ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client is prescribed Propranolol for dysrhythmia. Which action should the nurse plan to take?
- A. Hold Propranolol if the client's apical pulse is greater than 100/min.
- B. Monitor the client's blood pressure after administering Propranolol.
- C. Assist the client when transitioning to a sitting or standing position after taking Propranolol.
- D. Monitor the client's potassium levels for signs of Propranolol toxicity.
Correct answer: C
Rationale: The correct action the nurse should plan to take when administering Propranolol to a client with dysrhythmia is to assist the client when transitioning to a sitting or standing position. Propranolol can cause orthostatic hypotension, leading to dizziness during position changes, so it is essential to help the client move slowly to prevent falls or injuries. Choices A, B, and D are incorrect because holding Propranolol based on pulse rate, monitoring blood pressure after administration, and monitoring potassium levels are not directly related to the common side effect of orthostatic hypotension associated with Propranolol.
2. When teaching a client with a prescription for Vancomycin, which instruction should the nurse include?
- A. Expect red man syndrome during treatment.
- B. Take the medication with a full glass of water.
- C. Increase your intake of potassium-rich foods.
- D. Monitor for hearing loss while taking this medication.
Correct answer: D
Rationale: The correct answer is D. Vancomycin is known to cause ototoxicity, which can result in hearing loss. Therefore, it is important for clients to monitor for any changes in their hearing while taking this medication and promptly report any issues to their healthcare provider for further evaluation and management. Choices A, B, and C are incorrect because red man syndrome is associated with rapid infusion of Vancomycin, not a common side effect during treatment; taking the medication with a full glass of water is a general instruction for many medications but not specific to Vancomycin; and increasing potassium-rich foods is not directly related to Vancomycin therapy.
3. A client has a new prescription for Calcitonin-salmon for postmenopausal osteoporosis. Which of the following instructions should the nurse include in the teaching?
- A. Swallow tablets on an empty stomach with plenty of water.
- B. Watch for skin rash and redness when applying calcitonin-salmon topically.
- C. Mix the liquid medication with juice and take it after meals.
- D. Alternate nostrils each time calcitonin-salmon is inhaled.
Correct answer: D
Rationale: Calcitonin-salmon is commonly administered intranasally for postmenopausal osteoporosis. It is essential to alternate nostrils daily when inhaling the medication to ensure equal distribution and optimal absorption. This technique helps prevent irritation and congestion in one nostril and enhances the effectiveness of the medication. Choices A, B, and C are incorrect because calcitonin-salmon is not swallowed, applied topically, or taken as a liquid medication after meals. Therefore, instructing the client to alternate nostrils during inhalation is the most appropriate teaching for this medication.
4. A client has a new prescription for a Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?
- A. Remove the patch each evening.
- B. Do not cut the patch in half even if angina attacks are under control.
- C. Take off the nitroglycerin patch if a headache occurs.
- D. Apply a new patch every 48 hours.
Correct answer: A
Rationale: The correct instruction is to remove the nitroglycerin patch each evening to prevent tolerance. This allows for a 10- to 12-hour nitrate-free period daily, reducing the risk of developing tolerance to nitroglycerin. Cutting the patch in half is not recommended because it can alter the dosing and absorption rate, leading to inadequate symptom control. Taking off the patch for a headache is not necessary as headaches are a common side effect that may improve with continued use. Applying a new patch every 48 hours is not correct as it may not provide continuous symptom relief for angina.
5. When teaching a client with a new prescription for Warfarin, which herbal supplement should the nurse instruct the client to avoid?
- A. St. John's wort
- B. Echinacea
- C. Garlic
- D. Ginseng
Correct answer: A
Rationale: The correct answer is St. John's wort. St. John's wort can reduce the effectiveness of Warfarin by interacting with its metabolism, potentially leading to decreased anticoagulant effects. Therefore, the nurse should instruct the client to avoid using St. John's wort while taking Warfarin to prevent adverse drug interactions. Echinacea, garlic, and ginseng are not the correct answers in this case. While these herbal supplements may also interact with Warfarin and affect its efficacy, St. John's wort has a well-known interaction with Warfarin that can significantly impact its anticoagulant effects. Educating the client about the specific interaction between St. John's wort and Warfarin is crucial to ensure patient safety and the medication's therapeutic benefit.
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