ATI RN
ATI Pharmacology Proctored Exam 2023
1. A client with end-stage cancer receiving Morphine is prescribed Methylnaltrexone. The client's daughter asks why the provider prescribed Methylnaltrexone. Which of the following responses should the nurse make?
- A. The medication will increase your mother's respirations.
- B. The medication will prevent dependence on the Morphine.
- C. The medication will relieve your mother's constipation.
- D. The medication works with the Morphine to increase pain relief.
Correct answer: C
Rationale: The correct response is C: 'The medication will relieve your mother's constipation.' Methylnaltrexone is an opioid antagonist used to treat severe constipation unrelieved by laxatives in opioid-dependent clients. It works by blocking the mu opioid receptors in the GI tract, which helps alleviate constipation without affecting pain relief or causing withdrawal symptoms. Choices A, B, and D are incorrect. Methylnaltrexone's primary action is related to managing constipation rather than increasing respirations, preventing dependence on Morphine, or enhancing pain relief when used alongside Morphine.
2. A client in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?
- A. Intestinal ileus
- B. Neutropenia
- C. Delirium
- D. Hyperthermia
Correct answer: C
Rationale: The correct answer is C: Delirium. When IV nitroprusside is administered at high dosages, it can lead to thiocyanate toxicity, resulting in mental status changes such as delirium. Monitoring thiocyanate levels during therapy is crucial to ensure they remain below 10 mg/dL to prevent this adverse reaction. Choices A, B, and D are incorrect because nitroprusside does not typically cause intestinal ileus, neutropenia, or hyperthermia as adverse reactions.
3. A healthcare professional is educating clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the professional inform the clients to expect a peak effect 1 to 5 hr after administration?
- A. Insulin glargine
- B. NPH insulin
- C. Regular insulin
- D. Insulin lispro
Correct answer: C
Rationale: The correct answer is C, Regular insulin. Regular insulin, also known as short-acting insulin, typically exhibits a peak effect around 1 to 5 hours following administration. This rapid onset and peak effect make it suitable for managing postprandial glucose levels. Insulin glargine is a long-acting insulin with no pronounced peak effect, making it unsuitable for rapid glucose control within 1 to 5 hours. NPH insulin has an intermediate duration of action and a different peak time frame. Insulin lispro is a rapid-acting insulin that peaks within 30 minutes to 2.5 hours after administration, not within the 1 to 5-hour range.
4. A healthcare provider is caring for several clients who came to the clinic for a seasonal influenza immunization. The healthcare provider should identify that which of the following clients is a candidate to receive the vaccine via nasal spray rather than an injection?
- A. 1-year-old with no health problems
- B. 17-year-old with a hypersensitivity to Penicillin
- C. 25-year-old who is pregnant
- D. 52-year-old who takes a multivitamin supplement
Correct answer: B
Rationale: A 17-year-old can be immunized for influenza with the LAIV via nasal spray. A hypersensitivity to penicillin is not a contraindication for an influenza immunization. Nasal spray influenza vaccine is generally recommended for healthy individuals between 2 and 49 years old. Choices A, C, and D are not candidates for nasal spray influenza vaccine. A 1-year-old is too young, pregnant individuals should not receive the nasal spray, and age is a factor for the use of the nasal spray vaccine.
5. A client is receiving discharge instructions for a new prescription of Warfarin. Which of the following over-the-counter medications should the client be instructed to avoid?
- A. Acetaminophen
- B. Ibuprofen
- C. Diphenhydramine
- D. Loratadine
Correct answer: B
Rationale: The correct answer is B: Ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with Warfarin due to its antiplatelet effects. Patients on Warfarin should avoid NSAIDs like Ibuprofen and opt for alternative pain relief options to prevent potential complications such as an increased risk of bleeding. Acetaminophen (Choice A), Diphenhydramine (Choice C), and Loratadine (Choice D) are not known to significantly interact with Warfarin in terms of bleeding risk and are generally considered safe to use alongside Warfarin.
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