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. When administering subcutaneous enoxaparin 40 mg using a prefilled syringe of Enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty, what action should the nurse plan to take?
- A. Expel any air bubbles from the prefilled syringe before injecting.
- B. Insert the needle completely into the client's tissue.
- C. Administer the injection in the client's thigh.
- D. Aspirate carefully after inserting the needle into the client's skin.
Correct answer: B
Rationale: When administering enoxaparin via a prefilled syringe for deep subcutaneous injection, the nurse should insert the needle completely into the client's tissue. This action ensures proper delivery of the medication into the subcutaneous layer, promoting optimal therapeutic effects. Choice A is incorrect because there is no need to expel air bubbles from a prefilled syringe. Choice C is incorrect as enoxaparin is typically administered in the abdomen for subcutaneous injections. Choice D is incorrect as aspiration is not recommended for subcutaneous injections to avoid trauma or damage to tissues.
3. A client with chronic renal disease is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?
- A. The leukocyte count
- B. The platelet count
- C. The hematocrit (Hct)
- D. The erythrocyte sedimentation rate (ESR)
Correct answer: C
Rationale: The correct answer is C: The hematocrit (Hct). Monitoring the hematocrit is essential to assess the therapeutic effect of epoetin alfa because this medication stimulates red blood cell production in clients with chronic renal disease. The leukocyte count (choice A) and platelet count (choice B) are not directly affected by epoetin alfa therapy. The erythrocyte sedimentation rate (ESR) (choice D) is a non-specific marker of inflammation and is not used to monitor the therapeutic effect of epoetin alfa.
4. A client has a prescription for Amphotericin B. Which of the following laboratory values should be monitored by the nurse to assess for an adverse effect of this medication?
- A. Serum creatinine.
- B. Serum potassium.
- C. Serum sodium.
- D. Serum calcium.
Correct answer: A
Rationale: Corrected Rationale: Amphotericin B is known to cause nephrotoxicity, a potential adverse effect that can be monitored by checking the client's serum creatinine levels. Regular monitoring of serum creatinine helps in early identification of kidney damage and allows for timely intervention to prevent further complications. Choice B, serum potassium, is not typically associated with adverse effects of Amphotericin B. Choice C, serum sodium, and choice D, serum calcium, are not directly affected by Amphotericin B and are not primary indicators of its adverse effects.
5. A client is taking oral Oxycodone and Ibuprofen. The nurse should identify that an interaction between these two medications will cause which of the following findings?
- A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication.
- B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication.
- C. An increase in the expected therapeutic effect of both medications.
- D. An increase in expected adverse effects for both medications.
Correct answer: C
Rationale: The interaction between oxycodone and ibuprofen results in an increase in the expected therapeutic effect of both medications. Oxycodone is a narcotic analgesic, while ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). They work through different mechanisms but complement each other in pain management. When taken together, they can enhance the pain-relieving effects of each other, providing better pain relief for the client.
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