ATI RN
ATI Pharmacology Proctored Exam
1. When providing teaching to a client with a prescription for Hydrochlorothiazide, which instruction should the nurse include?
- A. Take this medication at bedtime.
- B. Avoid foods high in potassium.
- C. Take this medication on an empty stomach.
- D. Monitor for signs of dehydration.
Correct answer: D
Rationale: The correct instruction for a client prescribed Hydrochlorothiazide is to monitor for signs of dehydration. Hydrochlorothiazide is a diuretic that can lead to fluid loss and electrolyte imbalance, potentially causing dehydration. Signs of dehydration include dry mouth, increased thirst, and decreased urine output. Therefore, it is essential for the client to be vigilant in recognizing these symptoms and seek medical attention if they occur. Choices A, B, and C are incorrect. Taking Hydrochlorothiazide at bedtime is not a specific instruction related to its effects or side effects. Avoiding foods high in potassium may be necessary for some medications, but it is not the primary concern with Hydrochlorothiazide. Taking this medication on an empty stomach is not a requirement and may vary depending on individual preferences or healthcare provider instructions.
2. A healthcare professional is planning to administer IV Alteplase to a client who is demonstrating manifestations of a massive Pulmonary Embolism. Which of the following interventions should the healthcare professional plan to take?
- A. Administer IM Enoxaparin along with the Alteplase dose.
- B. Hold direct pressure on puncture sites for up to 30 min.
- C. Administer Aminocaproic acid IV prior to alteplase infusion.
- D. Prepare to administer Alteplase within 8 hr of manifestation onset.
Correct answer: B
Rationale: The correct intervention when administering IV Alteplase is to hold direct pressure on puncture sites for 10 to 30 minutes or until oozing of blood stops. This helps prevent bleeding complications associated with thrombolytic therapy. Administering IM Enoxaparin is not indicated with Alteplase, as it is an anticoagulant rather than a thrombolytic agent. Aminocaproic acid is not typically administered prior to alteplase infusion in the context of a massive Pulmonary Embolism. While timely administration of Alteplase is important, the specific timeframe within which it should be administered may vary based on the clinical situation, so a strict 8-hour window is not universally applicable.
3. A client has a new prescription for Hydrochlorothiazide. Which of the following information should the nurse include?
- A. Take the medication with food.
- B. Plan to take the medication at bedtime.
- C. Expect increased swelling of the ankles.
- D. Fluid intake should be limited in the morning.
Correct answer: A
Rationale: The correct answer is to take the medication with food. Hydrochlorothiazide should be taken with or after meals to prevent gastrointestinal upset. Taking it with food can help reduce the chances of stomach discomfort or nausea. It is not necessary to take the medication at bedtime, expect increased swelling of the ankles, or limit fluid intake in the morning when taking Hydrochlorothiazide. Therefore, choices B, C, and D are incorrect.
4. A client with OCD has a new prescription for Paroxetine. Which of the following instructions should the nurse include?
- A. It can take several weeks before you feel like the medication is helping.
- B. Take the medication just before bedtime to promote sleep.
- C. You should take the medication when needed for obsessive urges.
- D. Monitor for weight gain while taking this medication.
Correct answer: A
Rationale: The correct answer is A. Paroxetine, an antidepressant commonly used for OCD, typically takes 1 to 4 weeks before the client experiences the full therapeutic benefit. Therefore, informing the client that it may take several weeks before feeling the medication's effects is crucial to manage expectations and ensure compliance with the treatment plan. Choice B is incorrect because Paroxetine is usually taken in the morning due to its activating effects and may cause insomnia if taken before bedtime. Choice C is incorrect because Paroxetine should be taken regularly as prescribed, not just when experiencing obsessive urges. Choice D is incorrect because although weight gain can be a side effect of Paroxetine, it is not a priority instruction compared to the delayed onset of therapeutic effects.
5. A healthcare professional is preparing to initiate IV therapy for an older adult client. Which of the following actions should the professional plan to take?
- A. Use an electric shaver to remove excess hair on the extremity.
- B. Select the antecubital area to insert the IV catheter.
- C. Distend the veins by using a blood pressure cuff.
- D. Instruct the client to keep the extremity still during the procedure.
Correct answer: C
Rationale: Distending the veins using a blood pressure cuff is essential for facilitating visualization and access to the veins during IV catheter insertion. This technique helps healthcare professionals identify suitable veins, reducing the risk of complications like infiltration or hematoma formation. Using an electric shaver to remove hair on the extremity (Choice A) may increase the risk of micro-cuts and introduce infection. Selecting the antecubital area (Choice B) may not always be appropriate, as vein condition and accessibility vary among older adult clients. Instructing the client to keep the extremity still (Choice D) is important but is not directly related to preparing for IV therapy.
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