ATI RN
ATI Pharmacology Proctored Exam 2023
1. A healthcare professional is monitoring a client who is receiving spironolactone. Which of the following findings should the professional report to the provider?
- A. Serum Sodium 144 mEq/L
- B. Urine output 120 mL in 4 hours
- C. Serum Potassium 5.2 mEq/L
- D. Blood Pressure 140/90 mm Hg
Correct answer: C
Rationale: A serum potassium level of 5.2 mEq/L indicates hyperkalemia, which is a potentially dangerous condition. Spironolactone, a potassium-sparing diuretic, can cause potassium retention, leading to hyperkalemia. This electrolyte imbalance can result in serious consequences such as cardiac dysrhythmias. The healthcare professional should promptly report this finding to the provider, withhold the medication, and take appropriate actions to prevent complications. Monitoring and managing potassium levels are crucial in clients receiving spironolactone. The other options do not directly relate to the potential adverse effects of spironolactone and are within normal limits, making them less urgent to report.
2. A client with type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?
- A. I'll take this medicine with my meals.
- B. I'll take this medicine 30 minutes before I eat.
- C. I'll take this medicine just before I go to bed.
- D. I'll take this medicine as soon as I wake up in the morning.
Correct answer: B
Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. It is crucial for the client to take this medication 15-30 minutes before each meal to synchronize the peak insulin availability with mealtime glucose elevation, maximizing its effectiveness in controlling blood sugar levels. Choice A is incorrect because taking the medicine with meals may not optimize its action. Choice C is incorrect as taking the medicine before going to bed is not in line with its mechanism of action. Choice D is incorrect as taking the medicine upon waking up does not coincide with mealtime glucose elevation.
3. A client has a new prescription for Brimonidine ophthalmic drops and wears soft contact lenses. Which of the following instructions should the nurse include in the teaching?
- A. This medication can stain your contacts.
- B. This medication can cause your pupils to constrict.
- C. This medication can absorb into your contacts.
- D. This medication can slow your heart rate.
Correct answer: C
Rationale: The correct answer is C. Brimonidine can absorb into soft contact lenses. To prevent this, the client should remove their contacts, instill the medication, and wait at least 15 minutes before putting the contacts back in to avoid potential absorption of the medication by the lenses. Choices A, B, and D are incorrect because Brimonidine's main concern with contact lenses is its absorption into the lenses rather than staining contacts, causing pupil constriction, or affecting heart rate.
4. A client has a new prescription for Metformin. Which of the following adverse effects of Metformin should the nurse instruct the client to report to the provider?
- A. Somnolence
- B. Constipation
- C. Fluid retention
- D. Weight gain
Correct answer: A
Rationale: The correct answer is 'A: Somnolence.' Somnolence can indicate lactic acidosis, which is manifested by extreme drowsiness, hyperventilation, and muscle pain. It is a rare but very serious adverse effect caused by metformin and should be reported to the provider promptly to prevent further complications.
5. A client has a new prescription for Nevirapine, an NNRTI. Which of the following statements should the nurse include in discharge teaching?
- A. Take this medication with food to increase absorption.
- B. Avoid alcohol while taking this medication.
- C. Take this medication at the same time every day.
- D. Take this medication on an empty stomach.
Correct answer: B
Rationale: The correct statement to include in discharge teaching about Nevirapine, an NNRTI, is to advise the client to avoid alcohol while taking this medication. Alcohol can interact with Nevirapine and lead to potential adverse effects or decreased effectiveness. Choice A is incorrect because Nevirapine should be taken without food or on an empty stomach for optimal absorption. Choice C is a general recommendation for most medications but not specifically for Nevirapine. Choice D is incorrect as Nevirapine should not be taken on an empty stomach.
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