ATI RN
ATI Pharmacology Proctored Exam 2024
1. A client with chronic kidney disease has a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances?
- A. Iron
- B. Protein
- C. Potassium
- D. Sodium
Correct answer: A
Rationale: Patients with chronic kidney disease are often prescribed epoetin alfa to treat anemia. Epoetin alfa stimulates red blood cell production, increasing the body's demand for iron to support this process. Therefore, clients taking epoetin alfa should be advised to increase their dietary intake of iron-rich foods to meet the increased demand and prevent iron deficiency anemia. Choices B, C, and D are incorrect because while protein is essential for overall health, potassium and sodium intake may need to be restricted in clients with chronic kidney disease to manage electrolyte balance and blood pressure.
2. A healthcare professional is reviewing the medical record of a client with a new prescription for Epoetin Alfa. Which of the following findings should the professional report to the provider?
- A. The client has a history of hypertension.
- B. The client has a hemoglobin level of 10 g/dL.
- C. The client has a history of chronic kidney disease.
- D. The client has a blood pressure of 140/90 mm Hg.
Correct answer: C
Rationale: The correct answer is C. Chronic kidney disease is a contraindication for the use of Epoetin Alfa because it can worsen hypertension, increase the risk of cardiovascular events, and lead to adverse outcomes. Epoetin Alfa is used to treat anemia by stimulating red blood cell production, but in the presence of chronic kidney disease, it can exacerbate hypertension and contribute to cardiovascular complications. Choices A, B, and D are not directly related to the contraindication of Epoetin Alfa in the presence of chronic kidney disease.
3. A client has a prescription for Alendronate. Which of the following instructions should the nurse include?
- A. Take this medication before bed.
- B. Take the medication with food.
- C. Sit upright for at least 30 minutes after taking the medication.
- D. Expect to have frequent headaches while on this medication.
Correct answer: C
Rationale: The correct instruction for a client prescribed Alendronate is to sit upright for at least 30 minutes after taking the medication. Alendronate can cause esophageal irritation, and maintaining an upright position helps prevent this adverse effect by reducing the risk of reflux of the medication into the esophagus. Choice A is incorrect because Alendronate should be taken in the morning, at least 30 minutes before the first food, beverage, or medication of the day with a full glass of plain water. Choice B is incorrect because Alendronate should not be taken with food. Choice D is incorrect because frequent headaches are not a common side effect of Alendronate.
4. What is the antidote for Warfarin?
- A. Vitamin D
- B. Vitamin C
- C. Vitamin K
- D. Vitamin B6
Correct answer: C
Rationale: Vitamin K is the antidote for Warfarin toxicity as it helps reverse the anticoagulant effects of Warfarin. Warfarin works by inhibiting vitamin K-dependent clotting factors, and administering vitamin K can replenish these factors, thereby counteracting the anticoagulant effects of Warfarin. Vitamin D, Vitamin C, and Vitamin B6 do not have the specific mechanism to counteract the anticoagulant effects of Warfarin, making them incorrect choices.
5. A client is prescribed Amitriptyline for depression. What should the nurse include in the teaching? (Select all that apply.)
- A. Expect therapeutic effects in 1-3 weeks.
- B. Discontinue the medication gradually under healthcare provider supervision.
- C. Change positions slowly to minimize dizziness.
- D. Increase dietary fiber intake to prevent constipation.
Correct answer: C
Rationale: The correct answer is C. Changing positions slowly can help prevent orthostatic hypotension, a common adverse effect of tricyclic antidepressants like Amitriptyline. It is essential to educate the client to avoid sudden position changes to minimize the risk of dizziness and falls. Choices A, B, and D are incorrect. The therapeutic effects of Amitriptyline may not be noticeable for 1-3 weeks, so expecting them in 24 to 48 hours (choice A) is unrealistic. Discontinuing the medication abruptly can lead to withdrawal symptoms and should be done gradually under healthcare provider supervision, so choice B is incorrect. Amitriptyline can actually cause constipation, so increasing dietary fiber intake would be recommended to prevent constipation, making choice D incorrect.
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