ATI RN
ATI Pharmacology Proctored Exam 2019
1. A client is starting therapy with Metformin. Which of the following instructions should be included by the healthcare provider?
- A. Take this medication with your first bite of food.
- B. Take this medication on an empty stomach.
- C. Take this medication before bedtime.
- D. Take this medication every other day.
Correct answer: A
Rationale: The correct answer is A: 'Take this medication with your first bite of food.' Metformin should be taken with meals to reduce gastrointestinal side effects and ensure better absorption. By taking the medication with the first bite of food, the client can help minimize potential stomach upset and improve the drug's effectiveness. Choice B is incorrect because taking Metformin on an empty stomach can increase the risk of gastrointestinal side effects. Choice C is incorrect as there is no specific recommendation to take Metformin before bedtime. Choice D is incorrect because Metformin is typically taken daily, not every other day, as prescribed by the healthcare provider.
2. A healthcare professional is reviewing the medication administration record for a client who is receiving transdermal Fentanyl for severe pain. Which of the following medications should the healthcare professional expect to cause an adverse effect when administered concurrently with Fentanyl?
- A. Ampicillin
- B. Diazepam
- C. Furosemide
- D. Prednisone
Correct answer: B
Rationale: Diazepam, a CNS depressant, can lead to severe sedation when administered concurrently with an opioid like Fentanyl due to their additive central nervous system depressant effects. This interaction can potentiate respiratory depression and other CNS effects, increasing the risk of adverse outcomes.
3. A client with Preeclampsia is receiving Magnesium Sulfate IV continuous infusion. Which of the following findings should the nurse report to the provider?
- A. 2+ deep tendon reflexes
- B. 2+ pedal edema
- C. 24 mL/hr urinary output
- D. Respirations 12/min
Correct answer: C
Rationale: In a client receiving Magnesium Sulfate IV for Preeclampsia, a urinary output less than 25 to 30 mL/hr indicates magnesium sulfate toxicity and should be reported to the provider for further evaluation and management. Choice A, 2+ deep tendon reflexes, is a normal finding with magnesium sulfate therapy. Choice B, 2+ pedal edema, is expected in clients with preeclampsia but does not indicate magnesium sulfate toxicity. Choice D, respirations 12/min, is within the normal range and not a concerning finding related to magnesium sulfate administration.
4. A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (Select all that apply.)
- A. Increased renal secretion
- B. Increased medication-metabolizing enzymes
- C. Liver failure
- D. Peripheral vascular disease
Correct answer: C
Rationale: Liver failure impairs metabolism, leading to increased medication concentrations. When liver function is compromised, lower dosages are necessary to prevent adverse effects. Increased renal secretion is not a reason for lower medication dosages, as it primarily affects excretion rather than metabolism. Increased medication-metabolizing enzymes would usually require higher dosages to achieve the desired effect. Peripheral vascular disease does not directly impact medication metabolism or dosage requirements.
5. A client has a new prescription for Labetalol. Which of the following instructions should the nurse include?
- A. Take this medication at bedtime.
- B. Avoid sudden discontinuation of the medication.
- C. Increase your intake of sodium-rich foods.
- D. Avoid drinking grapefruit juice.
Correct answer: B
Rationale: The correct instruction for a client on Labetalol is to avoid sudden discontinuation of the medication. Labetalol is a beta-blocker that, if abruptly stopped, can lead to rebound hypertension and other cardiac issues. It is essential for patients to taper off this medication under medical supervision to prevent adverse effects.
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