ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client is prescribed Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?
- A. Sodium level of 138 mEq/L
- B. Potassium level of 5.2 mEq/L
- C. Chloride level of 100 mEq/L
- D. Calcium level of 9.5 mg/dL
Correct answer: B
Rationale: Spironolactone is a potassium-sparing diuretic, causing potassium retention, potentially leading to elevated potassium levels. A potassium level of 5.2 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia, a serious condition. Elevated potassium levels can lead to life-threatening cardiac arrhythmias. Monitoring and reporting high potassium levels promptly to the healthcare provider are crucial to prevent potential complications. Sodium, chloride, and calcium levels are not directly influenced by Spironolactone, making choices A, C, and D incorrect.
2. A healthcare provider is assessing a client who takes Lithium Carbonate for the treatment of Bipolar disorder. The provider should recognize which of the following findings as a possible indication of toxicity to this medication?
- A. Severe hypertension
- B. Coarse tremors
- C. Constipation
- D. Muscle spasm
Correct answer: B
Rationale: Coarse tremors are a common sign of Lithium toxicity. It is important for healthcare providers to monitor for this symptom as it indicates a potential overdose of the medication. Severe hypertension, constipation, and muscle spasms are not typically associated with Lithium toxicity. Severe hypertension is not a common sign of Lithium toxicity but rather a symptom of hypertensive crisis. Constipation is not a typical sign of Lithium toxicity but could be seen in other conditions. Muscle spasms are not specific to Lithium toxicity but can occur due to various reasons.
3. A client has a new prescription for Adalimumab for Rheumatoid Arthritis. Based on the route of administration of Adalimumab, which of the following should the nurse plan to monitor?
- A. The vein for thrombophlebitis during IV administration.
- B. The subcutaneous site for redness following injection.
- C. The oral mucosa for ulceration after oral administration.
- D. The skin for irritation following removal of a transdermal patch.
Correct answer: B
Rationale: Adalimumab is administered subcutaneously. Injection-site redness and swelling are common adverse effects. Therefore, the nurse should monitor the subcutaneous site for redness following the injection to assess for any potential issues or reactions.
4. A client has a new diagnosis of Fibromyalgia. Which of the following medications should the nurse anticipate being prescribed for this client?
- A. Colchicine
- B. Hydroxychloroquine
- C. Auranofin
- D. Duloxetine
Correct answer: D
Rationale: The correct answer is Duloxetine. Duloxetine is commonly used to treat fibromyalgia as a serotonin-norepinephrine reuptake inhibitor. It is also indicated for depression and diabetic peripheral neuropathy. Colchicine, Hydroxychloroquine, and Auranofin are not typically prescribed for fibromyalgia. Colchicine is primarily used to treat gout, Hydroxychloroquine for conditions like malaria and rheumatoid arthritis, and Auranofin for rheumatoid arthritis.
5. A healthcare professional is preparing to administer a transfusion of a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?
- A. Ensure that the client has a patent IV line before obtaining the blood product from the refrigerator.
- B. Obtain help from another healthcare professional to confirm the correct client and blood product.
- C. Take a complete set of vital signs before beginning the transfusion and periodically during the transfusion.
- D. Stay with the client for the first 15 to 30 minutes of the transfusion.
Correct answer: B
Rationale: Obtaining help from another healthcare professional to confirm the correct client and blood product is crucial in preventing an acute hemolytic reaction during a blood transfusion. This reaction occurs due to ABO or Rh incompatibility. Verifying the correct client and blood product reduces the risk of administering the wrong blood type, which could lead to a life-threatening reaction. Checking for patency of the IV line (Choice A) is important but does not directly prevent an acute hemolytic reaction. Monitoring vital signs (Choice C) is essential for detecting transfusion reactions but does not prevent them. Staying with the client (Choice D) is important for early recognition of adverse reactions but does not address the root cause of preventing an acute hemolytic reaction.
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