ATI RN
ATI Proctored Pharmacology 2023
1. A client is starting a new prescription for enalapril. Which of the following instructions should the nurse include?
- A. Take the medication with food.
- B. Rise slowly from a sitting position.
- C. Avoid salt substitutes.
- D. Avoid exposure to sunlight.
Correct answer: C
Rationale: The correct instruction for a client starting enalapril is to avoid salt substitutes. Salt substitutes may contain potassium, which could lead to elevated potassium levels when combined with enalapril, increasing the risk of hyperkalemia. Choices A, B, and D are incorrect because there is no specific need to take enalapril with food, rise slowly from a sitting position, or avoid exposure to sunlight when taking this medication.
2. When teaching a client who has a prescription for Lisinopril, which of the following instructions should the nurse include?
- A. Take the medication at bedtime.
- B. Monitor for a persistent cough.
- C. Expect to have increased appetite.
- D. Avoid foods high in potassium.
Correct answer: B
Rationale: The correct answer is B: 'Monitor for a persistent cough.' Lisinopril, an ACE inhibitor, can cause a persistent dry cough as a side effect. It is essential for the client to report this symptom to their healthcare provider for further evaluation and management. Choice A is incorrect because Lisinopril is typically taken in the morning. Choice C is incorrect as Lisinopril is not known to cause increased appetite. Choice D is also incorrect as Lisinopril can lead to increased potassium levels in the blood, so avoiding foods high in potassium is not necessary.
3. A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.)
- A. A client at 8 weeks of gestation who asks for an Influenza immunization
- B. A client who takes Prednisone and has a possible Fungal infection
- C. A client who has chronic liver disease and is taking Hydrocodone
- D. A client who has Peptic Ulcer Disease, takes Sucralfate, and tells the nurse she has started taking OTC Aluminum Hydroxide
Correct answer: B
Rationale: Prednisone, a glucocorticoid, should not be taken by a client who has a possible systemic fungal infection as it can worsen the infection. This combination can suppress the immune response, allowing the fungal infection to proliferate. Therefore, the nurse should contact the provider regarding this potential contraindication to medication. The other options do not present a contraindication related to the medication interactions described in the question.
4. When starting amitriptyline, a client should be instructed to monitor for which of the following adverse effects?
- A. Diarrhea
- B. Urinary retention
- C. Bradycardia
- D. Dry cough
Correct answer: B
Rationale: When a client starts taking amitriptyline, an important adverse effect to monitor for is urinary retention. Amitriptyline is a tricyclic antidepressant that can cause anticholinergic effects, including urinary retention. It is crucial to educate the client on recognizing and reporting this adverse effect to their healthcare provider. Diarrhea is not a common adverse effect of amitriptyline and is more associated with other medications. Bradycardia is a possible adverse effect of amitriptyline, but urinary retention is a more common and significant concern. Dry cough is not a typical adverse effect of amitriptyline.
5. A client has a new prescription for Atorvastatin. Which of the following instructions should the nurse include?
- A. Take this medication with food.
- B. Avoid drinking grapefruit juice.
- C. Take this medication in the morning.
- D. Increase your intake of potassium-rich foods.
Correct answer: B
Rationale: The correct answer is B: 'Avoid drinking grapefruit juice.' Grapefruit juice can increase the blood levels of Atorvastatin by inhibiting its metabolism in the body, leading to a higher risk of adverse effects, such as muscle pain and liver damage. Therefore, it is important for the client to avoid consuming grapefruit juice while taking Atorvastatin. Choices A, C, and D are incorrect because Atorvastatin can be taken with or without food, at any time of the day, and there is no specific need to increase potassium-rich foods while on this medication.
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