ATI RN
ATI Pharmacology
1. When educating a client with a new prescription for Enalapril, which manifestation should the nurse instruct the client to report as an adverse effect of this medication?
- A. Tremors
- B. Dry cough
- C. Drowsiness
- D. Hyperactivity
Correct answer: B
Rationale: A persistent dry cough is a well-known adverse effect of ACE inhibitors, such as enalapril. This cough can be bothersome and may indicate the need for a medication adjustment. It is crucial for the client to report this symptom to their healthcare provider to explore potential alternatives or adjustments to the treatment plan. Tremors, drowsiness, and hyperactivity are not commonly associated with enalapril and are less likely to be attributed to this medication.
2. When a client has a new prescription for Dextromethorphan to suppress a cough, what adverse effect should they monitor for according to the nurse's instruction?
- A. Diarrhea
- B. Anxiety
- C. Sedation
- D. Palpitations
Correct answer: C
Rationale: The correct answer is C: Sedation. Dextromethorphan can lead to sedation as an adverse effect. The nurse should advise the client to avoid activities that require alertness when taking this medication to prevent any potential harm. Monitoring for sedation is crucial to ensure the client's safety and well-being. Choices A, B, and D are incorrect as diarrhea, anxiety, and palpitations are not commonly associated with Dextromethorphan use. While some individuals may experience gastrointestinal upset, central nervous system effects like sedation are more commonly observed.
3. A patient is prescribed acetaminophen 650 mg PO every 6 hr PRN for pain. The available acetaminophen liquid is 500 mg/5 mL. How many mL should the nurse administer per dose?
- A. 6.5 mL
- B. 7 mL
- C. 5 mL
- D. 8 mL
Correct answer: A
Rationale: To calculate the volume to administer: (Desired dose / Concentration) = Volume to administer. In this case, (650 mg / 500 mg) x 5 mL = 6.5 mL. Therefore, the nurse should administer 6.5 mL of acetaminophen liquid per dose to provide the prescribed 650 mg of acetaminophen. Choice B, 7 mL, is incorrect because the correct calculation results in 6.5 mL. Choice C, 5 mL, is incorrect as it is the concentration of the acetaminophen liquid, not the final volume needed. Choice D, 8 mL, is incorrect because it does not reflect the accurate calculation based on the prescription and concentration.
4. A healthcare professional in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for Digoxin toxicity?
- A. Calcium 9.2 mg/dL
- B. Calcium 10.3 mg/dL
- C. Potassium 3.4 mEq/L
- D. Potassium 4.8 mEq/L
Correct answer: C
Rationale: The correct answer is C: Potassium 3.4 mEq/L. Potassium 3.4 mEq/L is below the expected reference range and puts a client at risk for digoxin toxicity. Low potassium levels can lead to fatal dysrhythmias, especially in older clients taking Digoxin, as potassium plays a crucial role in the heart's electrical activity. Choices A and B are related to calcium levels, which do not directly increase the risk of Digoxin toxicity. Choice D, Potassium 4.8 mEq/L, is within the expected reference range and would not increase the risk of Digoxin toxicity.
5. A client in a long-term care facility has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?
- A. The client will start at a high dose, and the dose will be tapered as needed.
- B. The client will remain on the initial dosage during the course of treatment.
- C. The client's dosage will be adjusted daily based on blood levels.
- D. The client will start on a low dose, which will be gradually increased.
Correct answer: D
Rationale: Levothyroxine should be initiated at a low dose and titrated gradually over several weeks to achieve therapeutic levels. This approach helps to minimize the risk of adverse effects, particularly in older adult clients who may be more sensitive to medication changes. Starting at a low dose allows for close monitoring of the client's response and adjustment of the dosage as needed to optimize treatment outcomes. Choice A is incorrect because starting at a high dose can increase the risk of adverse effects and is not the recommended approach. Choice B is incorrect because maintaining the initial dosage throughout the treatment may not achieve optimal therapeutic levels. Choice C is incorrect because adjusting the dosage daily based on blood levels is not the standard practice for initiating Levothyroxine treatment.
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