ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client reports taking Aspirin about four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?
- A. Digoxin
- B. Metformin
- C. Warfarin
- D. Nitroglycerin
Correct answer: C
Rationale: The correct answer is C, Warfarin. Aspirin increases the effect of anticoagulants like warfarin by inhibiting platelet aggregation, leading to an increased risk of bleeding. Therefore, the use of aspirin is generally contraindicated for clients taking warfarin. Choices A, B, and D are not contraindicated with aspirin. Digoxin, Metformin, and Nitroglycerin do not have significant interactions with Aspirin, unlike Warfarin, making them safe to use concomitantly.
2. A client has a new prescription for Ranitidine. Which of the following instructions should the nurse include?
- A. Take the medication with an antacid.
- B. Avoid drinking coffee while taking this medication.
- C. Take the medication at bedtime.
- D. Stop the medication if you develop a headache.
Correct answer: C
Rationale: The correct instruction for a client prescribed Ranitidine is to take the medication at bedtime. Ranitidine is best taken at bedtime as it helps decrease the production of stomach acid during the night, providing optimal relief for conditions like heartburn or acid indigestion.
3. A client with Bipolar disorder has a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)
- A. This medication can safely be taken during pregnancy.
- B. Eliminate grapefruit juice from your diet.
- C. You will need to have a complete blood count and carbamazepine levels drawn periodically.
- D. Notify your provider if you develop a rash.
Correct answer: B
Rationale: The correct answer is B: "Eliminate grapefruit juice from your diet." Grapefruit juice affects carbamazepine metabolism and should be avoided. It can lead to increased levels of the medication, potentially causing toxicity. Monitoring carbamazepine blood levels and the complete blood count (CBC) is essential to ensure the medication's efficacy and safety. Although choice A is incorrect (This medication can safely be taken during pregnancy), carbamazepine is classified as a Pregnancy Category D drug, which means there is positive evidence of human fetal risk. Choice D (Notify your provider if you develop a rash) is also important because carbamazepine can cause serious adverse effects like Stevens-Johnson syndrome, which can be life-threatening. Regular monitoring and prompt reporting of any rash are crucial. Therefore, choices C and D are also relevant instructions for the client.
4. A client has a new prescription for Enfuvirtide to treat HIV infection. The nurse should monitor the client for which of the following adverse reactions?
- A. Bone marrow suppression
- B. Pancreatitis
- C. Pancreatitis
- D. Bone marrow suppression
Correct answer: D
Rationale: While bone marrow suppression is not typically associated with Enfuvirtide, a more relevant concern is the risk of severe allergic reactions such as anaphylaxis. Enfuvirtide, an HIV fusion inhibitor, can cause local injection site reactions and systemic allergic responses. Monitoring for signs of allergic reactions, such as rash, fever, and difficulty breathing, is crucial to ensure the client's safety.
5. A client has a new prescription for Levothyroxine to treat hypothyroidism. Which of the following instructions should be included in the teaching?
- A. Take this medication with food.
- B. Take this medication at bedtime.
- C. Expect to see results in 1 week.
- D. Do not discontinue the medication without consulting the provider.
Correct answer: D
Rationale: The correct instruction for a client with a new prescription for Levothyroxine to treat hypothyroidism is not to discontinue the medication without consulting the provider. Abrupt cessation could lead to the return of hypothyroid symptoms, emphasizing the importance of medical guidance when considering any changes to the treatment plan. Choice A is incorrect because Levothyroxine should be taken on an empty stomach, typically in the morning. Choice B is incorrect as it contradicts the timing of administration for Levothyroxine. Choice C is inaccurate as it usually takes a few weeks for the full effects of Levothyroxine to be seen, not just 1 week.
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