ATI RN
ATI Pharmacology Proctored Exam 2019
1. 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Rationale: When administering Filgrastim, only one dose should be withdrawn from the vial, and the vial should then be discarded to prevent any contamination or errors in dosing.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.
2. A healthcare professional is caring for a client who is prescribed Metformin. Which of the following laboratory values should the healthcare professional monitor to assess for potential adverse effects?
- A. Blood glucose
- B. Creatine kinase
- C. Hemoglobin A1c
- D. Serum creatinine
Correct answer: D
Rationale: Corrected Rationale: Metformin can lead to lactic acidosis, especially in individuals with impaired renal function. Monitoring the client's serum creatinine levels is crucial to assess kidney function because Metformin is eliminated by the kidneys, and impaired renal function can increase the risk of adverse effects. Monitoring blood glucose levels is essential for assessing the effectiveness of Metformin in managing diabetes but is not directly related to potential adverse effects of Metformin. Creatine kinase is not typically monitored in relation to Metformin therapy. Hemoglobin A1c is used to assess long-term glucose control in diabetes but is not specific for monitoring Metformin adverse effects.
3. A client reports taking Aspirin four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?
- A. Digoxin
- B. Metformin
- C. Warfarin
- D. Nitroglycerin
Correct answer: C
Rationale: Aspirin inhibits platelet aggregation, which can increase the effect of anticoagulants like warfarin, leading to an elevated risk of bleeding. Therefore, the concurrent use of aspirin and warfarin is generally contraindicated due to this potential interaction. Digoxin is not contraindicated with aspirin in most cases. Metformin and nitroglycerin do not have significant interactions with aspirin, making them less likely to be contraindicated in this scenario.
4. A client has a new prescription for combination oral NRTIs for the treatment of HIV. Which of the following statements should the nurse include in discharge teaching?
- A. These medications work by inhibiting enzymes to prevent HIV replication.
- B. These medications work by preventing protein synthesis within the HIV cell.
- C. These medications work by weakening the cell wall of the HIV virus.
- D. These medications work by blocking HIV entry into cells.
Correct answer: A
Rationale: The correct answer is A. NRTI antiretroviral medications inhibit the enzyme reverse transcriptase, which is essential for HIV replication. By blocking this enzyme, the medications prevent the virus from replicating and spreading. This mechanism of action helps to control the progression of HIV infection in the body. Choices B, C, and D are incorrect because NRTIs do not work by preventing protein synthesis, weakening the cell wall of the virus, or blocking HIV entry into cells. These mechanisms are associated with different classes of antiretroviral medications used in HIV treatment.
5. A client is receiving Gentamicin. Which of the following laboratory values should the nurse monitor to assess for nephrotoxicity?
- A. Serum sodium.
- B. Serum creatinine.
- C. Serum potassium.
- D. Serum glucose.
Correct answer: B
Rationale: When a client is receiving Gentamicin, the nurse should monitor serum creatinine levels to assess for nephrotoxicity. Gentamicin is known to potentially cause nephrotoxicity, leading to impaired kidney function. Monitoring serum creatinine levels helps in early detection of any kidney damage or dysfunction. Serum sodium, serum potassium, and serum glucose levels are not directly related to nephrotoxicity caused by Gentamicin, so they are not the appropriate values to monitor in this case.
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