ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client is to receive Tetracaine prior to a Bronchoscopy. Which of the following actions should the nurse include in the plan of care?
- A. Keep the client NPO until the pharyngeal response returns.
- B. Monitor the insertion site for a hematoma.
- C. Palpate the bladder to detect urinary retention.
- D. Maintain the client on bed rest for 12 hours following the procedure.
Correct answer: A
Rationale: The correct action the nurse should include in the plan of care is to keep the client NPO until the pharyngeal response returns. This is important to prevent aspiration until the client's normal pharyngeal sensation is restored, typically within about 1 hour after the procedure. Monitoring the insertion site for a hematoma, palpating the bladder, and maintaining the client on bed rest are not directly related to the administration of Tetracaine prior to a Bronchoscopy. Therefore, these actions are not necessary in the immediate post-procedure care of a client receiving Tetracaine for a Bronchoscopy.
2. A client has an infection and a prescription for gentamicin intermittent IV bolus every 8 hr. A peak and trough is required with the next dose. Which of the following actions should be taken to obtain an accurate gentamicin serum level?
- A. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
- B. Draw a peak level 90 min prior to administering the medication and a trough level 90 min after the dose.
- C. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
- D. Draw a peak level at 0900 and a trough level at 2100.
Correct answer: C
Rationale: To obtain an accurate gentamicin serum level, the trough should be drawn immediately before administering the medication, and the peak level should be drawn 30 minutes after the dose. This timing allows for the assessment of the lowest and highest drug concentrations in the bloodstream, ensuring therapeutic levels are achieved while minimizing the risk of toxicity. Choice A is correct as it follows this timing protocol. Choices B and D have incorrect timing for peak and trough levels, which would not provide an accurate representation of the drug's concentration in the bloodstream.
3. A healthcare professional is reviewing the medication administration record for a client who is receiving transdermal Fentanyl for severe pain. Which of the following medications should the healthcare professional expect to cause an adverse effect when administered concurrently with Fentanyl?
- A. Ampicillin
- B. Diazepam
- C. Furosemide
- D. Prednisone
Correct answer: B
Rationale: Diazepam, a CNS depressant, can lead to severe sedation when administered concurrently with an opioid like Fentanyl due to their additive central nervous system depressant effects. This interaction can potentiate respiratory depression and other CNS effects, increasing the risk of adverse outcomes.
4. A client has a new prescription for rituximab. Which of the following findings should the nurse instruct the client to report?
- A. Dizziness
- B. Fever
- C. Urinary frequency
- D. Dry mouth
Correct answer: B
Rationale: The nurse should instruct the client to report fever. Fever can be an indication of an infection, a potential complication of rituximab therapy. Monitoring and reporting fever promptly can help in early intervention to prevent further complications. Dizziness, urinary frequency, and dry mouth are not typically associated with rituximab therapy and are less likely to be directly related to the medication. Therefore, they are not the priority findings to report in this scenario.
5. A client is taking Somatropin to stimulate growth. The healthcare provider should plan to monitor the client's urine for which of the following?
- A. Bilirubin
- B. Protein
- C. Potassium
- D. Calcium
Correct answer: D
Rationale: When a client is taking Somatropin to stimulate growth, monitoring calcium levels in the urine is crucial. Excessive calcium excretion can occur in the urine of clients taking Somatropin, increasing the risk of renal calculi. Therefore, monitoring calcium levels is essential to assess for potential kidney stone formation. Bilirubin, protein, and potassium are not specifically monitored in the urine of clients taking Somatropin for growth stimulation.
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