ATI RN
ATI Pharmacology Proctored Exam 2023
1. A healthcare professional is educating clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the professional inform the clients to expect a peak effect 1 to 5 hr after administration?
- A. Insulin glargine
- B. NPH insulin
- C. Regular insulin
- D. Insulin lispro
Correct answer: C
Rationale: Regular insulin typically exhibits a peak effect approximately 1 to 5 hours after administration. It is important for clients to be aware of this timing to ensure optimal management of their blood glucose levels. Insulin glargine, NPH insulin, and Insulin lispro have different onset and peak times compared to Regular insulin. Insulin glargine has a slow, steady release with no pronounced peak, NPH insulin peaks around 4 to 12 hours after administration, and Insulin lispro has a rapid onset and a peak effect around 0.5 to 2.5 hours after administration. Therefore, Regular insulin is the correct choice for a peak effect within the specified time frame.
2. A client has a new prescription for Propranolol. Which of the following findings should the healthcare provider identify as a contraindication to this medication?
- A. Asthma
- B. Diabetes mellitus
- C. Hypertension
- D. Glaucoma
Correct answer: A
Rationale: Propranolol is a non-selective beta-blocker that can cause bronchoconstriction, making it contraindicated for clients with asthma. Asthma is a contraindication for Propranolol due to the potential of worsening bronchoconstriction and causing respiratory distress in individuals with this condition. Diabetes mellitus, hypertension, and glaucoma are not contraindications for Propranolol.
3. A client is taking Sucralfate PO for Peptic Ulcer Disease and has a new prescription for phenytoin to control seizures. Which of the following instructions should the nurse include?
- A. Take an antacid with the sucralfate.
- B. Take sucralfate with a glass of milk.
- C. Allow a 2-hour interval between these medications.
- D. Chew the sucralfate thoroughly before swallowing.
Correct answer: C
Rationale: Sucralfate can interfere with the absorption of phenytoin. To prevent this interaction, the client should allow a 2-hour interval between taking sucralfate and phenytoin. This timing helps to ensure adequate absorption and effectiveness of both medications without compromising therapeutic outcomes. Choices A, B, and D are incorrect because taking an antacid with sucralfate, taking sucralfate with a glass of milk, and chewing sucralfate thoroughly before swallowing do not address the need for a 2-hour interval between these medications to prevent interference with phenytoin absorption.
4. A client is starting therapy with raloxifene. Which adverse effect should the client monitor for as instructed by the nurse?
- A. Leg cramps
- B. Hot flashes
- C. Urinary frequency
- D. Hair loss
Correct answer: B
Rationale: Hot flashes are a common adverse effect associated with raloxifene therapy. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent and treat osteoporosis in postmenopausal women. Hot flashes are a well-known side effect of SERMs due to their estrogen-like effects on the body. Leg cramps, urinary frequency, and hair loss are not typically associated with raloxifene therapy. Therefore, the nurse should instruct the client to monitor for hot flashes as part of the medication education.
5. A client with end-stage cancer receiving Morphine is prescribed Methylnaltrexone. The client's daughter asks why the provider prescribed Methylnaltrexone. Which of the following responses should the nurse make?
- A. The medication will increase your mother's respirations.
- B. The medication will prevent dependence on the Morphine.
- C. The medication will relieve your mother's constipation.
- D. The medication works with the Morphine to increase pain relief.
Correct answer: C
Rationale: The correct response is C: 'The medication will relieve your mother's constipation.' Methylnaltrexone is an opioid antagonist used to treat severe constipation unrelieved by laxatives in opioid-dependent clients. It works by blocking the mu opioid receptors in the GI tract, which helps alleviate constipation without affecting pain relief or causing withdrawal symptoms. Choices A, B, and D are incorrect. Methylnaltrexone's primary action is related to managing constipation rather than increasing respirations, preventing dependence on Morphine, or enhancing pain relief when used alongside Morphine.
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