ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?
- A. Take the albuterol at the same time each day.
- B. Administer the albuterol inhaler before using the beclomethasone inhaler.
- C. Use beclomethasone if experiencing an acute episode.
- D. Avoid shaking the beclomethasone before use.
Correct answer: B
Rationale: When a client is prescribed an inhaled beta2-agonist (such as albuterol) and an inhaled glucocorticoid (such as beclomethasone) for asthma control, the beta2-agonist should be administered first. Administering the beta2-agonist before the glucocorticoid helps promote bronchodilation and enhances the absorption of the glucocorticoid, maximizing its effectiveness in the lungs. Choice A is incorrect because albuterol is usually taken as needed for quick relief of asthma symptoms and not necessarily at the same time each day. Choice C is incorrect as beclomethasone is a controller medication used for long-term asthma management, not for acute episodes. Choice D is incorrect as shaking the beclomethasone inhaler before use helps ensure proper medication dispersion for effective inhalation.
2. A healthcare professional is reviewing the laboratory results of a client who is taking Lithium for Bipolar Disorder. Which of the following findings should the healthcare professional report to the provider immediately?
- A. Lithium level of 1.0 mEq/L
- B. Potassium level of 3.5 mEq/L
- C. Sodium level of 140 mEq/L
- D. Creatinine level of 1.0 mg/dL
Correct answer: D
Rationale: A creatinine level of 1.0 mg/dL should be reported to the provider immediately. While a lithium level of 1.0 mEq/L falls within the therapeutic range, a creatinine level of 1.0 mg/dL could suggest early signs of kidney dysfunction, especially concerning in a client on long-term lithium therapy. It is crucial to monitor kidney function closely because lithium can be nephrotoxic over time. Elevated creatinine levels may indicate impaired kidney function and should prompt immediate reporting to the healthcare provider. Potassium and sodium levels within normal range are not immediate concerns when compared to potential kidney issues.
3. Which medication is contraindicated with Nitroglycerin?
- A. Hydrochloroquine
- B. Methylprednisolone
- C. Phenazopyridine
- D. Erectile dysfunction drugs
Correct answer: D
Rationale: The correct answer is D: Erectile dysfunction drugs. Erectile dysfunction drugs are contraindicated with Nitroglycerin because they can potentiate the hypotensive effects of Nitroglycerin, leading to severe hypotension. Choices A, B, and C are incorrect because they are not known to have significant interactions with Nitroglycerin.
4. A client has a new prescription for Amiodarone. Which of the following instructions should the nurse include?
- A. Take this medication with meals.
- B. Avoid drinking grapefruit juice.
- C. Take this medication at bedtime.
- D. Increase your intake of sodium-rich foods.
Correct answer: B
Rationale: The correct instruction the nurse should include is to advise the client to avoid drinking grapefruit juice while taking Amiodarone. Grapefruit juice can inhibit the metabolism of Amiodarone, leading to increased blood levels of the medication and raising the risk of adverse effects, such as cardiac toxicity. Choices A, C, and D are incorrect. Taking Amiodarone with meals, at bedtime, or increasing intake of sodium-rich foods are not necessary instructions for this medication.
5. In reviewing a client's health record, which condition would be a contraindication for using Propranolol to treat hypertension?
- A. Asthma
- B. Glaucoma
- C. Hypertension
- D. Tachycardia
Correct answer: A
Rationale: Propranolol is a nonselective beta-adrenergic blocker that blocks both beta1 and beta2 receptors. Blocking beta2 receptors in the lungs can lead to bronchoconstriction, making it unsuitable for clients with asthma. Therefore, asthma is a contraindication for taking Propranolol. Glaucoma, hypertension, and tachycardia are not contraindications for using Propranolol to treat hypertension.
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