ATI RN
ATI Pharmacology
1. A nurse is evaluating teaching for a client who has Rheumatoid Arthritis and a new prescription for Methotrexate. Which of the following statements by the client indicates understanding of the teaching?
- A. I will be sure to return to the clinic at least once a year to have my blood drawn while I'm taking methotrexate.
- B. I will take this medication on an empty stomach.
- C. I'll let the doctor know if I develop sores in my mouth while taking this medication.
- D. I should stop taking oral contraceptives while I'm taking methotrexate.
Correct answer: C
Rationale: Ulcerations in the mouth, tongue, or throat are often the first signs of methotrexate toxicity and should be reported to the provider immediately.
2. A healthcare provider is educating a client who has a new prescription for Simvastatin. Which of the following instructions should the healthcare provider include?
- A. Take this medication with food.
- B. Avoid drinking grapefruit juice.
- C. Take this medication in the morning.
- D. Increase your intake of potassium-rich foods.
Correct answer: B
Rationale: The correct instruction that the healthcare provider should include is to 'Avoid drinking grapefruit juice.' Grapefruit juice can increase the blood levels of Simvastatin, leading to potential side effects like muscle pain and liver damage. Instructing the client to avoid grapefruit juice helps prevent these adverse effects and ensures the medication's efficacy. Choices A, C, and D are incorrect because taking Simvastatin with food, at a specific time, or increasing potassium-rich foods intake are not essential instructions for this medication.
3. When starting therapy with bicalutamide, a client should be instructed to monitor for which of the following adverse effects?
- A. Muscle pain
- B. Flushing
- C. Gynecomastia
- D. Hyperglycemia
Correct answer: C
Rationale: The correct answer is C: Gynecomastia. Bicalutamide, due to its antiandrogenic properties, can lead to gynecomastia in clients. This condition involves the development of breast tissue in males and is an important adverse effect to monitor when taking this medication. Choices A, B, and D are incorrect. Muscle pain and flushing are not commonly associated with bicalutamide use. Hyperglycemia is not a typical adverse effect of bicalutamide therapy.
4. A hospitalized client has an activated partial thromboplastin time (aPTT) greater than 1.5 times the expected reference range. Which of the following blood products should be prepared for transfusion?
- A. Whole blood
- B. Platelets
- C. Fresh frozen plasma
- D. Packed red blood cells
Correct answer: C
Rationale: Fresh frozen plasma is the appropriate blood product for a client with an elevated aPTT as it contains various coagulation factors that can help correct coagulopathies and prevent bleeding. Elevated aPTT indicates a deficiency in specific clotting factors, and fresh frozen plasma is rich in these factors. Whole blood, platelets, and packed red blood cells do not contain the necessary coagulation factors to correct an elevated aPTT, so they are not indicated in this situation.
5. A client is taking Furosemide for heart failure. Which of the following findings is a priority to report to the provider?
- A. Weight loss of 1 kg in 24 hours
- B. Blood pressure of 104/60 mm Hg
- C. Potassium level of 3.5 mEq/L
- D. Urine output of 200 mL in 8 hours
Correct answer: D
Rationale: A urine output of 200 mL in 8 hours indicates decreased kidney function, potentially due to Furosemide therapy. This finding can suggest inadequate renal perfusion and impaired drug clearance, necessitating immediate reporting to prevent further complications like electrolyte imbalances and worsening heart failure. Choice A: Weight loss may be expected in heart failure patients due to fluid retention, but it is not an immediate concern. Choice B: A blood pressure of 104/60 mm Hg is slightly low but not a priority compared to the indication of kidney dysfunction. Choice C: A potassium level of 3.5 mEq/L is within the normal range, so it does not require immediate reporting.
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