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ATI RN Pharmacology 202 5 Comprehensive Exam
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1. Kayexalate and Lab Monitoring Question: A nurse is reviewing the laboratory results of a client who has a prescription for sodium polystyrene sulfonate (Kayexalate) every 6 hr. Which of the following should the nurse report to the provider? a. Creatinine 0.72 mg/dL b. Sodium 138 mEq/L c. Magnesium 2 mEq/L d. Potassium 5.2 mEq/L ✅ Rationale: Kayexalate is given to treat hyperkalemia. A potassium level of 5.2 mEq/L is above the normal range (3.5–5.0 mEq/L) and should be reported due to the risk for life- threatening dysrhythmias. 2. TB Treatment Effectiveness Question: A nurse is caring for a client who has tuberculosis and is taking isoniazid and rifampin. Which of the following outcomes indicates the client is adhering to the medication regimen? a. The client has a negative sputum culture ✅ b. The client tests negative for HIV c. The client has a positive purified protein derivative test d. The client's liver function test results are within the expected range Rationale: A negative sputum culture confirms that the TB bacteria are no longer present, indicating the medication regimen is effective and the client is compliant.
3. Anaphylactic Reaction – Priority Action Question: A client is receiving IV medication and develops an anaphylactic reaction. After assessing respiratory status and stopping the infusion, which action should the nurse take next? a. Replace the infusion with 0.9% sodium chloride b. Give diphenhydramine IM c. Elevate the client's legs and feet d. Administer epinephrine IM ✅ Rationale: Epinephrine IM is the first-line treatment for anaphylaxis. It reverses airway constriction and supports blood pressure. 4. IV Therapy and Fluid Overload Question: A nurse is assessing a client receiving IV therapy. Which of the following findings indicates fluid volume excess? a. Decreased bowel sounds b. Distended neck veins ✅ c. Bilateral muscle weakness d. Thread pulse Rationale: Distended neck veins are a classic sign of fluid overload , often seen with excess IV fluids or heart failure. 5. Hyponatremia Treatment Effectiveness Question: A nurse is caring for a client with hyponatremia receiving a hypertonic solution. Which finding shows the treatment is effective? a. Absent Chvostek's sign b. Improved cognition ✅ c. Decreased vomiting d. Cardiac arrhythmias absent
c. Tinnitus d. Hypotension ✅ Rationale: Lisinopril , an ACE inhibitor, can cause vasodilation , leading to hypotension , especially after the first dose.
9. Heparin and aPTT Monitoring Question: A client receiving IV heparin has an aPTT of 90 seconds. Which vital sign change should the nurse monitor for? a. Decreased temperature b. Increased pulse rate ✅ c. Decreased respiratory rate d. Increased blood pressure Rationale: An aPTT of 90 seconds is prolonged , increasing bleeding risk. Tachycardia (increased pulse) may be an early sign of internal bleeding. 10. Medication Error Reporting Question: A nurse finds a medication error. Who is responsible for completing the incident report? a. The quality improvement committee b. The nurse who identifies the error ✅ c. The nurse who caused the error d. The charge nurse Rationale: According to facility policy , the nurse who discovers the error is responsible for completing the incident report. 11. Morphine Epidural Monitoring Question: A nurse is caring for a client receiving morphine via continuous epidural infusion. Which complication should be monitored?
a. Pruritus ✅ b. Cough c. Tachypnea d. Gastric bleeding Rationale: Pruritus (itching) is a common side effect of epidural morphine due to histamine release. It should be monitored and managed appropriately. A nurse is preparing to administer digoxin orally to a client. Identify the sequence of steps the nurse should take. (Move the steps into the box on the right placing them in the order of performance. Use all the steps.) - - correct ans- - a. Obtain the client's apical heart rate b. Remove the medication from the dispensing system c. Open the medication package d. Compare the client's wristband to the medication administration record e. Document administration of the medication A nurse is reviewing the medical record of an adult client who has a fever and a prescription for acetaminophen. Which of the following findings should the nurse identify as a contraindication for receiving this medication? a. Alcohol use disorder b. Chronic kidney disease c. Hepatitis B vaccine within the last week d. Diabetes mellitus - - correct ans- - a. Alcohol use disorder A home health nurse is visiting a client who has heart failure and a prescription for furosemide. The nurse identifies that the client has gained 2.5 kg (5 lb.) since the last visit 2 days ago. Which of the following actions should the nurse take first? a. Encourage the client to dangle the legs while sitting in a chair b. Teach the client about foods low in sodium c. Determine medication adherence by the client
A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering it to client who has diabetes mellitus following actions should the nurse take first? a. Withdraw the regular insulin from the viral b. Withdraw the NPH insulin form the vial c. Inject air into the NPH vial d. Inject air into the regular insulin vial - - correct ans- - c. Inject air into the NPH vial A nurse is preparing to administer subcutaneous heparin to a client. Which of the following should the nurse take? a. Massage the site after administering the medication b. Use a 21-gauge needle for the injection c. Aspirate before injecting the medication d. Insert the needle at least 5 cm (2 in) from the umbilicus - - correct ans- - d. Insert the needle at least 5 cm (2 in) from the umbilicus A nurse is caring for a client who has a prescription for amoxicillin. Which of the following findings indicates the client is experiencing an allergic reaction? a. Nausea b. Cardiac dysrhythmia c. Laryngeal edema d. Insomnia - - correct ans- - c. Laryngeal edema b. Cardiac dysrhythmia Amoxicillin side effects include: Renal impairment, hyperkalemia, dysrhythmias, hypernatremia Allergic reaction: Urticaria, rash, hypotension, dyspnea, swelling of face/lips/tongue
A nurse is teaching a newly licensed nurse about medication reconciliation. The nurse should instruct the newly licensed nurse to perform medication reconciliation for which of the following? a. A client who has a referral for social services b. A client who is transdermal to radiology c. A client who is transferal to a step-down unit d. A client who has a consultation for physical therapy - - correct ans- - c. A client who is transferal to a step-down unit A nurse is reviewing the laboratory values of a client who is taking atorvastatin. Which of the following laboratory values indicates the treatment has been effective? a. BUN 15 mg/dL b. Blood glucose 90 mg/dL c. Urine specific gravity 1. d. LDL 120 mg/dL - - correct ans- - d. LDL 120 mg/dL A nurse is receiving a medication prescription by telephone from a provider. The provider states "Administer 6 milligrams of morphine IV push every 3 hours as needed for acute pain." How should the nurse transcribe the prescription in the client's medical record? a. Morphine 6 mg IV push every 3 hr PRN acute pain b. MSO 6 mg IV push every 3 hr PRN acute pain c. MS 6 mg IV push every 3 hr PRN acute pain d. Morphine 6.0 mg IV push every 3 hr PRN acute pain - - correct ans- - a. Morphine 6 mg IV push every 3 hr PRN acute pain A nurse is assessing a client's IV infusion site and notes that the site is cool and edematous. Which of the following actions should the nurse take? a. Show the IV solution rate b. Initiate a new IV distal to the initial site
b. "You should reduce your intake of calcium while taking this medication." c. "You should take this medication before meals." d. "You can take a second dose if symptoms persist up to 2 hours after the first dose." - - correct ans- - a. "You cannot take this medication with an antacid." A nurse is assessing for allergies with a client who is scheduled to receive the influenza vaccine. Which of the following allergies should the nurse report to the provider as a possible contraindication to receiving the vaccine? a. Eggs b. Shellfish c. Peanuts d. Milk - - correct ans- - a. Eggs A nurse is caring for a client who has a new diagnosis of benign prostate hypertrophy and a prescription for doxazosin. The client tells the nurse. "I do not take this medication. I would prefer a natural therapy." Which of the following supplements should the nurse suggest the client discuss with the provider? a. Black cohosh b. Garlic c. Feverfew d. Saw palmetto - - correct ans- - d. Saw palmetto A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following predisposes this client to developing digoxin toxicity? a. Taking a high ceiling diuretic b. Having a 10-year history of COPD c. Having a prolapsed mitral valve d. Taking an HMG CoA reductase inhibitor - - correct ans- - a. Taking a high ceiling diuretic
A nurse is administering naloxone to a client who has developed an adverse reaction to morphine. The nurse should identify which of the following findings as a therapeutic effect of naloxone? a. Decreased nausea b. Increased pain relief c. Decreased blood pressure d. Increased respiratory rate - - correct ans- - d. Increased respiratory rate A nurse is reviewing the medical record of a client who has sinusitis and a new prescription for cefuroxime. Which of the following client information is the priority for the nurse to report to the provider? a. The client has a BUN of 18 mg/dL b. The client takes an aspirin daily c. The client has a history of a severe penicillin allergy d. The client reports a history of nausea with cefuroxime - - correct ans- - c. The client has a history of a severe penicillin allergy A nurse is assessing a client who has hypermagnesemia. Which of the following medications should the nurse prepare to administer? a. Protamine sulfate b. Acetylcysteine c. Calcium gluconate d. Flumazenil - - correct ans- - c. Calcium gluconate A nurse is assessing a client following the administration of ondansetron (Zofran). Which of the following findings should indicate to the nurse that the ondansetron has been effective? a. Client reports a decrease in pain b. Client reports a decrease in nausea c. Client reports a decrease in coughing
A nurse is teaching a guardian of a school-age child who has a new prescription for a fluticasone metered-dose inhaler. Which of the following information should the nurse include in the teaching? (SATA) a. "Soak the inhaler in water after use." b. "Have your child take one inhalation as needed for shortness of breath." c. "Shake the device prior to administration." d. "A spacer will make it easier to use the device." e. "Rinse your child's mouth following administration." - - correct ans- - c. "Shake the device prior to administration." d. "A spacer will make it easier to use the device." e. "Rinse your child's mouth following administration." A nurse is preparing to administer potassium chloride elixir 20 mEq/day PO to divide equally 12 hr. available is 6.7 mEq/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trialing zero.) - - correct ans- - 7.5 mL A nurse is instructing a client who has a new prescription for a daily dose of lovastatin extended release. Which of the following information should the nurse include in the teaching? a. "You will need liver function tests before beginning therapy." b. "Avoid consuming dairy products while taking this medication." c. "You may crush the medication and mix it with applesauce." d. "You should take the medication in the morning." - - correct ans- - a. "You will need liver function tests before beginning therapy." A nurse is assessing a client who is receiving a peripheral IV infusion and notes infiltration of fluid into the tissue surrounding the insertion site. Which of the following actions should the nurse take? a. Flush the IV catheter b. Apply pressure to the IV site
c. Elevate the extremity d. Slow the infusion rate - - correct ans- - c. Elevate the extremity A nurse is preparing to administer 4000 units of heparin subcutaneously to a client who has deep-vein thrombosis. Available is heparin 10,000 units. How many mL of heparin should the nurse administer? (Round to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) a. 0.4 mL - - correct ans- - 0.4 mL A nurse us caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect? a. Oxygen saturation 96% b. PaCO2 30 mm Hg c. Increase in BP d. Decrease in protein - - correct ans- - c. Increase in BP A nurse is discussing adverse reactions to pain medications in older adult clients with a newly licensed nurse. Which of the following findings should the nurse include as risk factors for an adverse drug reaction? (SATA) a. Polypharmacy b. Increased rate of absorption c. Decreased percentage of body fat d. Multiple health problems e. Decreased renal function - - correct ans- - a. Polypharmacy d. Multiple health problems e. Decreased renal function A nurse is reviewing the laboratory data of a client prior to administering IV tobramycin. Which of the following laboratory values should the nurse report to the provider? a. Sodium 137 mEq/L
A nurse is assessing a client who reports taking over-the-counter antacids. Which of the following findings should the nurse identify as a manifestation of hypercalcemia? a. Constipation b. Decreased urine output c. Positive Trousseau's sign d. Headache - - correct ans- - a. Constipation A nurse is caring for a client who is to receive potassium replacement. The provider's prescription reads. "Potassium chloride 30 mEq in 0.9% sodium chloride 100 mL IV over 30 min." which of the following reasons should the nurse clarify this prescription with the provider. a. Potassium chloride should be diluted in dextrose 5% in water. b. The potassium infusion rate is too rapid c. Another formulation of potassium should be given IV d. The client should be treated by giving potassium by IV bolus - - correct ans- - b. The potassium infusion rate is too rapid A nurse is monitoring laboratory values for a client who has chronic heart failure and is receiving digoxin. Which of the following values should the nurse report to the provider? a. Sodium 1.38 mEq/dL b. Magnesium 1.5 mEq/L c. BUN level 10 mg/dL d. Potassium 2.9 mEq/L - - correct ans- - d. Potassium 2.9 mEq/L A client who has active tuberculosis and is taking rifampin reports that his urine and sweat have developed a red tinge. Which of the following actions should the nurse take? a. Check the client's liver function test results b. Instruct the client to increase his fluid intake c. Document this as an expected finding
d. Prepare the client for dialysis - - correct ans- - c. Document this as an expected finding A nurse accidently administers the medication metformin instead of metoprolol to a client. Which of the following actions should the nurse take? a. Monitor the client's thyroid function levels b. Collect the client's uric acid level c. Obtain the client's HDL level d. Check the client's glucose level - - correct ans- - d. Check the client's glucose level A nurse is administering 4 mg of hydromorphone to a client by mouth every 4 hr. the medication is provided as hydromorphone 8 mg per tablets. Which of the following actions is appropriate for the nurse to take? a. Return the remaining medication to the facility's pharmacy b. Store the remaining half of the pill in the automated medication dispensing system c. Place the remaining half of the pill in the unit dose package d. Dispose of the remaining medication while another nurse observes - - correct ans- - d. Dispose of the remaining medication while another nurse observes A nurse is caring for 4-year-old child following an orthopedic procedure. When assessing the child for pain. Which of the following pain scales should the nurse use? a. FACES b. Numeric c. CRIES d. Word graphic - - correct ans- - a. FACES A nurse is planning care for a client who requires treatment for high cholesterol. Which of the following prescriptions should the nurse expect to administer? a. Colchicine b. Cimetidine
A nurse is preparing to initiate IV therapy for a client. Which of the following sites should the nurse use to place the peripheral IV catheter? a. Nondominant dorsal venous arch b. Dominant distal dorsal vein c. Nondominant forearm basilic vein d. Dominant antecubital vein - - correct ans- - a. Nondominant dorsal venous arch A nurse is assessing a client who is taking an osmotic laxative which of the following findings should the nurse identify as an indication of fluid volume deficit? a. Nausea b. Weight gain c. Headache d. Oliguria - - correct ans- - d. Oliguria A nurse is reviewing the laboratory results of a client who is taking amitriptyline which of the following laboratory values should the nurse report to the provider? a. Total bilirubin 1.5 mg/dL b. Potassium 4.2 mEq/L c. Hct 0.44% d. WBC count 5000/mm3 - - correct ans- - a. Total bilirubin 1.5 mg/dL A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances? a. Hypocalcemia b. Hypokalemia c. Hyponatremia d. Hypomagnesemia - - correct ans- - c. Hyponatremia
A nurse is assessing a client after administering phenytoin IV bolus for a seizure. Which of the following should the nurse identify as an adverse effect of this medication? a. Hypoglycemia b. Bradycardia c. Red man syndrome d. Hypotension - - correct ans- - d. Hypotension A nurse is consulting a formulary about a client's new prescription for raloxifene. The nurse should identify that this medication is used to treat which of the following conditions? a. Osteoporosis b. Hypothyroidism c. Urinary tract infection d. Deep vein thrombosis - - correct ans- - a. Osteoporosis A nurse is providing discharge dietary teaching to a client who has a something and is taking medication theophylline and to provide general instructions the nurse should include? a. Avoid caffeinated beverages b. Take the medication with meals c. Restrict milk products d. Limit sodium intake - - correct ans- - a. Avoid caffeinated beverages the nurse is mixing regular insulin and NPH into a syringe for a client who has diabetes mellitus. Which of the following actions should the nurse take first? a. Withdrawal NPH from the vial b. Inject air into the NPH vial c. Inject air into the regular vial d. Withdrawal regular insulin from the vial - - correct ans- - b. Inject air into the NPH vial
