ATI RN
ATI Pharmacology Proctored Exam 2023
1. A client has a new prescription for Warfarin. The nurse should identify that the concurrent use of which of the following medications increases the client's risk of bleeding?
- A. Vitamin K
- B. Calcium carbonate
- C. Acetaminophen
- D. Ranitidine
Correct answer: C
Rationale: The correct answer is Acetaminophen (Choice C). Acetaminophen, especially in high doses, can increase the risk of bleeding in clients taking Warfarin. It can potentiate the anticoagulant effect of Warfarin, leading to an increased risk of bleeding. Vitamin K (Choice A) is actually used to reverse the effects of Warfarin in case of over-anticoagulation, so it does not increase the risk of bleeding. Calcium carbonate (Choice B) and Ranitidine (Choice D) do not significantly interact with Warfarin to increase the risk of bleeding.
2. A client has a new prescription for Ranitidine. Which of the following instructions should the nurse include?
- A. Take the medication with an antacid.
- B. Avoid drinking coffee while taking this medication.
- C. Take the medication at bedtime.
- D. Stop the medication if you develop a headache.
Correct answer: C
Rationale: The correct instruction for a client prescribed Ranitidine is to take the medication at bedtime. Ranitidine is best taken at night to reduce nighttime stomach acid production, providing optimal relief for conditions like gastroesophageal reflux disease (GERD) and ulcers.
3. A client is taking Digoxin and has a new prescription for Colesevelam. Which of the following instructions should the nurse include in the teaching?
- A. Take digoxin with your morning dose of colesevelam.
- B. Your sodium and potassium levels will be monitored periodically while taking colesevelam.
- C. Watch for bleeding or bruising while taking colesevelam.
- D. Take colesevelam with food and at least one glass of water.
Correct answer: D
Rationale: When taking colesevelam, it should be administered with food and at least 8 oz of water to ensure proper absorption and reduce the risk of gastrointestinal side effects. Taking colesevelam with food also helps in binding to bile acids efficiently. Options A, B, and C are incorrect because they do not provide the necessary instruction for taking colesevelam correctly or monitoring specific side effects associated with this medication.
4. A client has a new prescription for metronidazole. The client should avoid which of the following?
- A. Dairy products
- B. Alcohol
- C. Leafy green vegetables
- D. Grapefruit juice
Correct answer: B
Rationale: The correct answer is B: Alcohol. Clients should avoid alcohol while taking metronidazole to prevent a disulfiram-like reaction, which can cause symptoms such as nausea, vomiting, headache, and flushing. Alcohol can interact with metronidazole and lead to adverse effects. Choices A, C, and D are not typically contraindicated with metronidazole. Dairy products, leafy green vegetables, and grapefruit juice do not have significant interactions with metronidazole, unlike alcohol.
5. When teaching a client with a new prescription for Warfarin, which herbal supplement should the nurse instruct the client to avoid?
- A. St. John's wort
- B. Echinacea
- C. Garlic
- D. Ginseng
Correct answer: A
Rationale: The correct answer is St. John's wort. St. John's wort can reduce the effectiveness of Warfarin by interacting with its metabolism, potentially leading to decreased anticoagulant effects. Therefore, the nurse should instruct the client to avoid using St. John's wort while taking Warfarin to prevent adverse drug interactions. Echinacea, garlic, and ginseng are not the correct answers in this case. While these herbal supplements may also interact with Warfarin and affect its efficacy, St. John's wort has a well-known interaction with Warfarin that can significantly impact its anticoagulant effects. Educating the client about the specific interaction between St. John's wort and Warfarin is crucial to ensure patient safety and the medication's therapeutic benefit.
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