ATI RN
ATI Pharmacology Proctored Exam 2019
1. During a unit of whole blood transfusion, a client develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The healthcare professional should anticipate a prescription for which of the following medications?
- A. Epinephrine
- B. Lorazepam
- C. Furosemide
- D. Diphenhydramine
Correct answer: C
Rationale: In the scenario described, the client is exhibiting signs of fluid overload, which can occur during blood transfusion. Furosemide, a loop diuretic, is commonly prescribed in such situations to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Therefore, the correct choice is C - Furosemide. Epinephrine (Choice A) is not indicated for fluid overload but for severe allergic reactions. Lorazepam (Choice B) is a benzodiazepine used for anxiety or sedation, not for fluid overload. Diphenhydramine (Choice D) is an antihistamine often used for allergic reactions, not for fluid overload.
2. A client has a new prescription for Clozapine. Which of the following statements should the nurse include in the teaching?
- A. You should have a high-carbohydrate snack between meals and at bedtime.
- B. You are likely to develop hand tremors if you take this medication for a long period of time.
- C. You may experience temporary numbness of your mouth after each dose.
- D. You should have your white blood cell count monitored every week.
Correct answer: D
Rationale: Clozapine has a risk for fatal agranulocytosis, making weekly monitoring of the client's white blood cell (WBC) count essential to detect any potential issues early. This monitoring helps in managing the risk and ensuring the client's safety while on clozapine.
3. A nurse is teaching a client who has a new prescription for Atenolol. Which of the following adverse effects should the nurse instruct the client to monitor?
- A. Tachycardia
- B. Hypoglycemia
- C. Bradycardia
- D. Hypertension
Correct answer: C
Rationale: Atenolol is a beta-blocker that can cause bradycardia as an adverse effect. The client should monitor their pulse regularly and report any significant decreases.
4. A healthcare provider is providing discharge instructions to a client who is prescribed Enalapril. Which of the following adverse effects should the healthcare provider instruct the client to monitor?
- A. Dry cough
- B. Weight gain
- C. Diarrhea
- D. Nausea
Correct answer: A
Rationale: The correct answer is A: Dry cough. A persistent dry cough is a common adverse effect of Enalapril, an ACE inhibitor. Enalapril can cause a non-productive cough due to its effect on bradykinin levels. The client should be advised to report this symptom to their healthcare provider to consider alternative treatments. Choices B, C, and D are incorrect because weight gain, diarrhea, and nausea are not typically associated with Enalapril use.
5. A client who has been taking prednisone to treat asthma is advised to discontinue the medication. The client should be instructed to reduce the dose gradually to prevent which of the following adverse effects?
- A. Hyperglycemia
- B. Adrenocortical insufficiency
- C. Severe dehydration
- D. Rebound pulmonary congestion
Correct answer: B
Rationale: Abruptly stopping prednisone can result in adrenocortical insufficiency due to suppression of the adrenal glands. Gradually tapering the dose helps the body adjust and resume its natural cortisol production, preventing adrenal insufficiency. Choice A, hyperglycemia, is a possible adverse effect of prednisone, but it is not the primary reason for gradual tapering. Severe dehydration (Choice C) and rebound pulmonary congestion (Choice D) are not typically associated with discontinuing prednisone.
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