ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client is prescribed Propranolol for a dysrhythmia. Which of the following actions should the nurse plan to take?
- A. Hold Propranolol if the client's apical pulse is greater than 100/min.
- B. Administer Propranolol to decrease the client's blood pressure.
- C. Assist the client with sitting up or standing after taking this medication.
- D. Monitor the client for hypokalemia due to the risk of Propranolol toxicity.
Correct answer: C
Rationale: The correct action the nurse should plan to take when administering Propranolol is to assist the client when sitting up or standing after taking the medication. Propranolol can lead to orthostatic hypotension, causing dizziness upon sudden position changes. It is essential to help the client with position changes to prevent falls or injury. Holding Propranolol if the client's apical pulse is greater than 100/min (Choice A) is incorrect because Propranolol is often used to manage dysrhythmias and slowing down the heart rate. Administering Propranolol to decrease the client's blood pressure (Choice B) is not the primary indication for using this medication. Monitoring the client for hypokalemia due to the risk of Propranolol toxicity (Choice D) is not a direct effect of Propranolol; rather, it is more related to other medications like diuretics.
2. A client has a new prescription for radioactive iodine to treat Hyperthyroidism. Which of the following instructions should the nurse include?
- A. Expect a metallic taste in the mouth.
- B. Avoid contact with pregnant women for 1 week.
- C. Administer iodine solution using a straw.
- D. Take thyroid replacement medication for 3 weeks after treatment.
Correct answer: B
Rationale: When a client undergoes radioactive iodine treatment for hyperthyroidism, they can emit radiation for a short time. To prevent radiation exposure to others, especially pregnant women, infants, and small children, clients should avoid close contact for about 1 week following therapy. This precaution is essential to protect vulnerable individuals from potential harm. Choice A is incorrect because a metallic taste in the mouth is not a common side effect of radioactive iodine treatment. Choice C is incorrect because administering iodine solution using a straw is not a standard practice in this treatment. Choice D is incorrect because taking thyroid replacement medication for 3 weeks after treatment is not a typical instruction associated with radioactive iodine therapy for hyperthyroidism.
3. A client who has been taking prednisone to treat asthma is advised to discontinue the medication. The client should be instructed to reduce the dose gradually to prevent which of the following adverse effects?
- A. Hyperglycemia
- B. Adrenocortical insufficiency
- C. Severe dehydration
- D. Rebound pulmonary congestion
Correct answer: B
Rationale: Abruptly stopping prednisone can result in adrenocortical insufficiency due to suppression of the adrenal glands. Gradually tapering the dose helps the body adjust and resume its natural cortisol production, preventing adrenal insufficiency. Choice A, hyperglycemia, is a possible adverse effect of prednisone, but it is not the primary reason for gradual tapering. Severe dehydration (Choice C) and rebound pulmonary congestion (Choice D) are not typically associated with discontinuing prednisone.
4. A client has a new prescription for Maraviroc to treat HIV infection. The healthcare provider should monitor the client for which of the following adverse reactions?
- A. Liver failure
- B. Kidney failure
- C. Pancreatitis
- D. Severe allergic reactions
Correct answer: D
Rationale: The correct answer is D: Severe allergic reactions. Maraviroc, used to treat HIV infection, can lead to severe allergic reactions, including hepatotoxicity. While liver failure is a potential adverse effect, it is often preceded by hepatotoxicity manifestations like jaundice or right upper quadrant pain. Kidney failure and pancreatitis are not typically associated with Maraviroc use. Therefore, monitoring for signs of severe allergic reactions and hepatotoxicity is crucial for early detection and intervention.
5. What is the expected pharmacological action of propranolol?
- A. Block stimulation of beta1 receptors
- B. Alter water and electrolyte transport in the large intestine
- C. Block stimulation of beta2 receptors
- D. Both A and C are correct
Correct answer: D
Rationale: Propranolol exerts its pharmacological action by blocking stimulation of both beta1 and beta2 receptors. By doing so, it leads to decreased heart rate and blood pressure. Therefore, both options A and C are correct as propranolol affects both types of beta receptors. Choice B is incorrect as propranolol does not alter water and electrolyte transport in the large intestine.
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