ATI RN
ATI Pharmacology Proctored Exam
1. A client has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?
- A. Hypokalemia
- B. Hypernatremia
- C. Neutropenia
- D. Bradycardia
Correct answer: C
Rationale: Neutropenia is a serious adverse effect associated with ACE inhibitors like Captopril. Neutropenia refers to a decreased level of neutrophils, which are important white blood cells in fighting infection. Monitoring the client's complete blood count (CBC) is essential to detect neutropenia early. Hypokalemia (Choice A) is more commonly associated with diuretics, not ACE inhibitors. Hypernatremia (Choice B) is an increase in sodium levels, not typically caused by Captopril. Bradycardia (Choice D) is not a common adverse effect of ACE inhibitors like Captopril.
2. A client is receiving imatinib. Which of the following adverse effects should the nurse monitor?
- A. Edema
- B. Constipation
- C. Dry mouth
- D. Urinary retention
Correct answer: A
Rationale: The correct answer is A: Edema. The nurse should monitor the client for edema when receiving imatinib. Imatinib, a tyrosine kinase inhibitor, can lead to fluid retention and edema as a common adverse effect. This can manifest as swelling in various parts of the body, indicating the need for close monitoring by the nurse to prevent complications related to fluid overload. Choices B, C, and D are incorrect because constipation, dry mouth, and urinary retention are not typically associated with imatinib use. Therefore, they are not the priority adverse effects to monitor in a client receiving this medication.
3. A healthcare provider is preparing to administer Belimumab to a client with Systemic Lupus Erythematosus. Which of the following actions should the healthcare provider plan to take?
- A. Warm the medication to room temperature before administering.
- B. Administer the medication by IV bolus over 5 minutes.
- C. Dilute the medication in a 5% dextrose and water solution.
- D. Monitor the client for hypersensitivity reactions.
Correct answer: D
Rationale: Correct Answer: Monitoring the client for hypersensitivity reactions is crucial when administering Belimumab due to its known potential for severe infusion reactions and anaphylaxis. The healthcare provider should closely observe the client during the administration to promptly identify and manage any hypersensitivity reactions that may occur. Choice A is incorrect because warming Belimumab is not necessary before administration. Choice B is incorrect as Belimumab should not be administered as an IV bolus over 5 minutes; it should be given as an IV infusion over a longer duration. Choice C is incorrect as Belimumab should not be diluted in a 5% dextrose and water solution.
4. A client has a new prescription for Digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?
- A. Contact the provider if the heart rate is less than 60/min.
- B. Check the pulse rate for 30 seconds and multiply the result by 2.
- C. Increase the intake of sodium.
- D. Take with food if nausea occurs.
Correct answer: A
Rationale: The correct answer is A. It is crucial for clients on Digoxin to monitor their heart rate. A heart rate less than 60/min can indicate bradycardia, a potential side effect of Digoxin. Therefore, the client should be instructed to contact the provider if their heart rate is less than 60/min to prevent complications and receive appropriate management. Choices B, C, and D are incorrect. Checking the pulse rate for 30 seconds and multiplying by 2 is not specific to Digoxin administration. Increasing sodium intake is contraindicated as Digoxin can lead to sodium retention. Taking Digoxin with food if nausea occurs is not recommended as it may affect the drug's absorption.
5. A client with a history of migraine headaches is starting prophylaxis therapy with Propranolol. Which of the following findings in the client history should be reported to the provider by the nurse?
- A. The client had a prior myocardial infarction.
- B. The client takes warfarin for atrial fibrillation.
- C. The client takes an SSRI for depression.
- D. An ECG indicates a first-degree heart block.
Correct answer: D
Rationale: Propranolol is contraindicated in clients with a first-degree heart block due to its negative chronotropic properties that can further slow the heart rate. This can worsen conduction through the atrioventricular node, potentially leading to heart block progression. Therefore, the nurse should report the finding of a first-degree heart block to the provider before initiating Propranolol therapy. Choices A, B, and C are not contraindications for Propranolol therapy. A prior myocardial infarction, taking warfarin for atrial fibrillation, or using an SSRI for depression do not directly impact the initiation of Propranolol therapy in a client with a history of migraine headaches.
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