ATI RN
ATI Pharmacology
1. A client in a long-term care facility has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?
- A. The client will start at a high dose, and the dose will be tapered as needed.
- B. The client will remain on the initial dosage during the course of treatment.
- C. The client's dosage will be adjusted daily based on blood levels.
- D. The client will start on a low dose, which will be gradually increased.
Correct answer: D
Rationale: Levothyroxine should be initiated at a low dose and titrated gradually over several weeks to achieve therapeutic levels. This approach helps to minimize the risk of adverse effects, particularly in older adult clients who may be more sensitive to medication changes. Starting at a low dose allows for close monitoring of the client's response and adjustment of the dosage as needed to optimize treatment outcomes. Choice A is incorrect because starting at a high dose can increase the risk of adverse effects and is not the recommended approach. Choice B is incorrect because maintaining the initial dosage throughout the treatment may not achieve optimal therapeutic levels. Choice C is incorrect because adjusting the dosage daily based on blood levels is not the standard practice for initiating Levothyroxine treatment.
2. A client has a prescription for Erythromycin. Which of the following instructions should be included?
- A. Take the medication with food.
- B. Expect your urine to turn dark yellow.
- C. Take the medication with a full glass of milk.
- D. Report persistent diarrhea to your provider.
Correct answer: D
Rationale: The correct answer is D: 'Report persistent diarrhea to your provider.' Erythromycin is known to cause Clostridium difficile-associated diarrhea, which can be severe. Instructing the client to report any persistent diarrhea to their healthcare provider promptly is crucial to prevent complications. Choices A, B, and C are incorrect. Taking Erythromycin with food is generally recommended to reduce stomach upset, but it is not the most critical instruction. Expecting urine to turn dark yellow is not a common side effect of Erythromycin. Taking Erythromycin with a full glass of milk is not necessary and may not be appropriate for all clients, especially those with lactose intolerance or dairy allergies.
3. When educating a patient on taking levothyroxine, a drug used to balance thyroid activity, what should you include in their education?
- A. Don't disregard side effects and consult your healthcare professionals
- B. Take this at the same time every day
- C. Thyroid tests are necessary while taking this drug
- D. It is not recommended to take this drug if you have recently had a myocardial infarction
Correct answer: B
Rationale: The correct answer is to take levothyroxine at the same time every day. Consistent timing helps maintain stable thyroid levels, ensuring the effectiveness of the medication. It is important to establish a routine to optimize its therapeutic benefits. Choice A is incorrect as patients should not ignore side effects but should consult healthcare professionals if they experience any. Choice C is incorrect because thyroid tests may still be necessary to monitor thyroid function while on levothyroxine. Choice D is incorrect as it is not advisable to take levothyroxine if the patient has recently had a myocardial infarction without consulting their healthcare provider.
4. A client has a new prescription for Ferrous sulfate. Which of the following instructions should the nurse include?
- A. Take this medication with milk.
- B. Take this medication on an empty stomach.
- C. Take this medication before bedtime.
- D. Take this medication with antacids.
Correct answer: B
Rationale: The correct answer is to take Ferrous sulfate on an empty stomach. This medication is best absorbed when taken 1 hour before or 2 hours after meals. Instructing the client to take it with milk, before bedtime, or with antacids can decrease its absorption and effectiveness. Taking it with milk can reduce the absorption of iron due to the calcium in milk. Taking it before bedtime is not necessary and may cause gastrointestinal upset. Taking it with antacids can interfere with the absorption of iron.
5. 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.
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