ATI RN
ATI Pharmacology Proctored Exam 2019
1. When teaching a client with a new prescription for Clopidogrel, which laboratory value should the nurse monitor to assess for potential adverse effects?
- A. White blood cell count
- B. Platelet count
- C. Hemoglobin
- D. Blood glucose
Correct answer: B
Rationale: Clopidogrel is an antiplatelet medication that works by reducing the formation of blood clots. Therefore, the nurse should monitor the client's platelet count to assess for potential bleeding complications. A decrease in platelet count could indicate a risk of bleeding, which is an adverse effect associated with Clopidogrel therapy. Monitoring other laboratory values like white blood cell count, hemoglobin, and blood glucose is important for assessing overall health status but is not directly related to the potential adverse effects of Clopidogrel.
2. A client presents in the Emergency Department with chest pain. Which of the following conditions is least likely to cause chest pain?
- A. Arthritis
- B. Peptic ulcer disease
- C. Myocardial infarction
- D. Gastric reflux
Correct answer: A
Rationale: Arthritis is a condition primarily affecting the joints and is not known to cause chest pain. Peptic ulcer disease, myocardial infarction, and gastric reflux are conditions that can present with chest pain due to various reasons such as inflammation, ischemia, or reflux of stomach acid into the esophagus, respectively.
3. A client receives a local anesthetic of Lidocaine during the repair of a skin laceration. For which of the following adverse reactions should the nurse monitor the client?
- A. Seizures
- B. Tachycardia
- C. Hypertension
- D. Fever
Correct answer: A
Rationale: Seizures are a potential adverse reaction to local anesthetics like Lidocaine. Lidocaine can affect the central nervous system and, in some cases, lead to seizure activity. Therefore, it is important for the nurse to monitor the client for any signs of seizures during and after the administration of Lidocaine.
4. During discharge instructions, a client with a new prescription for Phenytoin should be advised to take which of the following actions?
- A. Brush and floss your teeth regularly.
- B. Avoid drinking grapefruit juice.
- C. Take this medication on an empty stomach.
- D. Increase your intake of calcium-rich foods.
Correct answer: A
Rationale: The correct instruction for a client with a new prescription for Phenytoin is to brush and floss their teeth regularly. Phenytoin is known to cause gingival hyperplasia, a condition that affects the gums. By maintaining good oral hygiene practices such as regular brushing and flossing, the client can help minimize the risk of developing this side effect. Choices B, C, and D are incorrect. Avoiding grapefruit juice is more relevant for medications affected by grapefruit juice metabolism, taking medication on an empty stomach is not specifically indicated for Phenytoin, and increasing calcium-rich foods is not directly related to the side effects or administration of Phenytoin.
5. A client with Bipolar disorder has a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)
- A. This medication can safely be taken during pregnancy.
- B. Eliminate grapefruit juice from your diet.
- C. You will need to have a complete blood count and carbamazepine levels drawn periodically.
- D. Notify your provider if you develop a rash.
Correct answer: B
Rationale: The correct answer is B: "Eliminate grapefruit juice from your diet." Grapefruit juice affects carbamazepine metabolism and should be avoided. It can lead to increased levels of the medication, potentially causing toxicity. Monitoring carbamazepine blood levels and the complete blood count (CBC) is essential to ensure the medication's efficacy and safety. Although choice A is incorrect (This medication can safely be taken during pregnancy), carbamazepine is classified as a Pregnancy Category D drug, which means there is positive evidence of human fetal risk. Choice D (Notify your provider if you develop a rash) is also important because carbamazepine can cause serious adverse effects like Stevens-Johnson syndrome, which can be life-threatening. Regular monitoring and prompt reporting of any rash are crucial. Therefore, choices C and D are also relevant instructions for the client.
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