ATI RN
Proctored Pharmacology ATI
1. Which drug undergoes extensive first-pass hepatic metabolism?
- A. Heparin
- B. Insulin
- C. Propranolol
- D. Nitroglycerin
Correct answer: C
Rationale: Propranolol undergoes extensive first-pass hepatic metabolism in the liver. When administered orally, propranolol is extensively metabolized by the liver before reaching systemic circulation, leading to reduced bioavailability. This process is known as first-pass hepatic metabolism, which significantly affects the drug's effectiveness and necessitates higher oral doses compared to other routes of administration. Heparin (Choice A) is not metabolized by the liver but excreted unchanged by the kidneys. Insulin (Choice B) is a peptide hormone that is not subject to significant first-pass metabolism. Nitroglycerin (Choice D) is primarily metabolized in the blood and tissues, bypassing significant first-pass metabolism in the liver.
2. A client has a new prescription for Tetracycline. Which of the following instructions should be included?
- A. Take the medication with milk.
- B. Avoid prolonged sun exposure.
- C. Take the medication at bedtime.
- D. Expect urine to turn dark yellow.
Correct answer: B
Rationale: The correct instruction to include for a client prescribed Tetracycline is to 'Avoid prolonged sun exposure.' Tetracycline can cause photosensitivity, making the client more sensitive to the sun's rays. This can lead to adverse reactions like sunburn or skin rashes. Therefore, it is crucial for the client to minimize sun exposure and wear protective clothing when outdoors. Choice A is incorrect because taking Tetracycline with milk can reduce its absorption. Choice C is incorrect as there is no specific requirement to take Tetracycline at bedtime. Choice D is also incorrect as Tetracycline does not typically cause dark yellow urine.
3. A client has a prescription for Acyclovir. Which of the following instructions should the nurse include?
- A. Expect to take this medication long-term.
- B. Increase fluid intake during therapy.
- C. Avoid sexual contact while on this medication.
- D. Consult your healthcare provider if you experience nausea.
Correct answer: B
Rationale: The correct instruction for a client taking Acyclovir is to increase fluid intake during therapy. Acyclovir can cause nephrotoxicity, potentially leading to kidney damage. Increasing fluid intake helps prevent this adverse effect by promoting adequate renal function and drug elimination. Choices A, C, and D are incorrect. Acyclovir is usually prescribed for short-term use, there is no need to avoid sexual contact while on the medication, and nausea is not a common side effect that necessitates immediate consultation with a healthcare provider.
4. A client has a new prescription for Verapamil. Which of the following instructions should the nurse include?
- A. Increase your intake of high-fiber foods.
- B. Take the medication with grapefruit juice.
- C. Expect to feel drowsy or lightheaded.
- D. Avoid dairy products while taking this medication.
Correct answer: A
Rationale: The correct instruction to include when a client is prescribed Verapamil is to increase their intake of high-fiber foods. Verapamil can cause constipation as a side effect, and increasing fiber intake can help prevent constipation. High-fiber foods promote bowel regularity and can counteract the constipating effects of Verapamil. Choices B, C, and D are incorrect because taking Verapamil with grapefruit juice can lead to adverse reactions, drowsiness or lightheadedness is not a typical side effect of Verapamil, and there is no need to avoid dairy products specifically while taking this medication.
5. A healthcare professional is reviewing the laboratory results of a client taking Warfarin for atrial fibrillation. Which of the following findings should the professional report to the provider immediately?
- A. INR of 4.0
- B. Potassium level of 4.5 mEq/L
- C. Creatinine level of 1.0 mg/dL
- D. BUN of 18 mg/dL
Correct answer: A
Rationale: An INR of 4.0 indicates that the client's blood is clotting too slowly, increasing the risk of bleeding. This level is above the therapeutic range for a client on Warfarin therapy. Therefore, the healthcare professional should notify the provider immediately to prevent potential bleeding complications. The other laboratory values are within normal limits and do not pose an immediate risk to the client's health while on Warfarin therapy.
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