ATI RN
ATI Pharmacology Proctored Exam 2019
1. 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.
2. A client has Diabetes Mellitus, Pulmonary Tuberculosis, and a new prescription for Isoniazid. Which of the following supplements should the nurse expect to administer to prevent an adverse effect of INH?
- A. Ascorbic acid
- B. Pyridoxine
- C. Folic acid
- D. Cyanocobalamin
Correct answer: B
Rationale: Pyridoxine is administered with Isoniazid to prevent peripheral neuropathy, a common adverse effect of the drug. It is essential to provide this supplement to the client to minimize the risk of developing this adverse effect. Ascorbic acid (Vitamin C) is not typically given to prevent INH adverse effects. Folic acid and Cyanocobalamin are not commonly administered with INH for this purpose.
3. A nurse is caring for a client with hypertension who asks about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients with a history of which of the following conditions?
- A. Asthma
- B. Glaucoma
- C. Depression
- D. Migraines
Correct answer: A
Rationale: Corrected Rationale: Propranolol is contraindicated in clients with a history of asthma because it can cause bronchospasms due to its non-selective beta-blocking properties. By blocking beta-2 receptors in the lungs, propranolol can lead to bronchoconstriction, potentially triggering asthma symptoms and exacerbating respiratory issues. Asthma patients should avoid medications like propranolol that can worsen their condition. Choices B, C, and D are incorrect as propranolol is not contraindicated in clients with glaucoma, depression, or migraines. In fact, propranolol is sometimes used in the treatment of migraines and certain types of glaucoma.
4. A healthcare professional reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the professional take?
- A. Obtain a blood specimen immediately prior to administering the next dose of medication.
- B. Verify that the client has been taking the medication for 24 hours before obtaining a blood specimen.
- C. Ask the client to provide a urine specimen after the next dose of medication.
- D. Administer the medication, and obtain a blood specimen 30 minutes later.
Correct answer: A
Rationale: To verify trough levels of a medication, the healthcare professional should obtain a blood specimen immediately before administering the next dose of medication. This timing ensures an accurate representation of the medication's lowest concentration in the bloodstream, which is crucial for therapeutic monitoring and dose adjustments. Choice B is incorrect because waiting 24 hours after taking the medication would not provide an accurate trough level. Choice C is incorrect as urine specimens are not used to measure trough levels. Choice D is incorrect because obtaining a blood specimen 30 minutes after administering the medication would not reflect the trough level, as it is the lowest concentration before the next dose.
5. When caring for a school-age child with a new prescription for Atomoxetine, the nurse should monitor the client for which of the following adverse effects of this medication?
- A. Kidney toxicity
- B. Liver damage
- C. Seizure activity
- D. Adrenal insufficiency
Correct answer: B
Rationale: The correct answer is B: Liver damage. Atomoxetine can lead to liver damage as an adverse effect. Symptoms of liver damage include jaundice, upper abdominal tenderness, dark urine, and elevated liver enzymes. Monitoring for these signs is crucial when a child is on this medication. Choices A, C, and D are incorrect because Atomoxetine is not known to cause kidney toxicity, seizure activity, or adrenal insufficiency as primary adverse effects.
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