ATI RN
ATI Pharmacology Proctored Exam 2023
1. A healthcare provider is caring for several clients who came to the clinic for a seasonal influenza immunization. The 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 who has no health problems
- B. 17-year-old who has a hypersensitivity to Penicillin
- C. 25-year-old who is pregnant
- D. 52-year-old who takes a multivitamin supplement
Correct answer: B
Rationale: The correct answer is B. A 17-year-old can receive the influenza vaccine via nasal spray even if they have a hypersensitivity to penicillin, as this is not a contraindication for the influenza immunization. The nasal spray vaccine (LAIV) is a live attenuated vaccine that is suitable for healthy individuals aged 2-49 years. Pregnancy (choice C) is a contraindication for the nasal spray influenza vaccine. Children under 2 years of age (choice A) are also not candidates for the nasal spray. Taking a multivitamin supplement (choice D) is not a determining factor for the type of influenza vaccine a person should receive.
2. A client with Graves' disease is being taught about her prescribed medications. Which of the following statements by the client indicates an understanding of the use of Propranolol in the treatment of Graves' disease?
- A. Propranolol helps increase blood flow to my thyroid gland.
- B. Propranolol is used to prevent excess glucose in my blood.
- C. Propranolol will decrease my tremors and fast heart rate.
- D. Propranolol promotes a decrease in thyroid hormone in my body.
Correct answer: C
Rationale: The correct answer is C. Propranolol is a beta-adrenergic antagonist that helps decrease heart rate and control tremors in individuals with Graves' disease. It does not increase blood flow to the thyroid gland (choice A), prevent excess glucose in the blood (choice B), or directly decrease thyroid hormone levels in the body (choice D). Propranolol's primary role in Graves' disease is to alleviate symptoms like tremors and fast heart rate by blocking the effects of excessive thyroid hormone, rather than reducing the actual levels of thyroid hormone in the body.
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 client with Angina Pectoris asks the nurse about the next step if one tablet does not relieve Anginal pain after waiting 5 minutes. Which of the following responses should the nurse make?
- A. Take two more sublingual tablets simultaneously.
- B. Call emergency services.
- C. Take a sustained-release nitroglycerin capsule.
- D. Wait another 5 minutes before taking a second sublingual tablet.
Correct answer: B
Rationale: In a situation where Anginal pain persists after taking one sublingual tablet and waiting 5 minutes, it is crucial to call emergency services (911) immediately. This could indicate a myocardial infarction (heart attack) rather than a typical Anginal attack. The client should not take two more sublingual tablets simultaneously without seeking immediate medical help as this could delay appropriate intervention if the pain is due to a heart attack. Taking a sustained-release nitroglycerin capsule is not recommended for immediate relief of acute Anginal pain as it works too slowly. Waiting another 5 minutes before taking a second sublingual tablet is not appropriate if the pain persists, as prompt action is essential in suspected heart-related issues.
5. A client is prescribed an IM dose of penicillin. She reports developing a rash after taking penicillin 3 years ago. What action should the healthcare professional take?
- A. Administer the prescribed dose.
- B. Withhold the medication.
- C. Ask the provider to change the prescription to an oral form.
- D. Administer an oral antihistamine at the same time.
Correct answer: B
Rationale: The healthcare professional should withhold the medication and notify the provider of the client's previous reaction to penicillin. It is crucial to report any past allergic reactions to medications, as this information guides the provider in prescribing a safe alternative. Administering the prescribed dose without considering the client's history of developing a rash can lead to potentially severe adverse reactions. Changing the prescription to an oral form or administering an oral antihistamine does not address the risk of an allergic reaction to penicillin in this case.
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