ATI RN
ATI Pharmacology Proctored Exam 2023
1. A client has a new prescription for Atorvastatin. Which of the following instructions should the nurse include?
- A. Avoid drinking grapefruit juice.
- B. Take the medication with your evening meal.
- C. Increase your intake of leafy green vegetables.
- D. Stop taking the medication if you experience muscle pain.
Correct answer: A
Rationale: The correct answer is A: 'Avoid drinking grapefruit juice.' Grapefruit juice should be avoided when taking Atorvastatin because it can increase the blood levels of the medication, potentially leading to a higher risk of adverse effects like muscle pain and liver damage. It is important to follow this instruction to ensure the safe and effective use of Atorvastatin. Choices B, C, and D are incorrect. Taking Atorvastatin with food, specifically a low-fat meal, is recommended, but it is not necessary to specify the evening meal. While increasing intake of leafy green vegetables is generally beneficial for health, it is not a specific instruction for Atorvastatin. Lastly, stopping the medication if one experiences muscle pain is not advisable without consulting a healthcare provider, as muscle pain can be a symptom of a serious side effect of Atorvastatin that requires medical attention.
2. A client has a new prescription for Warfarin. The nurse should identify that the concurrent use of which of the following medications increases the client's risk of bleeding?
- A. Vitamin K
- B. Calcium carbonate
- C. Acetaminophen
- D. Ranitidine
Correct answer: C
Rationale: The correct answer is Acetaminophen (Choice C). Acetaminophen, especially in high doses, can increase the risk of bleeding in clients taking Warfarin. It can potentiate the anticoagulant effect of Warfarin, leading to an increased risk of bleeding. Vitamin K (Choice A) is actually used to reverse the effects of Warfarin in case of over-anticoagulation, so it does not increase the risk of bleeding. Calcium carbonate (Choice B) and Ranitidine (Choice D) do not significantly interact with Warfarin to increase the risk of bleeding.
3. A client is prescribed Amitriptyline for depression. What should the nurse include in the teaching? (Select all that apply.)
- A. Expect therapeutic effects in 1-3 weeks.
- B. Discontinue the medication gradually under healthcare provider supervision.
- C. Change positions slowly to minimize dizziness.
- D. Increase dietary fiber intake to prevent constipation.
Correct answer: C
Rationale: The correct answer is C. Changing positions slowly can help prevent orthostatic hypotension, a common adverse effect of tricyclic antidepressants like Amitriptyline. It is essential to educate the client to avoid sudden position changes to minimize the risk of dizziness and falls. Choices A, B, and D are incorrect. The therapeutic effects of Amitriptyline may not be noticeable for 1-3 weeks, so expecting them in 24 to 48 hours (choice A) is unrealistic. Discontinuing the medication abruptly can lead to withdrawal symptoms and should be done gradually under healthcare provider supervision, so choice B is incorrect. Amitriptyline can actually cause constipation, so increasing dietary fiber intake would be recommended to prevent constipation, making choice D incorrect.
4. A client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?
- A. Perform immediate gastric lavage.
- B. Prepare the client for hemodialysis.
- C. Administer an additional oral dose of lithium.
- D. Request a stat repeat of the laboratory test.
Correct answer: A
Rationale: In a client with a plasma lithium level of 2.1 mEq/L, immediate gastric lavage is appropriate for severe toxicity. Gastric lavage can help lower the client's lithium level by removing the unabsorbed lithium from the stomach.
5. A client has a new prescription for Cyclobenzaprine to treat muscle spasms. Which of the following instructions should the nurse include in the teaching?
- A. Avoid driving or operating heavy machinery while taking this medication.
- B. Take this medication on an empty stomach for best results.
- C. Take this medication only when experiencing muscle pain.
- D. Increase your intake of potassium-rich foods while taking this medication.
Correct answer: A
Rationale: The correct instruction that the nurse should include in the teaching for a client prescribed Cyclobenzaprine is to avoid driving or operating heavy machinery while taking this medication. Cyclobenzaprine can cause drowsiness, so it is important to advise clients to avoid activities that require alertness and coordination to prevent accidents or injuries. Choice B is incorrect because Cyclobenzaprine can be taken with or without food. Choice C is incorrect because Cyclobenzaprine is typically taken regularly as prescribed, not just when experiencing muscle pain. Choice D is incorrect because there is no specific need to increase potassium-rich foods while taking Cyclobenzaprine.
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