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 client is receiving treatment with bevacizumab. Which of the following findings should the nurse monitor?
- A. Hypertension
- B. Hypokalemia
- C. Hyperglycemia
- D. Hypocalcemia
Correct answer: A
Rationale: Corrected Rationale: Bevacizumab is known to potentially cause hypertension as a common adverse effect. The nurse should monitor the client's blood pressure regularly to detect and manage any elevations effectively. Choices B, C, and D are incorrect because bevacizumab is not typically associated with causing hypokalemia, hyperglycemia, or hypocalcemia. Therefore, monitoring for hypertension is the priority in this case.
3. 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.
4. A healthcare professional is preparing to administer Filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?
- A. Administer subcutaneously in a large muscle mass to prevent injury.
- B. Ensure that the medication is kept at room temperature until just prior to administration.
- C. Invert vial gently to mix well before withdrawing dose.
- D. Discard vial after removing one dose of the medication.
Correct answer: D
Rationale: The correct intervention when preparing to administer Filgrastim is to discard the vial after removing one dose of the medication. This practice helps prevent contamination and ensures the medication's effectiveness. Reusing the vial can lead to contamination and compromise the sterility of the medication, putting the client at risk. Therefore, it is crucial to follow proper aseptic technique and discard the vial after withdrawing the prescribed dose.
5. A client with chronic myeloid leukemia is receiving hydroxyurea. Which of the following findings should the nurse monitor?
- A. Hyperkalemia
- B. Hypertension
- C. Neutropenia
- D. Tinnitus
Correct answer: C
Rationale: The nurse should monitor the client for neutropenia when receiving hydroxyurea. Neutropenia is a common adverse effect caused by bone marrow suppression. It is essential to assess the client's white blood cell count regularly to detect neutropenia early and prevent complications such as infections.
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