ATI RN
ATI Pharmacology Proctored Exam
1. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?
- A. Take one tablet at the first sign of chest pain.
- B. If pain is not relieved, take another tablet in 10 minutes.
- C. You can take up to five tablets in 15 minutes.
- D. Swallow the tablet with water.
Correct answer: A
Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain is not relieved after 5 minutes, the client should call 911 and take a second tablet. Taking more than the recommended dose can lead to serious side effects, and swallowing the tablet would not provide the rapid effect needed in cases of chest pain. Choice A is correct because it aligns with the standard protocol for nitroglycerin use in treating angina. Choice B is incorrect as the second tablet should be taken after 5 minutes, not 10 minutes. Choice C is incorrect as taking up to five tablets in 15 minutes is excessive and can result in serious complications. Choice D is incorrect as nitroglycerin sublingual tablets should be placed under the tongue for rapid absorption, not swallowed.
2. A client with heart failure is being instructed on laxative use. Which of the following laxatives should the client avoid?
- A. Sodium phosphate
- B. Psyllium
- C. Bisacodyl
- D. Polyethylene glycol
Correct answer: A
Rationale: The correct answer is A: Sodium phosphate. Clients with heart failure often follow a sodium-restricted diet. Sodium phosphate laxatives can lead to sodium absorption, causing fluid retention, which is contraindicated in heart failure. It is crucial to avoid sodium phosphate laxatives in these clients to prevent exacerbation of fluid overload and heart failure symptoms. Psyllium (choice B), Bisacodyl (choice C), and Polyethylene glycol (choice D) are not contraindicated in clients with heart failure and can be used safely for bowel management.
3. A client has a new prescription for a Nitroglycerin transdermal patch. Which of the following instructions should the nurse include?
- A. Apply the patch to the same site each day.
- B. Remove the patch at night.
- C. Cover the patch with a heating pad.
- D. Apply the patch to a hairless area of skin.
Correct answer: D
Rationale: The correct instruction is to apply the Nitroglycerin transdermal patch to a hairless area of skin. This ensures proper absorption of the medication. It is important to rotate the application site daily to prevent skin irritation and tolerance development. Applying the patch to the same site each day can lead to decreased efficacy and potential skin reactions. Removing the patch at night is not necessary as the patches are usually worn continuously to provide constant medication delivery. Covering the patch with a heating pad can increase the absorption of the medication and lead to an overdose, which is not recommended.
4. A client with active pulmonary tuberculosis (TB) is to be started on intravenous rifampin therapy. The client should be informed by the nurse that this medication can cause which of the following adverse effects?
- A. Constipation
- B. Black-colored stools
- C. Staining of teeth
- D. Body secretions turning a red-orange color
Correct answer: D
Rationale: The correct answer is D: Body secretions turning a red-orange color. Rifampin is known to cause body secretions, such as urine, sweat, tears, and sputum, to turn a harmless red-orange color. This is a common and expected side effect of rifampin therapy. Choices A, B, and C are incorrect. Constipation is not a common adverse effect of rifampin. Black-colored stools and staining of teeth are not associated with rifampin therapy. It is important for the nurse to educate the client about the harmless red-orange discoloration that may occur with this medication.
5. A client has a new prescription for levothyroxine. Which of the following instructions should the nurse include?
- A. Take this medication at bedtime.
- B. Take this medication with food.
- C. Take this medication on an empty stomach in the morning.
- D. Take this medication with an antacid.
Correct answer: C
Rationale: Levothyroxine should be taken on an empty stomach in the morning to enhance its absorption. This timing allows for optimal absorption and effectiveness of the medication. Taking it with food, at bedtime, or with an antacid may interfere with its absorption and reduce its efficacy.
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