ATI RN
ATI Pharmacology Proctored Exam 2023
1. 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 instruction for a client prescribed Verapamil is to avoid drinking grapefruit juice. Grapefruit juice can inhibit the metabolism of Verapamil, leading to increased blood levels of the medication. This can result in a higher risk of adverse effects, such as hypotension and bradycardia. Therefore, it is essential for the client to avoid grapefruit juice while taking Verapamil to prevent potential complications. Choices A, B, and D are incorrect because taking Verapamil at bedtime, monitoring for signs of hyperglycemia, and increasing potassium-rich foods intake are not specific instructions related to Verapamil therapy and do not address the potential interaction with grapefruit juice.
2. While caring for a client receiving Heparin therapy, which of the following laboratory tests should the nurse monitor to evaluate the effectiveness of the therapy?
- A. PT
- B. INR
- C. aPTT
- D. Platelet count
Correct answer: C
Rationale: The nurse should monitor the aPTT (activated partial thromboplastin time) when caring for a client receiving Heparin therapy. The aPTT reflects the intrinsic pathway of the clotting cascade and is used to monitor the effectiveness of heparin, which primarily affects this pathway by potentiating antithrombin III. Monitoring the aPTT helps ensure that the client's blood is within the therapeutic range to prevent thrombus formation. Choices A, B, and D are incorrect. PT (Prothrombin Time) and INR (International Normalized Ratio) are used to monitor Warfarin therapy, not Heparin. Platelet count is important in assessing for thrombocytopenia but is not a specific indicator of Heparin therapy effectiveness.
3. A client with Preeclampsia is receiving Magnesium Sulfate IV continuous infusion. Which of the following findings should the nurse report to the provider?
- A. 2+ deep tendon reflexes
- B. 2+ pedal edema
- C. 24 mL/hr urinary output
- D. Respirations 12/min
Correct answer: C
Rationale: In a client receiving Magnesium Sulfate IV for Preeclampsia, a urinary output less than 25 to 30 mL/hr indicates magnesium sulfate toxicity and should be reported to the provider for further evaluation and management. Choice A, 2+ deep tendon reflexes, is a normal finding with magnesium sulfate therapy. Choice B, 2+ pedal edema, is expected in clients with preeclampsia but does not indicate magnesium sulfate toxicity. Choice D, respirations 12/min, is within the normal range and not a concerning finding related to magnesium sulfate administration.
4. A healthcare professional is preparing to administer a dose of Hydromorphone IV to a client. Which of the following actions should the healthcare professional take?
- A. Administer the medication over 5 minutes.
- B. Administer a dose of Naloxone prior to giving the Hydromorphone.
- C. Assess the client's blood pressure prior to administration.
- D. Inject the medication into the client's subcutaneous tissue.
Correct answer: A
Rationale: The healthcare professional should administer IV Hydromorphone slowly over 5 minutes to reduce the risk of hypotension and respiratory depression. Rapid administration can lead to adverse effects due to its potency. Choice B is incorrect because Naloxone is used as an antidote for opioid overdose, not routinely administered with Hydromorphone. Choice C is important but not specific to the administration of Hydromorphone. Choice D is incorrect as Hydromorphone is intended for intravenous use, not subcutaneous injection.
5. When teaching a client with cancer who has a prescription for methotrexate, which supplement should the nurse instruct the client to take?
- A. Folic acid
- B. Magnesium
- C. Vitamin D
- D. Iron
Correct answer: A
Rationale: The correct answer is folic acid. Methotrexate is a folic acid antagonist, so instructing the client to take folic acid helps reduce the risk of methotrexate toxicity by providing additional folic acid that the medication may deplete. Magnesium (choice B), Vitamin D (choice C), and Iron (choice D) are not the correct supplements to instruct the client to take with methotrexate.
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