ATI RN
Proctored Pharmacology ATI
1. A client with Bipolar disorder has a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)
- A. This medication can safely be taken during pregnancy.
- B. Eliminate grapefruit juice from your diet.
- C. You will need to have a complete blood count and carbamazepine levels drawn periodically.
- D. Notify your provider if you develop a rash.
Correct answer: B
Rationale: The correct answer is B: "Eliminate grapefruit juice from your diet." Grapefruit juice affects carbamazepine metabolism and should be avoided. It can lead to increased levels of the medication, potentially causing toxicity. Monitoring carbamazepine blood levels and the complete blood count (CBC) is essential to ensure the medication's efficacy and safety. Although choice A is incorrect (This medication can safely be taken during pregnancy), carbamazepine is classified as a Pregnancy Category D drug, which means there is positive evidence of human fetal risk. Choice D (Notify your provider if you develop a rash) is also important because carbamazepine can cause serious adverse effects like Stevens-Johnson syndrome, which can be life-threatening. Regular monitoring and prompt reporting of any rash are crucial. Therefore, choices C and D are also relevant instructions for the client.
2. A client is being discharged and will start long-term oral prednisone for chronic asthma treatment. The client should monitor for which of the following adverse effects of this medication?
- A. Weight gain
- B. Nervousness
- C. Bradycardia
- D. Constipation
Correct answer: A
Rationale: Weight gain is an adverse effect of oral prednisone due to sodium and water retention, which leads to fluid retention. This can be monitored by tracking weight changes. Nervousness (Choice B) is not a common adverse effect of prednisone. Bradycardia (Choice C) is not typically associated with prednisone use; in fact, tachycardia can be more common. Constipation (Choice D) is not a prominent adverse effect of prednisone.
3. A healthcare professional is preparing to administer Filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?
- A. Administer intravenously to prevent injury.
- B. Ensure that the medication is kept refrigerated until just prior to administration.
- C. Do not shake the vial; gently invert it to mix before withdrawing the dose.
- D. Discard the vial after removing one dose of the medication.
Correct answer: D
Rationale: When administering Filgrastim, only one dose should be withdrawn from the vial, and the vial should then be discarded to prevent any contamination or errors in dosing. It is crucial not to shake the vial but gently invert it to mix the medication before withdrawing the appropriate dose. Refrigeration is not required for Filgrastim; it should be stored at room temperature until just before administration. Choice A is incorrect because Filgrastim is typically administered subcutaneously, not intravenously. Choice B is incorrect as the medication should be stored at room temperature, not refrigerated, until administration. Choice C is incorrect as shaking the vial is not recommended for Filgrastim.
4. When teaching a client about preventing Otitis Externa, which of the following instructions should the nurse include?
- A. Clean the ear with a cotton-tipped swab daily.
- B. Place earplugs in the ears when sleeping at night.
- C. Use a cool water irrigation solution to remove earwax.
- D. Tip the head to the side to remove water from the ears after showering.
Correct answer: D
Rationale: To prevent Otitis Externa, the nurse should instruct the client to tip the head to the side to allow water to drain out after showering or swimming. This helps to prevent moisture buildup in the ear canal, reducing the risk of developing Otitis Externa, commonly known as swimmer's ear.
5. A client has a new prescription for hydrochlorothiazide. The client should monitor for which of the following adverse effects?
- A. Hyponatremia
- B. Ototoxicity
- C. Hypoglycemia
- D. Hyperkalemia
Correct answer: A
Rationale: Hyponatremia is a potential adverse effect of hydrochlorothiazide due to its diuretic action. Hydrochlorothiazide is a thiazide diuretic that can cause sodium and water loss, potentially leading to hyponatremia. Monitoring for symptoms such as weakness, confusion, and muscle cramps can help detect hyponatremia early. Ototoxicity (choice B) is not a common adverse effect of hydrochlorothiazide. Hypoglycemia (choice C) is not typically associated with hydrochlorothiazide use. Hyperkalemia (choice D) is more commonly associated with potassium-sparing diuretics rather than thiazide diuretics like hydrochlorothiazide.
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