a nurse is collecting data from a client who is taking gemfibrozil which of the following assessment findings should the nurse identify as an adverse

ATI RN

ATI Pharmacology Proctored Exam

1. When assessing a client taking Gemfibrozil, which of the following findings should the nurse identify as an adverse reaction to the medication?

A. Mental status changes
B. Tremor
C. Jaundice
D. Pneumonia

Correct answer: C

Rationale: Jaundice is an adverse reaction that can occur in clients taking Gemfibrozil due to the potential development of liver impairment. Other symptoms of liver impairment may include anorexia and upper abdominal discomfort. Monitoring for signs of jaundice is crucial to detect and manage adverse effects of the medication promptly. Mental status changes (choice A) are not commonly associated with Gemfibrozil use. Tremor (choice B) is not a typical adverse reaction of Gemfibrozil. Pneumonia (choice D) is not directly linked to Gemfibrozil use but can be a complication in some cases.

2. A healthcare professional is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the healthcare professional adjust the manual IV infusion to deliver?

A. 22 gtt/min
B. 24 gtt/min
C. 20 gtt/min
D. 18 gtt/min

Correct answer: A

Rationale: To calculate the flow rate, use the formula: (Volume in mL x Drop factor) / Time in minutes = Flow rate in gtt/min. In this case, (100 mL x 10 gtt/mL) / 45 min = 22 gtt/min. Thus, the healthcare professional should adjust the manual IV infusion to deliver 22 gtt/min. Choice B, 24 gtt/min, is incorrect because it miscalculates the flow rate. Choices C and D, 20 gtt/min and 18 gtt/min, are also incorrect as they do not accurately calculate the flow rate based on the given information.

3. A client has a prescription for Timolol eye drops for the treatment of glaucoma. Which of the following instructions should the nurse include?

A. Apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application.
B. Avoid blinking immediately after instilling the drops.
C. Keep your eyes closed for 5 minutes after application.
D. Administer the drops directly onto the cornea.

Correct answer: A

Rationale: The correct instruction for the nurse to include is to apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds after application. This technique helps prevent systemic absorption of the medication, reducing the risk of systemic side effects. By applying pressure, the drainage of the medication into the bloodstream through the nasolacrimal duct is minimized, enhancing the drug's local ocular effects. Choices B, C, and D are incorrect because blinking immediately after instilling the drops, keeping eyes closed for 5 minutes, and administering the drops directly onto the cornea are not recommended practices for administering Timolol eye drops.

4. A healthcare professional is admitting a toddler to the hospital after an Acetaminophen overdose. Which of the following medications should the healthcare professional anticipate administering to this client?

A. Acetylcysteine
B. Pegfilgrastim
C. Misoprostol
D. Naltrexone

Correct answer: A

Rationale: The correct answer is Acetylcysteine. Acetylcysteine is the antidote for acetaminophen overdose. It works by replenishing glutathione, which is depleted in cases of acetaminophen overdose, thus preventing liver damage. Pegfilgrastim is a medication used to stimulate white blood cell production, misoprostol is a medication used to prevent gastric ulcers, and naltrexone is used in the management of opioid addiction and alcohol dependence, which are not indicated in the scenario described.

5. What is the pharmacological action of metformin?

A. Blocks stimulation of beta1 and beta2.
B. Blocks vasoconstriction and aldosterone.
C. Acts at many levels in the CNS to produce an anxiolytic effect.
D. Decreases hepatic glucose production.

Correct answer: D

Rationale: The correct answer is D: Decreases hepatic glucose production. Metformin's primary pharmacological action is to decrease hepatic glucose production, leading to lower blood sugar levels and improved insulin sensitivity in the liver. Choices A, B, and C are incorrect because metformin does not block stimulation of beta1 and beta2 receptors, vasoconstriction, aldosterone, or act in the CNS to produce an anxiolytic effect. Therefore, these options are not reflective of metformin's mechanism of action.