ATI RN
ATI Capstone Pharmacology Assessment 1
1. A client prescribed hydromorphone for severe pain has a decreased respiratory rate from 16 breaths per minute to 6. Which of the following medications should the nurse prepare to administer?
- A. Flumazenil
- B. Naloxone
- C. Activated charcoal
- D. Aluminum hydroxide
Correct answer: B
Rationale: Naloxone is the correct answer as it is used to reverse opioid-induced respiratory depression. Hydromorphone is an opioid medication that can cause respiratory depression at high doses. Naloxone is an opioid antagonist that competes with opioids at receptor sites, reversing the effects of opioids like hydromorphone. Flumazenil (Choice A) is a benzodiazepine antagonist used for benzodiazepine overdose, not opioid overdose. Activated charcoal (Choice C) is used for toxin ingestion to prevent absorption in the gastrointestinal tract, but it is not indicated for opioid overdose. Aluminum hydroxide (Choice D) is an antacid and would not be the appropriate intervention for respiratory depression caused by opioid overdose.
2. A nurse is providing client education regarding lithium therapy. Which of the following instructions should the nurse include?
- A. Take with food to decrease nausea
- B. Avoid excessive intake of caffeinated beverages
- C. Monitor for signs of dehydration
- D. Restrict salt intake to prevent water retention
Correct answer: B
Rationale: The correct answer is B. The nurse should instruct the client to avoid excessive intake of caffeinated beverages as they can interfere with lithium levels. Option A is incorrect as lithium is usually recommended to be taken on an empty stomach. Option C is not directly related to lithium therapy. Option D is not a typical instruction for lithium therapy.
3. A client is prescribed spironolactone. Which of the following findings would indicate an adverse effect of this medication?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hyponatremia
- D. Hypernatremia
Correct answer: A
Rationale: Hyperkalemia is the correct answer as it is an adverse effect associated with spironolactone, a potassium-sparing diuretic. Spironolactone works by blocking the aldosterone receptor in the distal convoluted tubule, leading to decreased potassium excretion and potential hyperkalemia. Hypokalemia (choice B) and hyponatremia (choice C) are not typically associated with spironolactone use. Hypernatremia (choice D) is also an unlikely finding with spironolactone.
4. A client has been prescribed vasopressin for the treatment of diabetes insipidus. What is the expected pharmacologic action of this medication?
- A. To stimulate the pancreas to secrete insulin
- B. To slow the absorption of glucose in the intestine
- C. To increase reabsorption of water in the renal tubules
- D. To increase blood pressure
Correct answer: C
Rationale: The correct answer is C: To increase reabsorption of water in the renal tubules. Vasopressin, also known as antidiuretic hormone (ADH), works by increasing the reabsorption of water in the renal tubules, which helps to concentrate urine and reduce excessive urination in diabetes insipidus. Choice A is incorrect as vasopressin does not stimulate the pancreas to secrete insulin. Choice B is incorrect as vasopressin does not affect the absorption of glucose in the intestine. Choice D is incorrect as vasopressin's primary action is not to increase blood pressure, although it can have some vasoconstrictive effects.
5. A client has been prescribed metoclopramide. Which of the following should the nurse include in client education regarding this medication?
- A. Notify your provider if you experience restlessness or spasms of the face or neck
- B. This medication can cause insomnia
- C. Decrease your fluid intake while taking this medication
- D. This medication can cause urinary frequency
Correct answer: A
Rationale: The correct answer is A: 'Notify your provider if you experience restlessness or spasms of the face or neck.' Metoclopramide can lead to extrapyramidal symptoms such as restlessness or facial spasms, which are serious and require immediate medical attention. Choices B, C, and D are incorrect. Insomnia is not a common side effect of metoclopramide. Increasing fluid intake is usually recommended to prevent dehydration caused by potential side effects like diarrhea. Urinary frequency is not a typical side effect associated with metoclopramide.
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