Download A.T.I RN Pharmacology Proctored Exam 2024–2025 | 100 Real Test Bank Questions and more Exams Nursing in PDF only on Docsity!
ATI RN Pharmacology Proctored Exam 2024–2025 |
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Question 1: A nurse is caring for a client who is receiving parenteral nutrition and identifies that the client has hypoglycemia. Which of the following actions should the nurse take? A. Discontinue the infusion. B. Administer IV dextrose. C. Warm formula to room temperature. D. Obtain arterial blood gases. Rationale:
- A. Discontinue the infusion: While the infusion may eventually need adjustment, the immediate priority in hypoglycemia is to raise the client's blood glucose level. Discontinuing the infusion without intervention will worsen the hypoglycemia.
- B. Administer IV dextrose: This is the correct action. Intravenous dextrose provides a rapid source of glucose to increase the client's blood sugar level quickly.
- C. Warm formula to room temperature: Warming the formula is important for client comfort but does not address the immediate issue of hypoglycemia.
- D. Obtain arterial blood gases: Arterial blood gases assess oxygenation and acid- base balance, which are not the immediate concern in hypoglycemia caused by parenteral nutrition. Correct Answer: B Question 2: A nurse is caring for a group of clients. Which of the following situations requires an incident report?
A. Client experiences a seizure. B. A client vomits after receiving an oral medication. C. A client receives their insulin 1 hour before scheduled. D. A client receives their meal tray 20 min late. Rationale:
- A. Client experiences a seizure: While a seizure is a significant event, it may be an expected manifestation of the client's underlying condition and doesn't necessarily indicate an error or system failure requiring an incident report unless it was unexpected or resulted in injury due to negligence.
- B. A client vomits after receiving an oral medication: Vomiting is a potential adverse effect or reaction but doesn't inherently indicate an error in care requiring an incident report unless there were unusual circumstances.
- C. A client receives their insulin 1 hour before scheduled: This constitutes a medication error. Administering insulin at the wrong time can lead to significant fluctuations in blood glucose levels and potential harm to the client. Incident reports are crucial for documenting and analyzing such errors to prevent future occurrences.
- D. A client receives their meal tray 20 min late: While inconvenient, a slightly delayed meal tray is generally not an event that requires an incident report. Correct Answer: C Question 3: A nurse is assessing a client who has received oxycodone. The nurse notes that the client's respiratory rate is 8/min. The nurse should identify that which of the following is the pathophysiology for the client's respiratory rate? A. Oxycodone blocks the sodium channel suspending nerve conduction. B. Oxycodone promotes vasodilation of cranial arteries. C. Oxycodone causes central nervous system depression. D. Oxycodone inhibits prostaglandin synthesis. Rationale:
- A. Oxycodone blocks the sodium channel suspending nerve conduction: This is the mechanism of action for some local anesthetics and anticonvulsants, not opioids like oxycodone.
A nurse is preparing to transcribe a prescription for a client that reads "ondansetron 8 mg by mouth every 12 hr PRN." Which of the following parts of the prescription should the nurse clarify with the provider? A. Dose B. Route C. Frequency D. Reason Rationale:
- A. Dose: The dose (8 mg) is clearly stated.
- B. Route: The route of administration (by mouth) is clearly stated.
- C. Frequency: The frequency (every 12 hr) is clearly stated.
- D. Reason: "PRN" means "as needed," but the prescription lacks the indication or reason for administering the ondansetron (e.g., for nausea, vomiting). Without a specific reason, the nurse would not know when it is appropriate to administer the medication. Correct Answer: D Question 6: A nurse is caring for a client who has a prescription for nifedipine. Which of the following findings should the nurse assess prior to administration of the medication? A. Blood pressure B. Respiratory rate C. Temperature D. Oxygen saturation Rationale:
- A. Blood pressure: Nifedipine is a calcium channel blocker primarily used to lower blood pressure. Administering it to a client with already low blood pressure could cause hypotension. Therefore, assessing blood pressure prior to administration is crucial.
- B. Respiratory rate: While some medications can affect respiratory rate, nifedipine's primary action is on the cardiovascular system.
- C. Temperature: Nifedipine does not typically have a direct effect on body temperature.
- D. Oxygen saturation: While low blood pressure can indirectly affect oxygen saturation, the primary concern with nifedipine is its effect on blood pressure. Correct Answer: A Question 7: A nurse is providing teaching to a client who has a new prescription for carbamazepine for the treatment of seizures. The nurse should instruct the client to monitor for which of the following adverse effects? A. Blurred vision B. Insomnia C. Metallic taste D. Tachypnea Rationale:
- A. Blurred vision: Blurred vision is a common adverse effect of carbamazepine due to its effects on the nervous system.
- B. Insomnia: While sleep disturbances can occur with some medications, drowsiness is a more common side effect of carbamazepine.
- C. Metallic taste: Metallic taste is not a typical adverse effect associated with carbamazepine.
- D. Tachypnea: Tachypnea (rapid breathing) is not a common adverse effect of carbamazepine. Respiratory depression is a rare but more serious concern with some anticonvulsants, but tachypnea is not characteristic. Correct Answer: A Question 8: A nurse is preparing to administer a scheduled dose of warfarin to a client. Which of the following laboratory tests should the nurse review prior to administration? A. PT B. Total iron-binding capacity C. WBC D. PTT
monitoring the WBC count, particularly the absolute neutrophil count (ANC), is essential to evaluate the effectiveness of the treatment. Correct Answer: D Question 10: A nurse is assessing a client who has septic shock and is receiving dopamine by continuous IV infusion. Which of the following findings indicates that the nurse should increase the rate of infusion? A. Headache B. Hypotension C. Chest pain D. Extravasation Rationale:
- A. Headache: Headache is a potential side effect of dopamine due to its vasoconstrictive properties, but it doesn't necessarily indicate a need to increase the infusion rate.
- B. Hypotension: Dopamine is often used in septic shock to increase blood pressure by its adrenergic effects (vasoconstriction and increased cardiac output at higher doses). Persistent hypotension despite the dopamine infusion suggests that the current rate may be inadequate to achieve the desired blood pressure, and an increase may be warranted (as per the provider's orders or protocol).
- C. Chest pain: Chest pain could indicate myocardial ischemia due to the increased cardiac workload from dopamine and would likely warrant a decrease or discontinuation of the infusion rather than an increase.
- D. Extravasation: Extravasation is the leakage of the IV fluid into the surrounding tissues. Dopamine is a vesicant, and extravasation can cause tissue damage. This would necessitate stopping the infusion at the affected site and managing the extravasation, not increasing the rate. Correct Answer: B Question 11: A nurse is caring for a client who is taking warfarin and reports taking several new herbal supplements. The nurse should identify which of the following supplements is contraindicated for concurrent use with warfarin?
A. Ginkgo biloba B. Coenzyme Q C. Valerian D. Probiotics Rationale:
- A. Ginkgo biloba: Ginkgo biloba has antiplatelet effects and can increase the risk of bleeding when taken with anticoagulants like warfarin. This makes it contraindicated for concurrent use.
- B. Coenzyme Q10: Coenzyme Q10 is an antioxidant and is not known to significantly interact with warfarin.
- C. Valerian: Valerian is often used for its sedative effects and does not typically have significant interactions with warfarin.
- D. Probiotics: Probiotics are beneficial bacteria for gut health and are not known to have significant interactions with warfarin. Correct Answer: A A nurse is assessing a client with hypertension who is receiving propranolol. Which of the following findings requires the nurse's intervention? A. Heart rate of 56/min B. Sa02 95% on 2 L/min of oxygen C. Respirations 22/min D. Blood pressure 106/68 mm Hg - - correct ans- - A. HR of 56/min A nurse is preparing to administer the varicella vaccine to a group of clients. The nurse should identify which of the following clients as having a contraindication for receiving this immunization? A. An older adult client living in a long-term care facility. B. A young adult who has an allergy to eggs C. A child who recently received the human papillomavirus vaccine.
C. The client will take an additional dose of insulin glargine prior to exercise. D. The client will wear his reading glasses when drawing up a dose of insulin glargine. - - correct ans- - D. The client will wear his reading glasses when drawing up a dose of insulin glargine. A nurse is preparing to administer medication to a client for the first time and needs to know about potential food and medication interactions. Which of the following actions should the nurse take? A. Have the client take the medication on an empty stomach to avoid interactions. B. Consult a drug reference guide for possible interactions. C. Ask another nurse if they are aware of potential interactions. D. Check the client's medical record for medication and food interactions. - - correct ans- - B. Consult a drug reference guide for possible interactions. A nurse is taking a medication history from a client who has a new prescription for levothyroxine. The nurse should instruct the client to wait 4 hr after taking levothyroxine before taking which of the following supplements? A. Ginkgo biloba B. Calcium C. Vitamin C D. Zinc - - correct ans- - B. Calcium A nurse is preparing to administer total parenteral nutrition to a client. Which of the following actions should the nurse take? A. Obtain the client's weight three times a week. B. Check the client's WBC count daily. C. Keep the solution refrigerated until 1 hr before infusion.
D. Change the solution every 36 hrs. - - correct ans- - C. Keep the solution refrigerated until 1 hr before infusion. A nurse is preparing to administer a medication to a client. Using the rights of medication administration. Which of the following actions should the nurse take to ensure the right medication is administered to the client? A. Ask another nurse to check the medication dosage prior to administration. B. Verify a written order with the medication administration record. C. Use two client identifiers prior to administering the medication. D. Document the full name of the prescribed medication after administration. - - correct ans- - C. Use two client identifiers prior to administering the medication. A nurse is preparing to mix short-acting insulin with NPH insulin from two vials. Which of the following actions should the nurse take? A. Inject air into the vial to withdraw the short-acting insulin. B. Administer the insulin within 20 min of preparing it. C. Ensure the NPH insulin is drawn into the syringe first. D. use two separate syringes to mix the insulin. - - correct ans- - D. Use two separate syringes to mix the insulin. A nurse is reviewing the list of current medications for a client who has a new prescription for nitroglycerin. The nurse should identify that which of the following client medications is contraindicated for use with nitroglycerin? A. Sildenafil B. Gemfibrozil C. Lansoprazole D. Diazepam - - correct ans- - A. Sildenafil
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. Hypomagnesemia B. Hypocalcemia C. Hyponatremia D. Hypokalemia - - correct ans- - C. Hyponatremia A nurse is providing teaching to a client who is receiving intermittent parenteral metronidazole. Which of the following conditions should the nurse recognize as an indication for this medication? A. Endocarditis B. Kidney transplant C. Seizures D. Hypokalemia - - correct ans- - A. Endocarditis A nurse is caring for a client in the clinic. Vital Signs 1 week ago: Temp 37 HR64/min RR 12/min BP 118/72 mm Hg Today: Temp 37.2 HR 82/min RR 16/min BP 110/68 mm Hg. Which of the following client statements indicates to the nurse the teaching was effective? A. "I will consume foods that are soft or semisolid."
B. "I will avoid consuming alcoholic beverages." C. "I will perform oral hygiene using a firm-bristle toothbrush." D. "I will avoid taking folic acid supplements while taking this medication. - - correct ans- - A. "I will consume foods that are soft or semisolid." A nurse is caring for a client who has diabetes insipidus and is receiving desmopressin by intermittent IV bolus. Which of the following manifestations should the nurse identify as an indication of a therapeutic response to the medication? A. Increase in serum sodium. B. Decrease in urine output C. Increase in heart rate D. Decrease in blood pressure - - correct ans- - B. Decrease in urinary output. A nurse in a provider's office is caring for a client. Nurses' Notes 3 months ago: Client seen in provider's office for routine physical. Today: Client reports dizziness and light-headedness upon standing. Client reports waking up at night to void. What actions should the nurse take? (SATA). A. Advise the client to change positions slowly. B. Check the client for orthostatic hypotension. C. Monitor the client for dysrhythmias. D. Advise the client to restrict potassium intake. E. Advise the client to take the medication before bedtime. - - correct ans- - A. Advise the client to change positions slowly. B. Check the client for orthostatic hypotension. A nurse is assessing a client who is in labor and is receiving epidural anesthesia. Which of the following findings should the nurse identify as the priority?
A nurse is reviewing the medical record of a female client who asks about a prescription for alendronate for the treatment of osteoporosis. Which of the following findings should the nurse identify as a safety risk for the client when taking this medication? A. The client has a history of anaphylaxis following a bee sting. B. The client has a first-degree relative who has Paget's disease. C. The client is postmenopausal. D. The client has immobility that restricts her to a supine position. - - correct ans- - D. The client has immobility that restricts her to a supine position. A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin. Which of the following information should the nurse include in the teaching? A. "Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose. " B. "Plan to self-administer this medication for the next 6 months." C. "Lie down for 1 hour after administering the medication. " D. "Administer the medication into one nostril once per week." - - correct ans- - D. " Administer the medication into one nostril once per week." A nurse is teaching a client who has stable angina and a new prescription for nitroglycerin transdermal patches 0.8 mg/hr daily. Which of the following statements by the client indicates an understanding of the teaching? A. "I can cut the patches in half to save money. " B. "I will apply a new patch to the same site whenever I replace it. " C. "I will take the patch off after dinner every night. " D. "I can put a second patch on if I have chest pain." - - correct ans- - C. " I will take the patch off after dinner every night."
A nurse is assessing a client who is taking combination oral contraceptives. Which of the following findings should the nurse report to the provider immediately? A. Leg tenderness B. Cramps C. Nausea D. Abdominal bloating - - correct ans- - A. leg tenderness A nurse is caring for a client who has diabetes mellitus and is taking pioglitazone. The nurse should plan to monitor the client for which of the following adverse effects? A. Insomnia B. Fluid retention C. Tinnitus D. Orthostatic hypotension - - correct ans- - B. Fluid retention A nurse in the emergency department is caring for a client who reports a severe headache. The client's blood pressure is 280/160 mm Hg. The nurse should plan to administer which of the following medications? A. Dobutamine B. Epinephrine C. Dexamethasone D. Nitroprusside - - correct ans- - D. Nitroprusside A nurse is preparing to administer propranolol to a client. Which of the following should the nurse assess prior to administering this medication? A. Respiratory rate
D. Weight loss - - correct ans- - B. Confusion A nurse is providing teaching to a client who has a prescription for total parenteral nutrition (TPN). Which of the following information should the nurse include in the teaching? A. "You will be weighed twice a week while receiving TPN." B. "Your blood sugar will be checked once a day." C. "You will have a central line placed to receive TPN." D. "Your intake and output will be measured every 2 days." - - correct ans- - C. "You will have a central line placed to receive TPN." A nurse is caring for a client who has a life-threatening ventricular dysrhythmia. Which of the following medications should the nurse anticipate administering? A. Verapamil B. Digoxin C. Dopamine D. Amiodarone - - correct ans- - D. Amiodarone A nurse is assessing a client who received midazolam IV for moderate (conscious) sedation. Which of the following assessments is the nurse's priority? A. Heart rate B. Oxygen saturation C. Level of consciousness D. Temperature - - correct ans- - D. Level of consciousness
A nurse is obtaining a medical history from a client who is to start warfarin therapy and currently uses herbal supplements at home. The nurse should inform the client that which of the following herbal supplements can interact adversely with warfarin? A. Black cohosh B. Echinacea C. Feverfew D. Flaxseed - - correct ans- - C. Feverfew A nurse in a coronary care unit is admitting a client who has had CPR following a cardiac arrest. The client is receiving lidocaine IV at 2 mg/min. When the client asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions? A. Prevents dysrhythmias B. Relieves pain C. Dissolves blood clots D. Slows intestinal motility - - correct ans- - A. Prevents dysrhythmias A nurse in the emergency department is caring for a client who took 3 nitroglycerin tablets sublingually for chest pain. The client reports relief from the chest pain but now he is experiencing a headache. Which of the following statements should the nurse make? A. A headache is likely due to the anxiety about the chest pain. B. A headache indicates tolerance to the medication. C. A headache is an expected adverse effect of the medication. D. A headache is an indication of an allergy to the medication. - - correct ans- - C. A Headache is an expected adverse effect of the medication.
