ATI RN
ATI Pharmacology Proctored Exam 2023
1. A client has a new prescription for hydrochlorothiazide. The client should monitor for which of the following adverse effects?
- A. Hyponatremia
- B. Ototoxicity
- C. Hypoglycemia
- D. Hyperkalemia
Correct answer: A
Rationale: Hyponatremia is a potential adverse effect of hydrochlorothiazide due to its diuretic action. Hydrochlorothiazide is a thiazide diuretic that can cause sodium and water loss, potentially leading to hyponatremia. Monitoring for symptoms such as weakness, confusion, and muscle cramps can help detect hyponatremia early. Ototoxicity (choice B) is not a common adverse effect of hydrochlorothiazide. Hypoglycemia (choice C) is not typically associated with hydrochlorothiazide use. Hyperkalemia (choice D) is more commonly associated with potassium-sparing diuretics rather than thiazide diuretics like hydrochlorothiazide.
2. A client is taking Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?
- A. Sodium level of 138 mEq/L
- B. Potassium level of 5.2 mEq/L
- C. Chloride level of 100 mEq/L
- D. Calcium level of 9.5 mg/dL
Correct answer: B
Rationale: The correct answer is B: Potassium level of 5.2 mEq/L. Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia (elevated potassium levels). A potassium level of 5.2 mEq/L is considered elevated and should be reported to the provider for further assessment and management to prevent potential complications. Choices A, C, and D are not directly affected by Spironolactone and do not typically require immediate reporting unless there are other underlying issues or specific instructions for those electrolytes.
3. A male client recently started taking Haloperidol. Which of the following findings is the highest priority to report to the provider?
- A. Shuffling gait
- B. Neck spasms
- C. Drowsiness
- D. Impotence
Correct answer: B
Rationale: Neck spasms are an indication of acute dystonia, a serious side effect of Haloperidol that can quickly progress to a crisis situation. Immediate medical attention is necessary to prevent complications. Shuffling gait and drowsiness are common side effects of Haloperidol but are not as urgent as neck spasms. Impotence is not typically associated with Haloperidol use. Therefore, identifying neck spasms as the priority finding is crucial for the client's safety.
4. A client has a new prescription for Brimonidine ophthalmic drops and wears soft contact lenses. Which of the following instructions should the nurse include in the teaching?
- A. This medication can stain your contacts.
- B. This medication can cause your pupils to constrict.
- C. This medication can absorb into your contacts.
- D. This medication can slow your heart rate.
Correct answer: C
Rationale: The correct instruction the nurse should include is that Brimonidine can absorb into soft contact lenses. To prevent this, the client should remove the contacts, instill the medication, and wait at least 15 minutes before putting the contacts back in to avoid any potential absorption of the medication into the lenses. Choices A, B, and D are incorrect because Brimonidine is not known to stain contacts, cause pupil constriction, or slow heart rate.
5. When teaching a client with a new prescription for Simvastatin, which instruction should be included?
- A. Take this medication with food.
- B. Avoid drinking grapefruit juice.
- C. Take this medication in the morning.
- D. Increase your intake of potassium-rich foods.
Correct answer: B
Rationale: The correct instruction for a client with a new prescription for Simvastatin is to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of Simvastatin, leading to increased blood levels of the drug and a higher risk of adverse effects such as muscle pain and liver damage. It is important to educate the client about this potential interaction to ensure the safe and effective use of the medication. Choices A, C, and D are incorrect because taking Simvastatin with food or in the morning and increasing potassium-rich foods intake are not specifically related to the safe use of Simvastatin. Avoiding grapefruit juice is crucial to prevent drug interactions.
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