ATI RN
ATI Pharmacology Proctored Exam 2023
1. A client prescribed Warfarin is receiving discharge instructions from a nurse. Which of the following dietary instructions should the nurse include?
- A. Increase your intake of leafy green vegetables.
- B. Avoid foods high in vitamin K.
- C. Increase your intake of dairy products.
- D. Avoid foods high in iron.
Correct answer: B
Rationale: The correct answer is B: 'Avoid foods high in vitamin K.' Vitamin K can interfere with the effectiveness of Warfarin, an anticoagulant medication. Foods high in vitamin K, such as leafy green vegetables, can reduce the medication's anticoagulant effect. Therefore, clients taking Warfarin should be advised to avoid or consume a consistent amount of foods high in vitamin K to maintain the medication's effectiveness. Choices A, C, and D are incorrect because increasing leafy green vegetables, dairy products, or avoiding foods high in iron are not directly related to the interaction with Warfarin.
2. A client is to receive Pamidronate for bone pain related to cancer. What precaution should the nurse take during the administration of Pamidronate?
- A. Inspect the skin for redness and irritation around the injection site.
- B. Assess the IV site for thrombophlebitis frequently during administration.
- C. Instruct the client to lie down for 30 minutes after oral administration.
- D. Monitor for signs of anaphylaxis for 20 minutes after intramuscular injection.
Correct answer: B
Rationale: Pamidronate is typically administered through IV infusion, which can cause irritation to veins. The nurse should frequently assess the IV site for thrombophlebitis during the administration to promptly detect any potential complications related to the infusion. Inspecting the skin for redness and irritation around the injection site (Choice A) is not directly related to IV infusion. Instructing the client to lie down after oral administration (Choice C) is not necessary for IV administration. Monitoring for signs of anaphylaxis after an intramuscular injection (Choice D) is not relevant for an IV infusion of Pamidronate.
3. A client has a new prescription for Verapamil. Which of the following instructions should the nurse include?
- A. Take this medication at bedtime.
- B. Monitor for signs of hyperglycemia.
- C. Avoid drinking grapefruit juice.
- D. Increase your intake of potassium-rich foods.
Correct answer: C
Rationale: The correct answer is to instruct the client to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of Verapamil, leading to increased blood levels of the medication, which can potentiate its effects, potentially causing adverse reactions like hypotension and bradycardia. Choices A, B, and D are incorrect. Taking Verapamil at bedtime is not a specific instruction related to its metabolism or side effects. Monitoring for signs of hyperglycemia is not directly related to Verapamil use. Increasing potassium-rich foods intake is not necessary with Verapamil and could potentially lead to hyperkalemia in some cases.
4. In caring for a client who received IV Verapamil to treat supraventricular tachycardia (SVT) and presents with a pulse rate of 98/min and blood pressure of 74/44 mm Hg, the nurse should anticipate a prescription for which of the following IV medications?
- A. Calcium gluconate
- B. Sodium bicarbonate
- C. Potassium chloride
- D. Magnesium sulfate
Correct answer: A
Rationale: In this scenario, the client is experiencing severe hypotension due to Verapamil administration. The appropriate medication to counteract the vasodilation caused by Verapamil and reverse severe hypotension is Calcium gluconate, which should be administered slowly IV. Therefore, the correct choice is Calcium gluconate (Choice A). Sodium bicarbonate (Choice B) is not indicated for hypotension related to Verapamil use. Potassium chloride (Choice C) and Magnesium sulfate (Choice D) are not the appropriate medications to address the hypotension in this situation.
5. A client with Atrial Fibrillation is prescribed Dabigatran to prevent Thrombosis. Which medication is prescribed concurrently to treat an adverse effect of Dabigatran?
- A. Vitamin K1
- B. Protamine
- C. Omeprazole
- D. Probenecid
Correct answer: C
Rationale: Omeprazole or another proton pump inhibitor is commonly prescribed for clients taking dabigatran who experience abdominal pain and other gastrointestinal adverse effects associated with dabigatran use. Proton pump inhibitors help alleviate these symptoms by reducing gastric acid secretion, which can contribute to gastrointestinal discomfort. Vitamin K1 is not indicated for adverse effects of dabigatran. Protamine is used to reverse the anticoagulant effects of heparin, not dabigatran. Probenecid is not typically used to treat adverse effects of dabigatran.
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