ATI RN
ATI Pharmacology
1. A client has a new prescription for a Nitroglycerin transdermal patch. Which of the following instructions should the nurse include?
- A. Apply the patch to a different site each day.
- B. Remove the patch at bedtime each day.
- C. Apply the patch over an area with little or no hair.
- D. Keep the patch on for 24 hours at a time.
Correct answer: B
Rationale: The correct instruction for a Nitroglycerin transdermal patch is to remove it each day, usually at bedtime, to prevent tolerance. Keeping the patch on for 24 hours at a time can lead to tolerance development. Applying the patch to a different site each day is not necessary, as long as the area is rotated to prevent skin irritation. Applying the patch over an area with little or no hair is not a critical instruction for the Nitroglycerin patch.
2. A client with prostate cancer is receiving leuprolide. Which of the following findings should the nurse monitor?
- A. Increased testosterone levels
- B. Increased libido
- C. Gynecomastia
- D. Hypoglycemia
Correct answer: C
Rationale: The nurse should monitor the client for gynecomastia when receiving leuprolide as it can cause decreased testosterone levels, leading to the development of gynecomastia. Choices A, B, and D are incorrect because leuprolide actually decreases testosterone levels, which would not result in increased testosterone levels or libido. Leuprolide is not associated with hypoglycemia, so monitoring for this is unnecessary in a client receiving this medication.
3. A client is receiving heparin therapy. Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the therapy?
- A. PT
- B. aPTT
- C. INR
- D. Platelet count
Correct answer: B
Rationale: The corrected answer is B: aPTT. The activated partial thromboplastin time (aPTT) is the laboratory value used to monitor the effectiveness of heparin therapy. The aPTT should be maintained at 1.5 to 2 times the normal level to ensure therapeutic anticoagulation. Monitoring aPTT helps healthcare providers adjust heparin doses to achieve the desired anticoagulant effects and prevent complications such as bleeding or clotting. Choice A, PT (prothrombin time), is used to monitor warfarin therapy, not heparin. Choice C, INR (international normalized ratio), is also used to monitor warfarin therapy. Choice D, platelet count, is important for assessing the risk of bleeding, but it does not directly monitor the effectiveness of heparin therapy.
4. A healthcare professional is preparing to administer Butorphanol to a client who has a history of substance use disorder. The healthcare professional should identify which of the following information as true regarding Butorphanol?
- A. Butorphanol has a lower risk of abuse than morphine.
- B. Butorphanol causes a lower incidence of respiratory depression than morphine.
- C. Butorphanol can be reversed with an opioid antagonist.
- D. Butorphanol can cause abstinence syndrome in opioid-dependent clients.
Correct answer: D
Rationale: The correct answer is D. Butorphanol is an opioid agonist/antagonist that can precipitate withdrawal symptoms in opioid-dependent individuals. Symptoms of abstinence syndrome can include abdominal pain, fever, and anxiety. This occurs because butorphanol competes with and displaces opioid agonists from receptors, leading to withdrawal symptoms in opioid-dependent clients. Choices A, B, and C are incorrect. Butorphanol does not have a lower risk of abuse than morphine, it can cause respiratory depression similar to other opioids, and although it is an opioid antagonist, it does not get reversed by opioid antagonists.
5. A client is receiving daily doses of Oprelvekin. Which of the following laboratory values should the nurse monitor to determine the effectiveness of this medication?
- A. Hemoglobin
- B. Absolute neutrophil count
- C. Platelet count
- D. Total white blood cell count
Correct answer: C
Rationale: The nurse should monitor the platelet count to determine the effectiveness of Oprelvekin. The expected outcome for this medication is a platelet count greater than 50,000/mm^3. Oprelvekin is a medication used to stimulate platelet production, making platelet count a crucial parameter to assess its effectiveness. Monitoring hemoglobin, absolute neutrophil count, or total white blood cell count is not specifically related to the action or effectiveness of Oprelvekin.
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