ATI RN
Proctored Pharmacology ATI
1. A client is taking Warfarin for atrial fibrillation. Which of the following client statements indicates a need for further teaching?
- A. I will avoid eating broccoli.
- B. I will use an electric razor to shave.
- C. I will take aspirin for headaches.
- D. I will have my blood tested regularly.
Correct answer: C
Rationale: The correct answer is C. Taking aspirin along with Warfarin can increase the risk of bleeding. Clients should be advised to avoid medications that increase the risk of bleeding when taking Warfarin to prevent complications. Choices A, B, and D are all correct statements indicating good understanding of Warfarin therapy. Avoiding foods high in Vitamin K, using an electric razor to prevent cuts that can lead to bleeding, and regular blood testing to monitor Warfarin levels are all important aspects of managing Warfarin therapy.
2. A client has a new prescription for methotrexate to treat Rheumatoid Arthritis. The nurse should expect to monitor the client for which of the following adverse effects?
- A. Insomnia
- B. Hypertension
- C. Bone marrow suppression
- D. Constipation
Correct answer: C
Rationale: The correct answer is bone marrow suppression. Methotrexate can lead to bone marrow suppression, resulting in anemia, leukopenia, and thrombocytopenia. Monitoring for signs of decreased blood cell counts is crucial to prevent complications. Insomnia (choice A), hypertension (choice B), and constipation (choice D) are not typically associated with methotrexate use for Rheumatoid Arthritis.
3. A client with angina is being taught how to use nitroglycerin transdermal ointment. Which instruction should the nurse include?
- A. Remove the prior dose before applying a new dose.
- B. Rub the ointment directly into the skin until it is no longer visible.
- C. Cover the applied ointment with a clean gauze pad.
- D. Apply the ointment to the same skin area each time.
Correct answer: A
Rationale: The correct instruction is to remove the prior dose before applying a new one to prevent toxicity. Nitroglycerin ointment can cause adverse effects if accumulated doses are not removed. Rubbing the ointment until it's not visible or covering it with gauze may alter absorption. Applying it to the same area each time can lead to skin irritation or desensitization.
4. A client has a new prescription for Warfarin. The nurse should identify that the concurrent use of which of the following medications increases the client's risk of bleeding?
- A. Vitamin K
- B. Calcium carbonate
- C. Acetaminophen
- D. Ranitidine
Correct answer: C
Rationale: The correct answer is Acetaminophen (Choice C). Acetaminophen, especially in high doses, can increase the risk of bleeding in clients taking Warfarin. It can potentiate the anticoagulant effect of Warfarin, leading to an increased risk of bleeding. Vitamin K (Choice A) is actually used to reverse the effects of Warfarin in case of over-anticoagulation, so it does not increase the risk of bleeding. Calcium carbonate (Choice B) and Ranitidine (Choice D) do not significantly interact with Warfarin to increase the risk of bleeding.
5. A healthcare professional is reviewing laboratory findings and notes that a client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the healthcare professional?
- A. Perform immediate gastric lavage.
- B. Prepare the client for hemodialysis.
- C. Administer an additional oral dose of lithium.
- D. Request a stat repeat of the laboratory test.
Correct answer: A
Rationale: Performing immediate gastric lavage is the appropriate action for a client with severe lithium toxicity, indicated by a plasma lithium level of 2.1 mEq/L. Gastric lavage can help reduce the client's lithium level by removing the unabsorbed drug from the stomach.
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