ATI RN
ATI Pharmacology Proctored Exam
1. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone. What is the nurse's priority action?
- A. Administering a supplemental dose of hydrocortisone
- B. Instructing the client about coughing and deep breathing
- C. Collecting additional information from the client about his history of Addison's disease
- D. Inserting an indwelling urinary catheter
Correct answer: A
Rationale: The priority action for a client with Addison's disease undergoing surgery who takes hydrocortisone is to administer a supplemental dose of hydrocortisone. Acute adrenal insufficiency (adrenal crisis) is a significant risk during surgery due to the stress placed on the body. Supplemental doses help prevent acute adrenal insufficiency and ensure the client's safety during the surgical procedure. Instructing the client about coughing and deep breathing is important post-operatively but not the priority before surgery. Collecting additional information about the client's history of Addison's disease is relevant but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority action in this scenario.
2. A client has a new prescription for Metoclopramide to treat nausea. Which of the following client statements indicates an understanding of the teaching?
- A. I should take this medication before bedtime.
- B. I will discontinue this medication if I experience drowsiness.
- C. I should report restlessness or involuntary movements.
- D. This medication can change the color of my urine to orange.
Correct answer: C
Rationale: The correct answer is C. Reporting restlessness or involuntary movements is crucial as they can be signs of extrapyramidal symptoms, a potential side effect of Metoclopramide. These symptoms should be reported promptly to the healthcare provider for appropriate management. Choices A, B, and D are incorrect because taking the medication before bedtime, discontinuing it due to drowsiness, or expecting urine color changes are not relevant teaching points for Metoclopramide use.
3. A client with a new prescription for Verapamil to control hypertension is being taught by a healthcare professional. Which of the following client statements indicates an understanding of the teaching?
- A. I should avoid drinking grapefruit juice.
- B. I can expect my heart rate to increase while taking this medication.
- C. This medication will cause my urine to turn orange.
- D. I will stop taking this medication if I experience headaches.
Correct answer: A
Rationale: The correct answer is A. Grapefruit juice can increase blood levels of verapamil, leading to increased effects and potentially serious side effects such as hypotension or bradycardia. It is crucial for the client to avoid grapefruit juice while taking Verapamil to prevent these adverse reactions. Choice B is incorrect because verapamil is a calcium channel blocker that typically lowers heart rate. Choice C is incorrect as verapamil does not cause urine discoloration. Choice D is incorrect because stopping medication abruptly without consulting a healthcare provider can be dangerous.
4. A client has a new prescription for Enoxaparin. Which of the following instructions should the nurse include?
- A. Massage the injection site after administration.
- B. Aspirate before injecting the medication.
- C. Administer the medication into the abdomen.
- D. Administer the medication via intramuscular injection.
Correct answer: C
Rationale: The correct answer is to administer the medication into the abdomen. Enoxaparin is a medication that is administered subcutaneously, typically in the abdomen to ensure proper absorption. Massaging the injection site should be avoided as it can lead to bruising or bleeding under the skin. Aspirating before injecting the medication is not necessary for subcutaneous injections like Enoxaparin. Administering the medication via intramuscular injection is incorrect as Enoxaparin should be given subcutaneously.
5. A client has a new prescription for Simvastatin. Which of the following client statements indicates an understanding of the teaching?
- A. I will take this medication at bedtime.
- B. I should avoid eating grapefruit while taking this medication.
- C. I will need to monitor my blood sugar closely while taking this medication.
- D. I will stop taking the medication if I develop muscle pain.
Correct answer: B
Rationale: The correct answer is B. Grapefruit can increase the levels of simvastatin in the blood, leading to an increased risk of serious side effects, including muscle pain or damage. Therefore, it is crucial for the client to avoid consuming grapefruit while taking this medication to prevent potential complications.
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