoid Arthritis.
2. A healthcare professional is planning to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of Enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the healthcare professional plan to take?
- A. Expel the air bubble from the prefilled syringe before injecting.
- B. Insert the needle completely into the client's tissue.
- C. Administer the injection in the client's thigh.
- D. Aspirate carefully after inserting the needle into the client's skin.
Correct answer: B
Rationale: Correct Answer: B. When administering enoxaparin, it is essential to insert the needle completely into the client's tissue to ensure a deep subcutaneous injection. This method helps in the appropriate delivery of the medication. Choice A is incorrect because expelling air bubbles is not necessary with subcutaneous injections and may lead to medication loss. Choice C is incorrect as enoxaparin is usually administered in the abdomen, not the thigh. Choice D is incorrect as aspiration is not recommended for subcutaneous injections to avoid trauma or bleeding.
3. A client has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?
- A. Take the albuterol at the same time each day.
- B. Administer the albuterol inhaler before using the beclomethasone inhaler.
- C. Use beclomethasone if experiencing an acute episode.
- D. Avoid shaking the beclomethasone before use.
Correct answer: B
Rationale: When a client is prescribed an inhaled beta2-agonist (such as albuterol) and an inhaled glucocorticoid (such as beclomethasone) for asthma control, the beta2-agonist should be administered first. Administering the beta2-agonist before the glucocorticoid helps promote bronchodilation and enhances the absorption of the glucocorticoid, maximizing its effectiveness in the lungs. Choice A is incorrect because albuterol is usually taken as needed for quick relief of asthma symptoms and not necessarily at the same time each day. Choice C is incorrect as beclomethasone is a controller medication used for long-term asthma management, not for acute episodes. Choice D is incorrect as shaking the beclomethasone inhaler before use helps ensure proper medication dispersion for effective inhalation.
4. A client has a new prescription for Digoxin for heart failure. Which of the following adverse effects should the client be instructed to monitor for and report to the provider?
- A. Dry cough
- B. Pedal edema
- C. Bruising
- D. Yellow-tinged vision
Correct answer: D
Rationale: Yellow-tinged vision is a potential adverse effect of digoxin, which may indicate toxicity. It is crucial for the client to report this symptom promptly to the healthcare provider to prevent any further complications. Dry cough is not typically associated with digoxin use. Pedal edema is a common symptom of heart failure, which digoxin is prescribed to manage. Bruising is not a common adverse effect of digoxin.
5. A healthcare provider in an emergency unit is reviewing the medical record of a client who is being evaluated for angle-closure glaucoma. Which of the following findings are indicative of this condition?
- A. Insidious onset of painless loss of vision
- B. Gradual reduction in peripheral vision
- C. Severe pain around the eyes
- D. Intraocular pressure of 12mm Hg
Correct answer: C
Rationale: Severe pain around the eyes that radiates over the face is a characteristic symptom of acute angle-closure glaucoma. This intense pain is typically accompanied by other symptoms such as blurred vision, halos around lights, redness in the eye, and sometimes nausea and vomiting. The acute rise in intraocular pressure leads to these symptoms, indicating a medical emergency that requires immediate attention to prevent vision loss. Choices A, B, and D are incorrect. Insidious onset of painless loss of vision is more suggestive of conditions like age-related macular degeneration or diabetic retinopathy. Gradual reduction in peripheral vision is commonly seen in conditions like open-angle glaucoma. An intraocular pressure of 12mm Hg is within the normal range and not indicative of the acute rise seen in angle-closure glaucoma.
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