ATI RN
ATI Proctored Pharmacology 2023
1. What should you monitor when administering Clopidogrel to a patient?
- A. Signs of thrombotic thrombocytopenic purpura
- B. Bleeding during therapy
- C. CBC with differential and platelet count
- D. All of the above
Correct answer: D
Rationale: When administering Clopidogrel, it is crucial to monitor for signs of thrombotic thrombocytopenic purpura, bleeding during therapy, and changes in CBC with differential and platelet count. Thrombotic thrombocytopenic purpura is a rare but serious condition associated with Clopidogrel use, characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurological symptoms, fever, and renal dysfunction. Monitoring for signs of thrombotic thrombocytopenic purpura is essential to detect this potentially life-threatening condition early. Monitoring for bleeding helps to assess the risk of hemorrhagic events, a known side effect of Clopidogrel. Additionally, regular monitoring of CBC with differential and platelet count is necessary to evaluate the drug's impact on blood cell counts and detect any abnormalities that may require intervention. Therefore, monitoring all these parameters is vital to ensure patient safety and appropriate management during Clopidogrel therapy.
2. A healthcare provider is reviewing the health care record of a client who is asking about conjugated equine estrogens. The healthcare provider should inform the client this medication is contraindicated in which of the following conditions?
- A. Atrophic vaginitis
- B. Dysfunctional uterine bleeding
- C. Osteoporosis
- D. Thrombophlebitis
Correct answer: D
Rationale: Conjugated equine estrogens are contraindicated in individuals with a history of thrombophlebitis due to the increased risk of thrombotic events associated with estrogen use. Thrombophlebitis is a condition characterized by inflammation and blood clot formation in the veins, and estrogen therapy can exacerbate this condition, leading to serious complications such as deep vein thrombosis. Therefore, caution is advised when considering estrogen therapy in clients with a history of thrombophlebitis to prevent adverse outcomes. Choices A, B, and C are not contraindications for conjugated equine estrogens. Atrophic vaginitis and dysfunctional uterine bleeding may actually be conditions for which estrogen therapy is indicated. Osteoporosis can also be managed with estrogen therapy in certain cases to help prevent bone density loss.
3. A client is being discharged with a new prescription for Fluoxetine for PTS. Which of the following statements should the nurse include in the teaching?
- A. You may experience a decreased desire for intimacy while taking this medication.
- B. You should take this medication in the morning to avoid sleep disturbances.
- C. To minimize urinary adverse effects, ensure you urinate before taking this medication.
- D. It is recommended to wear sunglasses outdoors due to the light sensitivity caused by this medication.
Correct answer: A
Rationale: The correct statement for the nurse to include in the teaching is that the client may experience a decreased desire for intimacy while taking Fluoxetine for PTS. This is important because Fluoxetine, an SSRI used to treat PTS, can lead to decreased libido as a potential adverse effect. Choices B, C, and D are incorrect because they do not address the specific side effect associated with Fluoxetine and are not directly relevant to the medication's effects for this patient.
4. Why does a nurse on an oncology unit verify a client's current cumulative lifetime dose of doxorubicin before administering it to a client with breast cancer?
- A. Excessive doxorubicin can result in myelosuppression.
- B. Exceeding the lifetime cumulative dose limit of doxorubicin may lead to extravasation.
- C. An excess amount of doxorubicin can lead to cardiomyopathy.
- D. Exceeding the lifetime cumulative dose limit of doxorubicin may cause red-tinged urine and sweat.
Correct answer: C
Rationale: Verifying the client's current cumulative lifetime dose of doxorubicin is necessary because excessive amounts of the medication can lead to cardiomyopathy, a serious and potentially life-threatening side effect. By monitoring the cumulative dose, healthcare providers can help prevent cardiotoxicity and ensure patient safety during treatment.
5. A client has a new prescription for Enalapril. Which of the following adverse effects should the nurse monitor?
- A. Dry cough
- B. Weight gain
- C. Diarrhea
- D. Nausea
Correct answer: A
Rationale: The correct answer is A: Dry cough. A persistent dry cough is a common adverse effect of Enalapril, an ACE inhibitor. Enalapril can cause the accumulation of bradykinin, leading to cough. Monitoring for a persistent dry cough is crucial as it may indicate the need for further evaluation and possible medication adjustment. Choices B, C, and D are not typically associated with Enalapril use and are less likely to be monitored as adverse effects.
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