ATI RN
Proctored Pharmacology ATI
1. A client has a new prescription for Verapamil. Which of the following instructions should the nurse include?
- A. Increase your intake of high-fiber foods.
- B. Take the medication with grapefruit juice.
- C. Expect to feel drowsy or lightheaded.
- D. Avoid dairy products while taking this medication.
Correct answer: A
Rationale: The correct instruction to include when a client is prescribed Verapamil is to increase their intake of high-fiber foods. Verapamil can cause constipation as a side effect, and increasing fiber intake can help prevent constipation. High-fiber foods promote bowel regularity and can counteract the constipating effects of Verapamil. Choices B, C, and D are incorrect because taking Verapamil with grapefruit juice can lead to adverse reactions, drowsiness or lightheadedness is not a typical side effect of Verapamil, and there is no need to avoid dairy products specifically while taking this medication.
2. A healthcare provider is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The healthcare provider should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions?
- A. Bursitis
- B. Sinusitis
- C. Depression
- D. Glaucoma
Correct answer: D
Rationale: Oxybutynin is an anticholinergic medication that can increase intraocular pressure. It is contraindicated in clients with glaucoma due to the potential to worsen the condition by further elevating intraocular pressure, leading to harm. Choosing option D, Glaucoma, as the correct answer is crucial for the client's safety and to prevent exacerbation of their eye condition. Options A, B, and C are not contraindications for Oxybutynin use and are unrelated to the pharmacological effects of this medication.
3. A client with Hodgkin's disease is receiving Cyclophosphamide IV. Which medication should be administered concurrently to prevent an adverse effect of Cyclophosphamide?
- A. Uroprotectant agent, such as mesna
- B. Opioid, such as morphine
- C. Loop diuretic, such as furosemide
- D. H1 receptor antagonist, such as diphenhydramine
Correct answer: A
Rationale: Mesna, an uroprotectant agent, is administered with nitrogen mustard chemotherapy drugs like Cyclophosphamide to prevent hemorrhagic cystitis, a common adverse effect. Mesna works by binding to and inactivating the toxic metabolites of Cyclophosphamide in the bladder, thereby reducing the risk of bladder toxicity.
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. Which of the following conditions is not typically treated with Hydrochlorothiazide?
- A. CHF
- B. HTN
- C. Nephritis
- D. Hypercalciuria
Correct answer: C
Rationale: Nephritis is not commonly treated with Hydrochlorothiazide. Hydrochlorothiazide is primarily used for managing hypertension (HTN) and congestive heart failure (CHF) by reducing blood pressure and fluid retention. It is not a standard treatment for nephritis, which involves inflammation of the kidneys. Hypercalciuria, characterized by excessive calcium excretion in the urine, is not typically treated with Hydrochlorothiazide either.
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