ATI RN
Proctored Pharmacology ATI
1. A client has a new prescription for Amlodipine. Which of the following instructions should the nurse include during discharge teaching?
- A. Take the medication at bedtime.
- B. Avoid drinking grapefruit juice.
- C. Increase your intake of high-sodium foods.
- D. Expect a dry cough.
Correct answer: B
Rationale: The correct instruction for the nurse to include during discharge teaching is to advise the client to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of amlodipine, a calcium channel blocker, leading to increased drug levels in the blood. This can result in potentiated side effects and potential toxicity. Option A is incorrect as amlodipine is usually taken once daily, not specifically at bedtime. Option C is incorrect because high-sodium foods are generally discouraged in individuals with hypertension. Option D is incorrect as a dry cough is not an expected side effect of amlodipine.
2. A hospitalized client receiving IV heparin for a deep-vein thrombosis begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?
- A. Vitamin K1
- B. Atropine
- C. Protamine
- D. Calcium gluconate
Correct answer: C
Rationale: In this scenario, the client is experiencing a serious complication of heparin therapy, likely due to heparin-induced thrombocytopenia. Protamine is the antidote for heparin and can reverse its anticoagulant effects. It is essential to administer protamine promptly to counteract the effects of heparin and manage the bleeding. Vitamin K1 is used to reverse the effects of warfarin, not heparin. Atropine is used to treat bradycardia or some types of poisoning. Calcium gluconate is used to manage hyperkalemia or calcium channel blocker toxicity, not to reverse heparin's effects.
3. A client has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?
- A. Hypokalemia
- B. Hypernatremia
- C. Neutropenia
- D. Bradycardia
Correct answer: C
Rationale: Neutropenia is a serious adverse effect associated with ACE inhibitors like Captopril. Neutropenia refers to a decreased level of neutrophils, which are important white blood cells in fighting infection. Monitoring the client's complete blood count (CBC) is essential to detect neutropenia early. Hypokalemia (Choice A) is more commonly associated with diuretics, not ACE inhibitors. Hypernatremia (Choice B) is an increase in sodium levels, not typically caused by Captopril. Bradycardia (Choice D) is not a common adverse effect of ACE inhibitors like Captopril.
4. In reviewing a client's health record, which condition would be a contraindication for using Propranolol to treat hypertension?
- A. Asthma
- B. Glaucoma
- C. Hypertension
- D. Tachycardia
Correct answer: A
Rationale: Propranolol is a nonselective beta-adrenergic blocker that blocks both beta1 and beta2 receptors. Blocking beta2 receptors in the lungs can lead to bronchoconstriction, making it unsuitable for clients with asthma. Therefore, asthma is a contraindication for taking Propranolol. Glaucoma, hypertension, and tachycardia are not contraindications for using Propranolol to treat hypertension.
5. When should Montelukast be taken?
- A. At least two hours before exercise
- B. Daily in the evening
- C. Two hours before exercise or daily in the evening
- D. None of the above
Correct answer: B
Rationale: Montelukast should be taken daily in the evening to effectively manage asthma symptoms. Taking it at the same time each day helps maintain a consistent level of the medication in the body, providing optimal control over asthma symptoms and inflammation. Choice A is incorrect because Montelukast should not be taken specifically before exercise, but rather daily. Choice C is incorrect because although taking Montelukast two hours before exercise is not necessary, taking it daily in the evening is essential for its effectiveness. Choice D is incorrect as Montelukast should be taken daily to manage asthma.
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