ATI RN
ATI Pharmacology Proctored Exam 2019
1. 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.
2. A healthcare provider is preparing to administer metoprolol to a client. Which of the following findings should the provider identify as a contraindication to receiving this medication?
- A. Bradycardia
- B. Hypertension
- C. Fever
- D. Rash
Correct answer: A
Rationale: Metoprolol, a beta-blocker, is contraindicated in clients with bradycardia as it can further lower the heart rate, potentially leading to more serious complications. Bradycardia is defined as a heart rate below 60 beats per minute, and administering metoprolol in such cases can exacerbate this condition, causing adverse effects on cardiac output. Hypertension, fever, and rash are not contraindications for metoprolol administration.
3. A client with heart failure is prescribed digoxin. Which of the following findings should the nurse identify as an adverse effect of digoxin?
- A. Constipation
- B. Blurred vision
- C. Nausea
- D. Headache
Correct answer: B
Rationale: Blurred vision is a common adverse effect of digoxin and can indicate toxicity. Monitoring for visual changes is essential to prevent serious complications in clients taking digoxin.
4. A client has been prescribed Warfarin for atrial fibrillation. Which of the following instructions should the nurse include in the discharge teaching?
- A. Avoid foods high in vitamin K.
- B. Take this medication with food to prevent nausea.
- C. Monitor your heart rate daily before taking the medication.
- D. Limit your fluid intake to 1 liter per day.
Correct answer: A
Rationale: The correct instruction for the nurse to include in the discharge teaching for a client prescribed Warfarin is to 'Avoid foods high in vitamin K.' Foods high in vitamin K can decrease the effectiveness of Warfarin by interfering with its anticoagulant effects, potentially leading to blood clotting issues. It is crucial for clients on Warfarin therapy to maintain a consistent intake of vitamin K-containing foods to ensure the stability of the medication's effects. Choices B, C, and D are incorrect because taking Warfarin with food, monitoring heart rate daily, or limiting fluid intake are not directly related to optimizing the effectiveness of Warfarin therapy.
5. A client has a prescription for a Nitroglycerin transdermal patch. Which of the following instructions should be included by the healthcare provider?
- A. Apply the patch to a hairless area of the body.
- B. Remove the patch every 12 hours.
- C. Massage the patch after applying it.
- D. Place the patch over a hairless area of the body.
Correct answer: D
Rationale: The correct instruction for a Nitroglycerin transdermal patch is to place it over a hairless area of the body. This is essential to ensure proper adhesion and consistent absorption of the medication. Hair can impede the patch's ability to stick to the skin and deliver the medication effectively. Therefore, choices A, B, and C are incorrect. Applying the patch to the same site every day (Choice A) may lead to skin irritation, removing the patch every 12 hours (Choice B) is not typically recommended for Nitroglycerin patches, and massaging the patch after applying it (Choice C) could alter its integrity and affect drug delivery.
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